Tag: social determinants of health
With Google’s acquisition of Fitbit in November 2019 and Apple’s recent foray into smartphone-based clinical research, the ‘big four’ tech giants are ramping up their efforts to take a slice of the $3.6 trillion healthcare industry pie. These investments aren’t new. Between 2013 and 2017, Apple, Microsoft and Google’s parent company, Alphabet, filed a combined 300 health-related patents, while Amazon has been looking to expand into the pharmacy space since the early 2000s. Historically, it hasn’t been easy for new players to get into the healthcare game. Up to now, tech companies have mostly stayed in their lanes, using their expertise in cloud-based computing, artificial intelligence and supply chain management to break into health markets around the edges. What gives them a big advantage now is the rise of healthcare consumerism, especially in the digital realm. Patients expect to be treated as individuals, with communications and services that are convenient and tailored to their needs. The personalization that so delights them is powered by their own health data and a focus on the consumer experience – two of the tech companies’ biggest strengths. Providing a consumer-centric experience has been challenging for the healthcare industry. In fact, it’s been challenging for many legacy industries (banking, insurance, etc.). Amazon and others have a head start in being able to leverage vast quantities of consumer data and turn insights about their customers’ lifestyles, behaviors and preferences into a better consumer experience. How can healthcare providers compete? Understanding consumer data is key to a better patient experience and better population health The buzz around consumer data opportunities isn’t limited to the tech world. Recognizing the role of consumer data in improving both the patient experience and population health, more health systems are investing heavily in data analytics, looking at how they use data to market to their consumers and address the social determinants of health. Mindy Pankoke, Senior Product Manager for Experian Health, says: “Consumer data is becoming more important in healthcare because patients are people. They're more than a clinical chart or claims form. They have lifestyles, they have interests, they have behaviors. This is called consumer data. ‘Social determinants of health’ has become a huge buzzword in the healthcare industry and it's more than buzz. It's data about people's lifestyles that we can use to improve their health.” Over 80% of health outcomes are attributed to the social determinants of health, so knowing who your patients are and what they need is increasingly important if you want to improve their wellbeing. When you understand what’s going on in your patients’ lives, you’ll know whether they need assistance with transportation, understanding their healthcare information, managing a care plan or accessing healthy food. You can communicate with them in the most effective way and point them towards services that could help them access care and avoid more serious conditions. And even better, much of this can be done through time-saving automation tools. Where to start with consumer data Today’s leading healthcare providers are using consumer data in three main areas: 1. Streamlining patient communications Whether a patient is getting treatment for a broken leg or multiple chronic conditions, their healthcare journey probably involves hundreds of touchpoints with your organization. Consumer data helps you cut to the chase and give them the exact information they need to make their next decision or complete their next task, in the most convenient way. Data analytics allow you to create a slicker patient experience, by giving the right message in the right format – whether that’s in marketing to new patients, sending bill reminders, or encouraging wellness checks. 2. Segmenting patients according to social determinants of health In a study of 78 social needs programs published this month, Health Affairs reported that health systems invested more than $2.5 billion in interventions focused on housing, employment, education, food security, community and transportation, between 2017-2019. Clearly, some patients will benefit from these services, while others won’t. There’s no point giving the same information to every patient. Consumer data lets you segment your patient population and target information about social programs to the ones who need them most. 3. Creating bespoke services for your specific patient population Consumer insights tell you exactly what’s blocking your particular patient population from accessing care, now and in the future. You’ll know how many have difficulty attending appointments, how many might struggle to read complicated instructions and how many will be too busy to download and use your new healthy recipe app. Analyzing your population’s needs and tendencies allows you to predict future demand for different services and develop interventions to solve those specific challenges. Future-proof your consumer data strategy by working with a trusted partner As the big tech companies are coming to discover, healthcare data regulations are complex. You need to know where your data comes from, for the sake of both accuracy and permissibility. Working with a trusted data vendor in the health space can help ensure the reliability and integrity of your data, as they will have expertise in the appropriate use of consumer data in healthcare. They’ll help you pull insights from only the most relevant, current data, so you can build a competitive consumer experience on the strongest foundations. Find out more about how Experian Health’s consumer data analytics can give you a holistic view of your patients and the social determinants that affect their health.
