Today’s youth understand the role SDoH plays in their health outcomes. But health systems are woefully ill-equipped to meet this growing demand. That needs to change. And with the right technology, it can.
A true social revolution began on August 1, 1981. That’s the day teens and tweens everywhere started telling their parents, “I want my MTV!”
Music Television (MTV)—streamed via satellite and a proprietary set-top box 14 years before the Internet was a glimmer in the consumer’s mind—kicked off a disruptive trend that would ultimately turn the music business upside down. The first music video to air accurately predicted the end game: The Buggles’ “Video Killed the Radio Star.” (Go ahead, I’ll wait.)
Fast-forward 41 years, and there’s a new mantra coming from today’s youth: “I want my SDoH!” That’s according to new research published in the Journal of Adolescent Health, which found 81% of youth aged 14–24 years think it is important for their doctor or medical team to ask about SDoH. The report concludes that “healthcare-based SDoH interventions for youth should optimize opportunities for face-to-face discussions about assistance during clinical encounters.”
But it’s not just Gen-Z that wants their SDoH. At Innovaccer’s recent annual customer meeting, Xccelerate, a leader of one of the country’s largest health systems told me, “What we've come to appreciate is that the health of our patient population is 50% a function of their zip code, 30% a function of their genetic code, and 20% a function of their care.”
He was only slightly off. In fact, more than 80% of the factors that influence health outcomes occur outside the walls of hospitals and clinics. Moreover, social factors account for 25-60% of deaths in the United States in any given year. That’s according to the National Academy of Medicine.
The CMS is also escalating the importance of SDoH in its regulatory and innovation efforts. Look no further than the recently introduced ACO REACH model to see how SDoH are moving to the center of CMS’s radar. While the ACO REACH program targets only a small percentage of current and prospective ACOs, make no mistake, it’s a flare to the healthcare community in terms of CMS’s interests and intentions for future payment and reporting models.
The implication is that if you want to make sense of all of those social determinants of health, all of those biomarkers, biometric data, and the exploding amount of consumer-generated data from wearables and implantables, we're going to need more than a bigger boat. We're going to need a completely different boat.
That boat isn’t the EHR. Indeed, according to a recent national study of providers by Morning Consult, 58% of health leaders say their EHR vendor can't support their enterprise data strategy. And a big part of that enterprise data strategy needs to be seamlessly integrating external social, community, device, and consumer data sources into the patient’s record. That record itself needs to represent the unification of all their medical data now housed across myriad siloed IT systems, as well as all of their SDoH data pulled in from external sources.
Yet 48-55% of health system leaders plan to use error-prone manual processes to capture SDoH at the point of care, according to Morning Consult. Only 28% have plans to integrate medical data with social data, and only 31% plan to use software and data to identify at-risk patients. Fully 83% of respondents said they are only “somewhat," “slightly," or “not at all” prepared to capture and act on consumer-generated data (CGD).
What the what? Can we legitimately talk about the digital transformation of healthcare when less than one-third of health leaders report they plan to use technology to integrate, analyze, and understand their patients’ social determinants, and use that data to improve their health journeys and experiences? And when less than 20% are even prepared to capture and integrate CGD, which is growing by leaps and bounds on a daily basis?
No, we can’t. Healthcare transformation isn’t a point problem that can be solved by a point solution, and it can’t be solved without integrating social determinants into the very fabric of care. But that’s how many providers feel they are forced to approach it, because that’s how most vendors approach it. Launch an EHR app. Check. Add a telehealth app. Check. Add an appointment setting app. Check. Throw in a CRM and start sending SMS messages and conducting satisfaction surveys. Check. Check. Check.
Just this week, a healthcare executive told me she is being “point solutioned to death” in her effort to accelerate digital transformation. The answer isn’t point solution after point solution, with brittle point-to-point integrations that create additional data silos, further fragment patient data, and completely miss the point (no pun intended) of the pressing need to incorporate SDoH into care workflows.
The answer is a platform; specifically, a healthcare data and analytics platform that creates the foundation for rapid innovation and digital transformation. Completely open and interoperable, it can integrate SDoH data from outside of the health system’s four walls as readily and easily as it can integrate EHR, clinical, claims, labs, pharmacy, CRM, and, frankly, any other data.
Once a healthcare data platform is in place atop your chosen public cloud, it can aggregate, activate, and harmonize data across all downstream applications. It becomes like a “power strip” that other transformative solutions can simply be “plugged into” because it provides a common data model.
The only difference: these are sophisticated healthcare IT solutions that can now leverage a common, unified (longitudinal) patient record that contains everything a health system needs to know about its patient—including a massive amount of SDoH information, culled from external sources, that provides caregivers the insight they need into the 80% of health determinants now (and forever) missing from their EHR.
The EHR is the first center of gravity in healthcare, collecting the 10-20% of medical data that’s a function of patient care. The time has come to establish healthcare’s second center of gravity to use and move beyond the EHR, fragmented data, and being point-solutioned to death.
The EHR and other mission-critical systems will remain mission critical, but their data can (and must) be unified and transformed to usher in a new world order that gives providers anywhere, anytime access to a single source of patient truth in all crucial systems and care settings—including the more than 80% of social factors that influence health outcomes and, in an increasingly value-based world, the financial health of providers.
The public wanted their MTV. The public, and regulators, want their SDoH. A healthcare data platform serves as the missing link between the EHR and the Real World that everyone wants: the unified patient record!