Social and Behavioral data in EHR

Social and Behavioral data in Electronic Health record

November 24, 2014

Various studies have been done on past decades about the social and behavioral factors influencing people’s health. Despite the strong evidence, social and behavioral factors are not well addressed in clinical care; especially EHRs that do not record more about social and behavioral factors.

Patient data in EHR is very helpful for public health agencies and researchers in analyzing the effectiveness of treatment. Limited availability of social and behavioral data in EHRs results in delay of on-set in treating disease and improved well-being.

If standardized social and behavioral data are recorded in EHRs, it would be more helpful in preventing the disease, maintaining public’s health, providing better patient care, improving population health and more informative research study.

To do that, IOM [Institute of Medicine] formed a committee to identify the social and behavioral domains that is to be included as core measures for all EHRs. Race/Ethnicity, alcohol use, tobacco use and residential address are already in part of EHR data collection. In addition to these, there are eight more measures recommended by IOM committee which are as follows

  • Education
  • Financial resource strain
  • Stress
  • Depression
  • Physical activity
  • Social isolation
  • Intimate partner violence [for women of reproductive age]
  • Neighborhood median household income

IOM committee earlier came up with 17 domains for social and behavioral factors. Out of which, the above 8 are mentioned as core. However, for betterment we feel to grab few more from those 17 domains.

  • Employment details
  • Dietary patterns
  • Work Conditions
  • Environmental exposures

CMS and ONC are in process of framing Stage 3 Meaningful use measures which are expected to start by 2017, the core social and behavioral domains are expected to be a part of it.

The inclusion of these factors provides

  • More effective treatment
  • More effective population management for health care systems and public health agencies
  • Discovery of pathways that link social and behavioral factors to diseases.

Now, EHR vendors have to decide upon the factors to be included in their own application for better patient care and effectiveness.

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