A recent study conducted in a large nonprofit network of community health centers assessed the extent to which patients’ social determinants of health influence safety-net primary care clinicians’ decisions at the point of care, and how that information came to the clinician’s attention. Descriptive statistics and generalized estimating equation models were used to assess relationships between clinician, patient and encounter characteristics and clinicians’ reported use of social determinants of health data in clinical decision-making.

Social determinants of health influenced care in 35% of surveyed encounters. Most common sources of information on patients’ social determinants of health were conversations with patients (76%); prior knowledge of the patient’s social determinants of health (64%); and social determinants of health information documented in the EHR (46%).

Social determinants of health were significantly more likely to influence care for male and non-English-speaking patients, and those with social determinants of health screening data documented in discrete (i.e., more easily measurable and reportable) fields in the EHR. The authors assert that EHRs present an opportunity to support clinicians in integrating information about patients’ social and economic circumstances into care planning.

Although there is increased interest in conducting social risk screening in primary care settings and in how that knowledge might impact patient outcomes, little is known about how and whether social risk information influences clinicians’ decisions at the time the patient presents in the clinic.

Using an EHR-embedded card study, which is a unique method of obtaining information about patient-clinician interactions, the research team found that the combination of discrete social determinants of health information and directed conversations are likely to provide the nuanced data that enable personalized care.

The work is published in The Annals of Family Medicine journal.

More information:
Arwen Bunce et al, Patient-Reported Social Risks and Clinician Decision Making: Results of a Clinician Survey in Primary Care Community Health Centers, The Annals of Family Medicine (2023). DOI: 10.1370/afm.2953

Journal information:
Annals of Family Medicine

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