Understanding a patient’s social determinants of health promotes more holistic and patient-centered care, but integrating non-clinical data into the EHR for providers to use can be a challenge.
Patients’ social determinants of health are becoming increasingly important for physicians to understand and address. These non-clinical factors influence health outcomes more than direct care, so providers need tools to understand the impact these determinants have on their patients if they are to appropriately address them.
Information on patients’ social determinants of health is often sensitive, disparate, and outdated. Some organizations are implementing screening tools to ask patients about their challenges at the point of care while others are integration non-traditional data sources like the Census to understand patient’s needs.
Regardless of the method for collecting this information, there is no comprehensive or standardized way to record this information in the EHR. Even if organizations are collecting information on their patients’ social determinants of health, accessing that information can be convoluted, non-intuitive, and tedious to providers.
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The Midwest Institute for Minimally Invasive Therapies (MIMIT) is integrating publicly available data sources such as Facebook and LinkedIn profiles into patient engagement platforms and EHRs. The result is a more holistic view of the patient.
“We combined the two for a 360 view of our patients,” said MIMIT founder and CEO Paramjit “Romi” Chopra, MD. “There’s public Facebook profiles and LinkedIn profiles. We started collecting that and understanding what our patients are doing.”
MIMIT is an independent, multi-specialty physician group that focuses on minimally invasive treatments and emphasizes helping patients live their best lives through lifestyle strategies and wellness solutions. This integration technology was a perfect fit to help enhance its mission.
“We started saying, let’s take the best practices of the industry and start applying it. How can we be centered on the patient, ensure their success, stay connected to them, collaborate and be mobile, and be accurate?” Chopra explained. “We cover different aspects of this from primary care to very specialized procedures, but we take the patient out of an expensive, complicated, disjointed environment to a more collaborative, connected, and cohesive environment that’s centered around the patient.”
The EHR was created primarily to file claims, making it inhospitable to less traditional health information. This means a provider looking at a patient’s medical chart only understands a piece of the patient.
An executive with a vascular problem who travels extensively for work would find it challenging to maintain routine medication and fill prescriptions on time, Chopra offered as an example. The EHR traditionally would only show a provider that this patient is non-compliant.
By integrating the social determinants of health into the EHR, Bridge Connector technology allows MIMIT providers to understand the patient’s social circumstances and adjust treatment options accordingly.
The technology also integrates the EHR with MIMIT’s patient engagement platform, helping with what Chopra refers to as the ‘Amazonification’ of healthcare.
“In our day to day lives, we are addicted to companies like Amazon. It’s simple. They offer the trifecta of doing things better, faster, and cheaper,” he explained. “They’re constantly improving, constantly innovating. For us, this interoperability is helping us do things better, faster, and cheaper.”
MIMIT has access to every interaction the organization has ever had with the patient or someone in their household so they understand when and how a patient will be receptive to follow up.
“Our systems allow us to track every interaction from the first time we receive a phone call. So we can text, call, or email patients easily,” Chopra said.
Integrating the patient engagement platform, EHR, and social determinants of health has also helped MIMIT better understand why patients were canceling appointments and helped prevent future cancellations.
“We didn’t know why somebody would cancel. That’s where social determinants come in,” Chopra said. “Given all the data we have, we’ve set up predictive models that allow us to predict what the possibility of cancellation is and helps us get another patient and prevent the cancelation, keeping our costs down.”
Using ten years of patient engagement and EHR data, MIMIT was able to study the factors that influenced cancellations and work towards preventing these in the future.
“We weren’t looking at the probability that a patient would cancel and how we could prevent that,” Chopra said, articulating the difference between their strategy and others.
Instead, their predictive modeling highlighted social factors that contributed to a patient canceling his appointment rather than the odds of that patient canceling. Such a distinction allowed MIMIT to make recommendations at the point of care based on the individual patient’s social determinants of health.
The key component of this endeavor is having high-quality data.
“You can’t do any of that without having the right information,” emphasized Chopra. “There’s data everywhere.”
Some might be worried about the amount of information available to MIMIT but Chopra ensured that all of their tools and strategies are HIPAA compliant.
“We follow all the guidelines. We are very diligent about maintaining privacy,” he stated.
Publicly available data is already abundant, Chopra pointed out.
“We can’t live without big data,” he argued. “Try switching off your phone and not buying anything for an entire day. We really need wisdom and information. You can’t get that without the underlying data.”
Big data might be seen as a necessary evil, but organizations still need to take active steps towards protecting individual’s privacy concerns.
“It’s how you use data safely. They said knives are bad, but I use them to help save lives,” he emphasized. “It’s the intent behind it and how you use it.”
“If big data is used from the point of view of allowing people to live as long as they can and make their lives better, it’s very welcome,” Chopra concluded. “It ties to our mission of preserving life and making it better.”
Source: Patient Engagement Hit