The stats are alarming: Up to 80% of health outcomes are not due to medical factors, but to a patient’s social and economic circumstances—such as their income, housing situation and even whether they own a car.68% of Americans are affected by at least one social determinant of health (SDOH).Approximately 24% of hospitals and 16% of physician practices screen for food insecurity, housing instability, utility needs, transportation needs, and interpersonal violence—which means the majority don’t screen for all relevant social needs. The healthcare industry has been talking about the importance of addressing social determinants of health for years, but many struggle with how to collect the insights. For example, if 68% of Americans are affected by at least one SDOH, how do they even discover the one? What is the ideal way for providers to screen for SDOH? Should they simply ask the patient? Do they start a visit with a survey, probing for details that could ultimately impact care management decisions? Providers know these sensitive topics – housing instability, financial instability, food insecurity and onward – can be tough and uncomfortable conversations. So, where to begin? Should you rely on patient surveys to capture SDOH? Patient surveys can be a useful way to find out about many potential barriers to care. However, they bring limitations: Your insights will be limited to the patients who show up—so anyone who has struggled to attend an appointment (and therefore potentially with higher needs) will be left out It can be time-consuming and expensive to give staff the time and space to conduct personal interviewsThey rely on patients to be willing to share openly, but some may not feel comfortable doing soThere is room for error in how questions and answers are interpreted by both the survey team and respondentsSocial circumstances can change over time, so it’s possible that the information gleaned in the survey may not be relevant a few months down the line. Knowing SDOH can have such a huge impact on a patient’s health certainly means clinicians should discuss these topics in the exam room, but relying solely on patient surveys and conversations could lead to gaps in intel. When should you screen for SDOH? Screening for social needs when a patient first registers or engages with your services is a good starting point. But what happens when their situation changes between diagnosis and treatment? What if they disclose a social need to a specialist that wasn’t flagged on their initial intake form? Does your staff know how to discuss sensitive social issues? Can they create a safe space for patients to share? Have you got clear referral pathways when an issue is flagged? Look for possible touchpoints in the patient’s journey where referrals to support services would be appropriate. Looping in the relevant primary care services is a good way to make sure your patients are connected to community-based programs and supported throughout their journey, whenever a new or changed social need is identified. What types of data could offer the SDOH insights a provider needs? Geographical and community-level data can help a healthcare organization understand their patient population’s income, housing situation and employment status. These are useful for population-level care planning but aren’t patient-specific. A better way is to analyze securely collected consumer marketing data for more specific and accurate information. Working with a trusted data vendor that is a compiler of original-source consumer data can help you navigate your options. The real predictive power of SDOH data comes when you combine patient-specific information obtained through screening, with consumer databases. A third-party vendor can help you access data on your patient population’s income, occupations, length of residence and other social and economic circumstances. Your care managers can use this to inform proactive, preventative conversations with patients to solve any non-clinical gaps in care. Bottom line … When healthcare organizations have a holistic view of patients—and the SDOH that play a role in their lives—they can take steps to help prevent avoidable hospital visits, emergency department (ED) utilization, appointment no-shows and worsened conditions by encouraging and facilitating earlier interventions. The key is to start with the right data.
