Since the Institute of Medicine recommended last April that social and behavioral health information should be included in electronic health records, it convened a 13-member committee to determine which ones are most likely to affect health.
From a proposed list of 17 social and behavioral "domains," it winnowed that list down to 11 to be included as a guide for federal officials developing criteria for Meaningful Use Stage 3. These pieces of information, the thinking goes, will provide healthcare providers with a more complete picture of the patient, according to a new report.
In addition to four domains already routinely collected--race/ethnicity, tobacco use, alcohol use, and residential address--IOM recommended adding eight others, including educational attainment, financial resource strain, stress, depression, physical activity, social isolation, intimate partner violence (for women of reproductive age) and neighborhood median-household income.
Measures left off the list were deemed a lower priority, but could be added later, the report states.
While social and behavioral scientists on the committee were most focused on domains linked to health or longevity, clinicians and practitioners had concerns about how the information would be collected and stored. The report notes that this phase of the process did not focus on the feasibility of doing so.
Much of this data could be reported by the patients themselves, either on paper forms or on computer, it says.
Linking data from EHRs to local public health departments and community agencies can provide benefits to the patients themselves and to the broader community, the report says. Data in EHRs, for instance, could help public health practitioners identify people affected by environmental pollutants and identify affected areas. And public health departments or community agencies might be in the best position to address problems such as food insecurity, lack of housing and social isolation.
The Tiger Team workgroup has been working on how to protect sensitive patient data in EHRs, including behavioral health and substance abuse information. The Office of the National Coordinator for Health IT's new privacy chief, Lucia Savage, says that data segmentation continues to be an area of intense focus, a key area for the interoperability roadmap.
To learn more:
- find the report