Social determinants of health (SDoH) such as education, economic stability, and neighborhood all play an important role in the impact and effectiveness of healthcare delivery.
Now, health providers and insurers are joining forces, using SDoH data to identify patients with social needs and facilitate interventions to improve care. While the potential for data sharing is incredibly exciting, it also presents ethical dilemmas for healthcare organizations.
“Because of the sensitive nature of this consumer data, we felt it was critical to put a stake in the ground around the ethical use of this data,” says Jennifer Covich Bordenick, CEO of eHealth Initiative. “Lots of industry groups are publishing papers and producing research, but there is not a lot of direction on how to use this data.”
What is The eHealth Initiative?
The eHealth Initiative and Foundation (eHI) is a Washington, DC-based, independent, nonprofit organization whose mission is to drive improvements in the quality, safety, and efficiency of healthcare through information technology.
The benefits of The eHealth Initiative
In September 2006, eHI released its Third Annual Survey of Health Information Exchange. The report featured 165 responses from initiatives in 49 states, the District of Columbia, and Puerto Rico. At the time, 47% of respondents identified themselves as being in the advanced stages of development while 26 initiatives identified themselves as being “fully operational.”
This feedback illustrates an increasing level of maturity in the functionality of health information exchange efforts, with one-fifth of respondents saying they now use technology to:
- Transmit insurance claims
- Dictate patient reports
- Share laboratory results
- Monitor patient enrollment/eligibility
What are the possible pitfalls of The eHealth Initiative?
Thanks to new technologies, sharing and reviewing patient data is easier than ever. However, access to this information presents an array of ethical dilemmas for medical providers, insurers, and community organizations.
Patient and consumer data is highly confidential, but currently, there’s little guidance on what steps organizations should take in order to prevent identity theft or jeopardizing patient privacy.
In an effort to prevent some of these issues going forward, The eHealth Initiative has released a white paper on guiding principles for the ethical use of SDoH data.
“eHealth Initiative lays the groundwork by establishing a framework for the ethical use of SDOH to improve outcomes and assess impact while protecting the privacy interests of individuals,” says Eduardo Sanchez, MD, chief medical officer for prevention at the American Heart Association.
5 guiding principals for the ethical use of SDoH
To ensure client data is protected and used only for population health improvement purposes, The eHealth Initiative established five guiding principles:
- Care coordination: Identify individuals with SDOH needs, coordinate delivery of holistic care, and facilitate connections to additional services or interventions.
- Recognizing risk via SDOH analytics: Identify risk through the use of analytics tools to develop population health management interventions for persons and communities.
- Mapping community resources: Assess individual SDOH needs against available community resources to identify gaps that address health and wellness.
- Service and impact assessment: Assess the results of SDOH interventions and services.
- SDOH as a tool: Support for customizing health services and interventions, use SDOH as a guide for quality discussions with individuals or their guardians and caregivers to jointly decide which services and interventions are the best fit.
Using SDoH to improve whole person care and community care coordination
For these principals to work effectively, primary care doctors, nurses, and physician’s assistants need to improve communication both inside the office and with community entities like law enforcement.
Fortunately, achieving these goals is possible, via the integration of electronic health records, community health information exchanges, and care coordination software. Data from The eHI Foundation suggests practicing physicians deliver the majority of healthcare in the United States’, and 67% of Americans view their doctor as a “trusted source.”
The eHealth Initiative argues that by improving collaboration and ethical data sharing methods, hospitals, government agencies, clinicians, and health plans can provide better care and ultimately save lives.
These newly established ethical guidelines for handling and sharing SDOH data give healthcare providers a useful resource for how to provide whole-person care while protecting their patients’ privacy.
To learn how one community in Central Ohio developed an integrated, secure healthcare delivery system for high-risk, hard-to-reach populations, check out our webinar “Connected Communities Treat the Whole Person.”