Did you ever have someone tell you, “there’s no magic pill” for reaching a goal? It’s a somewhat ironic analogy, given that so many people struggle to take their meds as prescribed. Following a medicine schedule actually takes a lot of organization and discipline, never mind the financial and emotional cost of having a daily reminder that you’re not well. It’s estimated that 50% of patients don’t take medications as prescribed. Sometimes a patient is busy and misses a dose. Maybe they forget whether they’ve taken it already and accidentally take double. Perhaps they feel better and decide to stop a course of meds early. Or maybe they can’t get to the pharmacist to get their refill on time. Unfortunately, medication non-adherence (MNA) can have a more direct impact on a patient’s condition than the specific treatment itself, according to the World Health Organization. Non-adherence is thought to contribute to nearly 125,000 deaths and 10% of hospitalizations each year. It costs the health care system between $100–$289 billion each year, and according to a study by Walgreens, for every 1% improvement in adherence, $50 can be saved in healthcare spending. The causes are varied. Of course, patients have a role. But healthcare organizations operating at various points along the care continuum can also play a big part in helping or hindering patients in sticking to their prescriptions. Doing so is in everyone’s interest, as tackling non-adherence can help reduce readmissions and avoid more serious medical conditions, improve patient loyalty, yield financial savings and create a better experience all around. Here are three ways different healthcare organizations can help patients stay on track with their meds: 1. Keeping accurate patient records from hospital to home When a patient is hospitalized, it’s fairly easy for them to stick to a medicine schedule. Drugs are dispensed in the same building and brought right to the patient’s bed at the appropriate time. The problems arise when the patient goes home. They may leave hospital with new prescriptions which can be confusing and if they already have a prescription, the admission itself can disrupt their usual routine. As things stand, hospitals tend not to be reimbursed for interventions to improve adherence, so these are less likely to be prioritized during care transitions. But given the likely improvements to patient outcomes and consumer loyalty, and the fact that hospitals could save $37 for every dollar spent tackling MNA, these interventions are worth a second look. A simple but effective place for hospitals to start is in improving patient identities. When your clinical teams know they have a 100% accurate and up-to-date record for each patient, including their current prescriptions, they can help the patient stay on track and prescribe new medicines with confidence. New identity management platforms such as Universal Identity Manager can help you keep track of patients and their meds, reducing the risk of medical errors and avoiding billing mistakes associated with duplicate prescriptions and preventable readmissions. This ‘golden thread’ of patient information can also improve communications within and between providers in your health system, such as Accountable Care Organizations (ACOs), pharmacies and other community providers. 2. Understanding and addressing wider barriers to adherence Common barriers to adherence often relate to a patient’s circumstances at home, such as not being able to get to the pharmacy because of a lack of transport, or because the opening hours don’t fit with their work schedule. For patients juggling work, childcare and other responsibilities, refilling their prescription can easily slip down the to-do list. Pharmacies can help by offering logistical support such as automatic refill programs, home delivery and help with organizing medication into pill boxes. But how do you know which intervention will be most relevant? This requires a wider understanding of the make-up of your patient population and their needs, preferences and behaviors. Understanding the social determinants of health can help you identify the specific barriers to care for your healthcare consumers, so you can put in place the right response. 3. Develop patient engagement strategies to help patients take their meds It’s not just those directly involved in providing care who can help improve MNA. Payers can help in two major ways: firstly, by supporting members to overcome barriers such as cost and confusion, and secondly, by working with hospitals and pharmacies to help them develop effective strategies to reduce non-adherence. For example, Blue Cross Blue Shield of Arizona (BCBSAZ) has introduced a text messaging service to send reminders to members about their prescriptions, with a $45-50 discount on copays for those that refill on time. It’s hoped this program will tackle behavioral barriers to adherence such as procrastination or forgetfulness, while also addressing price concerns. Chris Hogan, Chief Pharmacy Officer at BCBSAZ described the program “as being a very high tech, modern, simple and effective addition to our overall initiative to improve medication compliance.” This kind of personalized patient engagement can be very effective in helping patients to stay on track. With ConsumerView, you can access a wide range of high-quality demographic, psychographic and behavioral consumer data, to help you offer personalized support such as digital reminders to your patients. You can develop engagement strategies tailored to the specific needs of your patients in just a couple of clicks. Could one of these strategies help your organization do more to improve medication management? Learn more about how we can help you help your patients – and your bottom line.
