Social determinants of health (SDOH) has become one of the biggest buzzwords in healthcare. In the quest to provide more complete care—and lower healthcare costs—stakeholders across the healthcare industry, are realizing that treating a patient doesn’t have to begin or end in a hospital.
SDOH encompass a variety of factors, from housing availability to water access to income to food stability—not typically factors considered by most stakeholders.
There’s no question that SDOH affect health outcomes, but stakeholders are grappling with how big a role they should take in addressing them. As Benjamin Zaniello, chief medical officer at Collective Medical, a network for care coordination, put it, addressing SDOH is “not simply a healthcare problem. It’s a societal problem. We have not yet fully addressed food and shelter and security in either rural areas like Kentucky or urban areas like Chicago or New York. To expect hospital physicians to fix those problems within their four walls is an unreasonable expectation.”
However, he adds, “health systems do tend to gravitate toward where the money is. There is a widespread perception that focusing on SDOH have a measurable impact on healthcare quality and costs. I think there will be increasing investment in this area.”
The trend is already gathering steam: according to a 2017 Deloitte survey of hospitals looking at SDOH, 88% at least screened for social needs—an indication that SDOH are, if nothing else, coming into focus.
As more attention is placed on lowering costs, experts say SDOH are likely to become a larger part of the healthcare conversation.
Zaniello says that “In the ED, providers and social workers will tell you that social determinants—specifically, challenges with food, shelter and security—are directly tied to the huge volumes of patients admitted to EDs. The expression for a huge volume of ED admissions, for a ‘hot and a cot,’ was always taken as being dismissive of patient’s needs—but it probably most accurately describes them! And now that health systems are increasingly taking on risk, they are more incentivized to leverage their hard-earned insight into the ways social determinants undermine the cost of healthcare.”
AI, often touted as the next great innovation in healthcare, is also being used to address SDOH.
Sashi Padarthy, AVP, Healthcare Business Consulting at Cognizant, a technology consulting firm, says that machine learning will be one of the most important technologies for success. He sees AI being used to detect SDOH factors in EMRs, which can then notify providers and care managers in real time.
Currently, he says, “capture of SD data is still very much based on manual, and often time-consuming processes (e.g., care managers often leverage standard paper-based questionnaires). Recent advancements in artificial intelligence and machine learning—new methods of identifying SDoH—have started to show significant promise. These new methods leverage the data that is already present within a patient’s electronic health record as an input to a machine learning model that analyzes and predicts the likelihood the patient is at risk for a SDOH.”