1/5/2024 0 Comments Slicer dicer epicHealth care providers should assess the availability and characteristics of SBDH data in EHRs. Of approximately 1.2 million unique patients with unstructured data, 30,893 (2.60%) had at least one clinical note containing phrases referring to social connection/isolation, 35,646 (3.00%) included housing issues, and 11,882 (1.00%) had mentions of financial resource strain.Īpart from demographics, SBDH data are not regularly collected for patients. Using the International Classification of Diseases-10th Revision diagnoses codes, we identified 35,171 (0.65%) patients with information related to social connection/isolation, 10,433 (0.19%) patients with housing issues, and 3543 (0.07%) patients with income/financial resource strain. Information regarding alcohol use and smoking status was coded for 490,348 (9.08%) and 1,728,749 (32.01%) patients, respectively. Ethnicity was captured for 2.7 million (50.00%), whereas race was documented for 4.9 million (90.00%) and a preferred language for 2.7 million (49.00%) patients. We identified a valid address or zip code for 5.2 million (95.00%) of approximately 5.4 million patients. We used text-mining techniques to extract a subset of SBDH factors from EHR's unstructured data. EHR's unstructured data represented information captured for 1,188,202 patients between July 2016 and May 2018 (a shorter time frame because of limited availability of consistent unstructured data). EHR's structured data were represented by information collected between January 2003 and June 2018 from 5,401,324 patients. We assessed various SBDH including demographics, preferred language, alcohol use, smoking status, social connection and/or isolation, housing issues, financial resource strains, and availability of a home address. We measured the availability of selected patient-level SBDH in both structured and unstructured EHR data. Our aim was to examine the availability and characteristics of SBDH data captured in the EHR of a multilevel academic health care system that provides both inpatient and outpatient care to patients with varying SBDH across Maryland. A potential approach to facilitate targeted SBDH data collection is applying information extraction methods to EHR data to prescreen the population for identification of immediate social needs. Meanwhile, collecting SBDH data using traditional surveys on a large sample of patients is infeasible for health care providers attempting to rapidly incorporate SBDH data in their population health management efforts. Consequently, at the point of care, SBDH data are often documented within unstructured EHR fields that require time-consuming and subjective methods to retrieve. However, standardized data formats to capture social and behavioral determinants of health (SBDH) in structured EHR fields are still evolving and not adopted widely. Most US health care providers have adopted electronic health records (EHRs) that facilitate the uniform collection of clinical information.
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