When it comes to value-based care, there’s really just one measure that matters: patient satisfaction. As CMS incentivizes providers to help patients find better care, improve population health and lower healthcare costs, more top health systems are seeing patient engagement as the path to value-over-volume success. Patients are finding themselves footing more of the bill for medical expenses, so elevating the patient experience is essential. If they’re not satisfied, they’ll simply take their dollars elsewhere – not what your CFO wants to hear. Helping patients feel more engaged in their health creates a more satisfactory experience, and in turn, boosts patient loyalty. And what’s more, by giving them opportunity to make informed decisions about their care, you can also reduce preventable admissions, avoid no-shows and fix the revenue leaks in patient collections. It’s beneficial for everyone. Here are four strategies to help you boost patient engagement and create a more consumer-friendly experience in your organization. 4 ways to boost patient engagement 1. Use segmentation and customization The first route to consumer-friendly care is about treating each patient as an individual. With advances in data analytics, it’s now possible to group your patients according to risk (whether that’s risk of a particular disease, exposure to a social determinant of health, or likelihood of non-attendance at follow-up). This allows you to be more targeted in your marketing efforts, provide patients with information that’s more relevant to them, and help each patient move to the next stage of their healthcare journey. Stanford Medical School sees this data transformation as central to its vision of “‘Precision Health’ – a more preventive, predictive, personalized and precise” approach to healthcare. Analytics give you a wealth of insights about the clinical, financial, behavioral and social factors affecting your patients, so you can personalize your patient engagement strategy to each member’s specific preferences and needs. As noted in research undertaken by Frost and Sullivan on behalf of Experian Health: “Analytics help us select patients who will respond to engagement strategies and de-select patients who won’t respond are needed. Not everyone responds to engagement in the same way.” By prioritizing precision marketing, you can create a culture of precision care. 2. Help patients take ownership of their health journey Value-based care is an opportunity to empower patients to be active players in their health. Greater transparency into the billing process, access to healthcare data and consumer-friendly tech can all help patients see what’s happening at each stage of the process. When they’re more informed, they’re more likely to adhere to care plans, turn up to appointments and successfully navigate payments. Your patient portal is a good place to start. Research shows that use of portals enhances patient engagement, satisfaction and health outcomes. Patients can access their records, view test results, schedule appointments at a time that suits and sort out bills with less of the stress. It helps patients ask the right questions and builds a trusting patient-provider relationship. 3. Improve the patient financial experience When two-thirds of Americans are worried about being able to cover unexpected medical bills, any way you can make the payment process more transparent is a big plus. Help your patient navigate the financial side of their healthcare experience with clear, real-time information about their coverage status, estimated co-pay calculations and appropriate payment plans based on their specific circumstances. Putting them at ease will help them meet their financial obligations without leaving a bad taste. In this way, you can build consumer trust and optimize your revenue cycle at the same time. 4. Use SDOH data for proactive outreach Research shows that medical tests and treatments alone are not enough to determine the outcome of a patient’s healthcare journey. We should be paying more attention to the social and economic factors that can get in the way of care. Because when patients struggle to access care, it’s harder for them to follow treatment plans or show up to important follow-up appointments. In a value-based world, tackling social needs is a growing priority for providers seeking to improve population health. When you have a more complete grasp of each patient’s motivations, support networks and personal circumstances, you can create a more efficient patient engagement plan. You’ll avoid wasting resources on patients who aren’t in a position to respond and instead can adopt outreach strategies to help those patients access the care they need. This might include offering alternative payment plans, signposting to logistical support such as childcare or transport, or referring to local community services, such as cooking classes or social clubs. To do this, you need reliable, relevant and accurate consumer data and the capability to draw actionable insights. Experian Health’s unrivaled consumer marketing data can help you better understand your patient population so you can communicate with them and support them in the most effective way. Consumer-friendly care is the new currency in value-based accounting – and the key to positive patient engagement. Find out more about how Experian Health can help your organization lift your patient engagement strategies for greater patient satisfaction, better health outcomes, and a healthier
