Recommended social and behavioral domains and measures for electronic health records
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Recommended Social and Behavioral Domains and Measures for Electronic Health Records. Robert S. Kahn, MD MPH Cincinnati Children’s Hospital Medical Center November 25, 2013. Unemployment Lack of high school degree Ex-offender reentry issues. Distressed/depressed parents

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Recommended Social and Behavioral Domains and Measures for Electronic Health Records

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Recommended social and behavioral domains and measures for electronic health records

Recommended Social and Behavioral Domains and Measures for Electronic Health Records

Robert S. Kahn, MD MPH

Cincinnati Children’s Hospital Medical Center

November 25, 2013


Recommended social and behavioral domains and measures for electronic health records

  • Unemployment

  • Lack of high school degree

  • Ex-offender reentry issues

  • Distressed/depressed parents

  • Lack of parenting role models

  • Inadequate education services

  • Domestic violence

  • Adult mental health issues

  • Food insecurity

  • Denial/delay of public benefits

  • Utility shut offs

  • Poor housing conditions

Henize, Kahn


Social risk screening

Social Risk Screening

Benefits

Housing

Parental

Depression

Domestic Violence

Food Insecurity


School related screening

School Related Screening


Ehr referrals legal aid society

EHR Referrals: Legal Aid Society


Tracking of ehr based legal aid referrals

Tracking of EHR-based Legal Aid Referrals


Referrals to the health department

Referrals to the Health Department


Recommended social and behavioral domains and measures for electronic health records

Change in physician behavior


Recommended social and behavioral domains and measures for electronic health records

Change in physician behavior

Percent with household food insecurity identified


Recommended social and behavioral domains and measures for electronic health records

EHR data driving focus on broader social risks


Recommended social and behavioral domains and measures for electronic health records

Broader social risks informing clinical care:

Census tract-level risks and asthma reutilization risk

2-3 risks

Days from the index admission

*Risks: census tract extreme poverty, adult educational attainment, median home value


Additional considerations

Intergenerational information from parents’ EHR

Prenatal/obstetric history

Family history (e.g., smoking, obesity)

Information from school’s database

Grades, missed school days, suspensions

Additional considerations


Ehr related studies in social determinants

EHR-related studies in social determinants

  • Beck AF, Sauers H, Kahn RS, Yau C, Weiser J, Simmons JM. Improved documentation and care planning with an asthma-specific history and physical. Hospital Pediatrics 2012; 2:194-201.

  • Beck AF, Simmons JM, Huang B, Kahn RS. Geomedicine: area-based socioeconomic measures for assessing risk of hospital reutilization among children admitted for asthma. American journal of public health 2012;102:2308-2314.

  • Burkhardt MC, Beck AF, Conway PH, Kahn RS, Klein MD. Enhancing accurate identification of food insecurity using quality-improvement techniques. Pediatrics. Feb 2012;129:e504-510.

  • Beck AF, Klein MD, Schaffzin J, Tallent V, Gillam M, Kahn RS. Identifying and treating a cluster of substandard housing using a medical-legal partnership. Pediatrics. 2012; 130:831-8.

  • Beck AF, Simmons JM, Sauers HS, Sharkey K, Alam M, Jones C, Kahn RS. Connecting at-risk inpatient asthmatics to a community-based program to reduce home environmental risks: care system redesign using quality improvement methods. Hospital Pediatrics 2013;3:326-334.

  • Klein MK, Beck AF, Henize AW, Parrish DS, Fink EE, Kahn RS. Doctors and lawyers collaborating to HeLP children – outcomes from a successful partnership between professions. Journal of Health Care for the Poor and Underserved. 2013; 24:1063-1073.


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