When a doctor pulls up a patient’s record, it should be a safe assumption that the information on the screen relates to the patient sitting in front of them. It should contain every detail of the patient’s medical history, along with their current address and accurate personal information. It certainly shouldn’t contain anyone else’s data! Yet all too often, patient records are plagued with inaccuracies. Around 30% of patient data in electronic health records is incomplete or inaccurate, and up to half of records are not linked to the correct patient. The ONC estimates that around a fifth of patients may not be matched to their entire medical record within an organization, while more than a half of records shared between organizations contain errors. Despite all of modern medicine’s ground-breaking achievements and our increasingly digitized world, the ability to share information between different payers and providers in a reliable and secure way remains frustratingly out of reach. Could a universal patient identifier unlock interoperability? Imagine a healthcare ecosystem where administrators and clinicians can safely exchange information without worrying about whether it’s inaccurate, incomplete, or incompatible with each other’s systems. Interoperability could make life easier for healthcare staff and patients alike. While regulations such as the Affordable Care Act introduced many carrots and sticks to drive up adoption of electronic medical records to support interoperability, they also revealed a critical gap in healthcare: the need for a universal patient identifier (UPI). This is an identifier that would help manage patient identification across the whole healthcare ecosystem. A UPI would allow providers and payers to follow patients throughout all their major medical and life events and be sure that the information they hold for their member or patient is 100% accurate, current and complete. Instead, the absence of a UPI, compounded by the sheer volume and fluidity of patient data, has created significant issues downstream. Billing errors, unnecessary treatment and testing, HIPAA breaches, prescriptions filled for the wrong patients and many other issues all play a role in the growing number of preventable medical errors (estimated to be the third leading cause of death in the US). Striving for truly interoperable patient information should be a priority across the entire healthcare industry. Still, while federal funding for a UPI is currently being considered by Congress, we’re seeing more and more industry-led responses to help improve patient identity management. 5 benefits of using a universal patient identifier for interoperability Improve patient safety How can physicians be sure they’re recommending the right treatment for a patient, when there could be a vital piece of information missing from their medical history or allergy list? How can a pharmacist feel confident handing over a prescription, when there’s a chance the patient in front of them isn’t the same patient named on the script? A UPI can help avoid ‘wrong patient’ events and allow providers to share information to spot trends in recurring errors so that action can be taken to prevent them in future. Lower healthcare costs The West Health Institute found that that medical device interoperability could save the U.S. healthcare system more than $30 billion per year. For individual providers, UPIs could improve productivity by reducing the amount of time clinicians and hospital staff spend trying to sort out inaccurate records. And with nearly a third of claims denied as a result of patient misidentification, this could mean savings in the region of $17.4 million for the average hospital. A better patient experience Patients are right to be frustrated when their physician doesn’t have up-to-date records about them, or their provider sends appointment reminders to an old address. Expecting patients to fill out multiple forms (often multiple times) is inefficient and hardly contributes to a positive patient experience. A tool such as Universal Identity Manager can help providers exchange timely data, eliminate duplicate records and coordinate care, so the patient is supported throughout their healthcare journey. Stronger privacy Electronic records linked with a UPI allow healthcare organizations to phase out manual processes—which is not only more efficient, but also helps minimize the risk of patient data falling into the wrong hands. It’s much easier to keep the data secure when it’s contained in a single record, compared to multiple versions of a record filled with scribbled notes and random updates that could easily end up attached to the wrong record. Experian Health’s Precise ID gives healthcare organizations a HIPAA-compliant way to authenticate patients and reduce the risk of a data breach during enrollment. Better data to tackle the social determinants of health As consumer data opens up new opportunities to improve population health, a network of shared data will be essential for identifying trends in the social and economic factors that affect medical outcomes. Interoperable data sets and technologies can enhance the way public health data is collected and used, for better patient outcomes and population health. Interoperability currently remains a challenge, but the tools exist to improve the way information is shared and used across the healthcare ecosystem. By integrating clinical data into the patient access workflow, you can increase productivity, reduce costs, and ultimately improve the patient experience. Contact our team to find out how this could help your organization achieve more efficient, accurate and actionable data sharing.
Last week, I spoke at the technology briefing of a national health plan group to give a presentation on the role of consumer data and patient identity in healthcare and how social determinants of health (SDOH) can help payers improve population health and lower costs. To illustrate the importance of leveraging consumer data for SDOH outcomes, I like to use the example of Vern. Vern is 78 years old, lives alone in a lower income apartment complex and hasn’t attended a wellness check in several years. Last month, he had an unexpected trip to the emergency room (ER) due to heart disease and continues to be readmitted for his condition. But why does he keep getting readmitted? Is it because he can’t afford his prescribed medication? Is he having a difficult time finding transportation? Or could it be that when it comes to healthy eating—buying fresh product on a weekly basis is challenging for him? These are some of the SDOH that could be contributing to Vern’s readmission—not solely his now heart disease. Had his care team known more about Vern, aside from his condition, they could have proactively addressed some of his barriers to care and prevented the ER admissions—saving them from costly care episodes and preventing negative outcomes for Vern. By utilizing SDOH insights, Vern’s care team can help ‘even the playing field’ for him by understanding his non-clinical barriers to health, what key things are driving those barriers, and what makes sense to address them. All of this, of course, underpinned by an accurate identity (but, let’s talk universal patient identification another day!). With SDOH insights, Vern’s care team could have gotten him to his wellness checks, his condition would have been detected earlier and he would have received the services he needs proactively. This would save countless dollars in repeated readmissions, ER visits and other costs associated with a chronic condition that can’t get better when your members don’t have the luxury of prioritizing health over basic needs. To avoid these missed opportunities, many healthcare organizations are turning to consumer data to understand their patients or members better. Insights on SDOH are transforming the care experience for people like Vern, as well as saving money for patients and the healthcare industry. Here are three ways consumer data is driving improvements in population health and lowering healthcare care costs at the same time: Helping patients lead healthier lives Research shows that clinical care alone is not enough to safeguard a person’s health. Up to 80% of health outcomes are attributable to non-medical factors such as your financial situation, stability of living arrangements, access to transportation and healthful food options, amongst other things. Around 68% of Americans are affected by at least one of these SDOH, which can make prioritizing good health a challenge. When healthcare organizations are more informed of the SDOH impacting their patients or members, they can take steps to help prevent avoidable hospital visits, ED utilization, appointment no-shows and worsened conditions by encouraging and facilitating earlier intervention. For example, 1 in 8 Americans are food insecure. If care teams are able to recognize when this is an issue for the people they’re caring for—they can look at partnering with community organizations, like a local food bank or meal delivery service, to address gaps in nutrition for better health outcomes. Reducing the financial burden of healthcare expenses In the U.S., healthcare has the world’s largest gross domestic product (GDP) spending (18%). By helping your members overcome barriers to attending appointments and potentially discovering health issues sooner, the healthcare industry can reduce the costs of healthcare. For example, 3.6 million Americans miss out on medical care due to transportation problems. If care teams knew who they were and what specifically is impacting them ahead of time, they could step in to arrange transportation or offer alternative options, like telemedicine, so problems can be detected earlier. Not only is this better for the patient’s health, it’s better financially too—emergency room visits cost an average of nearly $2,000 while inpatient hospital stays come in at an average of $10,000. When 33% of ER visits are from those experiencing homelessness—the extreme condition of housing instability—it’s imperative that we consider more than a patient’s profile from a claims or clinical data perspective. Offering a better patient experience When healthcare organizations can see each patient as a whole person, they can offer better engagement plans that make prioritizing their health a smaller mountain to climb. Does your patient prefer information by phone, text or email? Do they use their patient portal? Are there other services they might benefit from, that can help improve their health in other ways? Armed with the right data, you can answer these questions and tailor your communications with each patient, ultimately helping them achieve better outcomes. What’s more, when you leverage consumer insights to improve your population health strategies, you’ll also create a better patient experience through improved care coordination, prompt referrals and timely information sharing—making the whole process better for everyone. Translating consumer data into intelligent business decisions With reliable consumer data sourced from Experian—an original-source provider and data steward when it comes to consumer privacy—you can learn more about your patients and make the right care management decisions to address the non-clinical barriers to health impacting the health of your members and your organization. Learn more about how to leverage consumer data to help improve outcomes for your patient population. Mindy Pankoke is a Senior Product Manager for Experian Health
It’s a puzzle many healthcare providers are still working to solve: when over 80% of health outcomes are influenced by non-medical factors, how can health systems help their patients achieve better outcomes? From affording time off work so they can attend an appointment, to accessing healthy food, childcare or transport, your patients’ ability to engage with and benefit from health services can be heavily influenced by a host of social and economic dynamics Understanding these social determinants of health (SDOH) gives you a more complete picture of your patients’ health and life circumstances. You can anticipate their needs, coordinate their care more effectively, and ultimately give them a better healthcare experience. What’s more, harnessing the right data on SDOH leads to smarter investment and operational decisions, yielding advantages for your health system as a whole. That’s why many providers are starting to use non-medical consumer data in their care management planning. Here we look at some of the top use cases for SDOH data. 5 top use cases for data on social determinants of health Reduce missed appointments No-shows cost providers an average of $200 each (plus a lot of wasted physician time). Often these are down to lack of access to transportation or childcare. SDOH data can help you anticipate where these challenges might occur, so you can offer additional services like a free shuttle bus or crèche. You’ll make the experience a little easier for the patient, and potentially prevent an unchecked health issue from becoming something more serious. Save costs from preventable health events Unfortunately, life circumstances can lead to many people using health services in a way that could be avoided. Missed appointments or difficulty following a care plan can lead to escalating medical issues, entailing more treatment and readmissions. Patients might also fall back on emergency services because they can’t easily access appropriate alternatives. SDOH data helps you understand the circumstances that might lead to this kind of patient behavior. For example, if you can spot patients who may be likely to dial 911 because they have no other way to get to the health services they need, you can offer alternatives that avoid an unnecessary visit to the ED. This could help you save up to $2000 per Emergency Department visit and around $10,000 for each hospital stay (which often can’t be fully reimbursed if the patient ends up being readmitted). Increase care plan compliance A patient’s living situation can often determine whether or not they’ll be able to stick to their care plan. For example, specific dietary advice can be a real challenge for a diabetic patient if they have a limited food budget, lack of time to shop and prepare food, or a plain lack of options of where to buy it. An SDOH needs assessment can flag this in advance so clinicians can help patients find a plan that will work for them. Similarly, pharmacies might use consumer data to help minimize abandoned prescriptions or situations where a patient fails to follow dosage directions, which is estimated to cost the industry $290 billion per year. Save administrative and clinical time Analyzing consumer data can help your operations run more efficiently, which benefits your patients through well-coordinated care, timely information sharing and prompt referrals. Many providers are taking advantage of automated solutions for leveraging SDOH data, saving massive amounts of administrative time for care managers by pre-populating patient data and automating SDOH needs assessments. Consumer insights solutions like Experian Health’s ConsumerView analytics can optimize operational efficiencies and ensure your care managers use their time well. Investing in relevant community health programs One of the most impactful use cases for SDOH data is to gain a richer understanding of your member base, so you can invest in the most relevant community health programs. For example, a 2018 pilot project by Atrium Health in North Carolina screened for food insecurity in older patients who may have been at risk of readmission. Emergency food services were provided where needed, and as a result, readmissions dropped by 60%. Your purchasing power can also be a force for change. The Cleveland Clinic outsourced its laundry service to Evergreen Cooperative Laundry, a local collaborative working to combat poverty. Ralph Turner, executive director of patient support services at the Cleveland Clinic says: “Establishing the foundation for people to stabilize their incomes and become part owners in a business… in itself generates health and wellbeing in our community.” Leveraging consumer data to improve patient outcomes These examples show some of the varied ways screening for social determinants of health can open the door to understanding your patients and creating truly person-centered care services. Who knows what opportunities are hidden in the SDOH data for your patient population? Are there gaps in your data? Could you combine different data sets for a fuller picture? What exactly is your consumer data telling you, and how do you turn it into meaningful management decisions? At Experian Health, we have comprehensive data assets and analytics platforms to help you answer these questions and more, and leverage consumer data most effectively.
What if you could flag patients who are at risk of readmission? What if you could anticipate missed appointments or know ahead of time that someone is going to face challenges with their care plan? This knowledge could help you improve patient outcomes, streamline staff workflows and improve your bottom line. So how can you get this non-medical information and use it to improve treatment outcomes? A person’s circumstances can help us understand potential challenges in access to care to predict their behaviors More than 80% of health outcomes are unrelated to medical care. Instead, they are attributable to outside social and economic forces, such as housing, education, unemployment, low income, transportation, access to green space, loneliness, inequality and other non-medical factors. These social determinants of health (SDOH) are the living and working conditions that come together in just the right combination to either promote or a limit a person’s health and wellbeing. As a healthcare professional, you’re no doubt aware that people struggling with financial or life circumstances have a more difficult time focusing on their health and subsequently face more urgent hardships. And it isn’t just the patients who suffer. It has a negative impact on the entire healthcare ecosystem. Why providers should care about social determinants of health When patients struggle to access healthcare services, they’re less likely to follow treatment plans or adhere to follow-up visits. They’re more likely to need to come back with more serious conditions that could have been detected earlier, had they felt equipped to follow the care plan. Not only is this worrying for the patient, but it also leads to excessive service utilization that is costly for providers. Missed appointments are estimated to cost the US healthcare system a massive $150 billion, while each unused 60-minute slot costs an average of $200. And that’s not to mention the opportunity cost of equipment and rooms sitting idle, and all those wasted hours of billable physician time. The shift to value-based care puts more pressure on providers to improve outcomes. But how can they do that when those outcomes are partially determined by factors beyond their control? Considering that 68% of patients have at least one social determinant challenge, the only sensible move is to bring solving for SDOH to the forefront of care planning. “No patient wants to skip appointments and dial 911 as their only reliable means to get the care they need,” said Karly Rowe, Experian Health vice president of product management. “We want to level the playing field by helping providers identify and solve for these socio-economic challenges that make it hard for some patients to get the care they need. SDOH has the ability to improve outcomes, lower costs and increase patient satisfaction, removing the socio-economic obstacles hindering healthcare.” An example of providers and payers collaborating to solve for social determinants of health is the Aligning for Health coalition, which in 2016 referred 33,000 patients to community initiatives. Andy Friedell, a senior vice president at Maxim Healthcare Services said of the program: “We are prioritizing community-based care and social determinant solutions for our patients and clients. In fact, we have effectively used these tools to help reduce readmissions by over 65% for high-risk patients.” How can social determinant data improve outcomes? Let’s look at two examples of how healthcare providers might analyze social determinants to help improve care management. 1. Reducing appointment no-shows For many patients, a lack of transportation is the main barrier to compliance. How do they get to an appointment or procedure if they don’t have a car, don’t live in an area well served by public transport, and can’t afford a cab? Looking at vehicle registration data and public transport services in the area would be one way for a provider to gauge access to care. But does that give the full story? Even if they can find transport, are they juggling two jobs? Do they need childcare? By synthesizing data on transportation, family arrangements, average incomes, and more, providers can anticipate the propensity of someone being unable to access care, and offer solutions such as a free hospital bus service or crèche facility. 2. Preventing escalated health conditions Understanding social determinants is not about identifying unhealthy behavior. For example, a provider might see poor health and point to poor diet. But a patient’s poor diet may not simply result from poor choices. A provider who’s aware of the potential impact of social determinants might consider the propensity of food insecurity – maybe the patient doesn’t have access to healthy food? However, putting the patient at the center and truly understanding social determinants means thinking beyond the ‘food desert’ explanation. Even where healthy food is available, the ability to eat it might be limited by lack of time to cook it, or money to buy it. The provider must adjust their lens and understand how a stressful work schedule, chaotic household and readily available cheap food converge to make it virtually impossible for the patient to even think about putting their health first with a healthy meal. As a result, a patient who could have been identified early on with symptoms indicating the onset of diabetes, for example, instead has their diagnosis delayed because they can’t get to an appointment, while their condition worsens due to their unhealthy diet. Instead of offering dietary advice or signposting to a wholesome supermarket, the provider might choose to work with a registered dietician nutritionist, direct patients to community resources, participate in community partnerships, or even engage with local planning departments and commercial developers. When you understand what drives your patients and recognize the real barriers preventing them from prioritizing or accessing healthcare, you can proactively identify opportunities to solve them. 3. Using the right data to understand and solve for social determinants of health Better care management and improved health outcomes start with understanding the whole patient and the social determinants impacting their life, and then turning those insights into actions. For providers to be proactive, preventative and patient-friendly, they need to know the patient’s socioeconomic background before they enter the room. They must have an idea of what that conversation should look like before they even say hello, and know which SDOH-related programs might be relevant to this patient. Analytics platforms can help leverage wider consumer data sets to spot patterns that affect operational efficiencies so providers can offer more patient-centered care. Of course, if you’re using consumer data, you must have confidence both in its accuracy and in your ability to safeguard consumer privacy. Both can be achieved if you work with a data management partner who can collect data from consumers at scale, with solutions that check all the privacy boxes necessary to allow this data to be used in a healthcare setting. So if you weren’t already thinking about what social determinants of health mean for your organization, perhaps think about what you could do now to incorporate a solution that tells you what patients need, provides the right amount of context to understand what external factors might be causing or affecting that need, and then solve for it at the point of care. — The solution exists to help you. You could have the power to identify and solve for social determinants at your fingertips.