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      How 6 Organizations Developed Tools and Processes for Social Determinants of Health Screening in Primary Care : An Overview

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          Abstract

          Little is known about how health care organizations are developing tools for identifying/addressing patients' social determinants of health (SDH). We describe the processes recently used by 6 organizations to develop SDH screening tools for ambulatory care and the barriers they faced during those efforts. Common processes included reviewing literature and consulting primary care staff. The organizations prioritized avoiding redundant data collection, integrating SDH screening into existing workflows, and addressing diverse clinic needs. This article provides suggestions for others hoping to develop similar tools/strategies for identifying patients' SDH needs in ambulatory care settings, with recommendations for further research.

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          Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: a systematic review.

          Amit X Garg, Neill K. J. Adhikari, Heather McDonald … (2005)
          Developers of health care software have attributed improvements in patient care to these applications. As with any health care intervention, such claims require confirmation in clinical trials. To review controlled trials assessing the effects of computerized clinical decision support systems (CDSSs) and to identify study characteristics predicting benefit. We updated our earlier reviews by searching the MEDLINE, EMBASE, Cochrane Library, Inspec, and ISI databases and consulting reference lists through September 2004. Authors of 64 primary studies confirmed data or provided additional information. We included randomized and nonrandomized controlled trials that evaluated the effect of a CDSS compared with care provided without a CDSS on practitioner performance or patient outcomes. Teams of 2 reviewers independently abstracted data on methods, setting, CDSS and patient characteristics, and outcomes. One hundred studies met our inclusion criteria. The number and methodologic quality of studies improved over time. The CDSS improved practitioner performance in 62 (64%) of the 97 studies assessing this outcome, including 4 (40%) of 10 diagnostic systems, 16 (76%) of 21 reminder systems, 23 (62%) of 37 disease management systems, and 19 (66%) of 29 drug-dosing or prescribing systems. Fifty-two trials assessed 1 or more patient outcomes, of which 7 trials (13%) reported improvements. Improved practitioner performance was associated with CDSSs that automatically prompted users compared with requiring users to activate the system (success in 73% of trials vs 47%; P = .02) and studies in which the authors also developed the CDSS software compared with studies in which the authors were not the developers (74% success vs 28%; respectively, P = .001). Many CDSSs improve practitioner performance. To date, the effects on patient outcomes remain understudied and, when studied, inconsistent.
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            Patient reported outcome measures in practice.

            Eugene C Nelson, Elena Eftimovska, Cristin Lind … (2015)
            Article 0 comments Cited 208 times – based on 0 reviews     Review now
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              Addressing social determinants of health at well child care visits: a cluster RCT.

              Arvin Garg, Sarah Toy, Yorghos Tripodis … (2015)
              To evaluate the effect of a clinic-based screening and referral system (Well Child Care, Evaluation, Community Resources, Advocacy, Referral, Education [WE CARE]) on families' receipt of community-based resources for unmet basic needs.
              Article 0 comments Cited 169 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Ambul Care Manage
                Journal ID (iso-abbrev): J Ambul Care Manage
                Journal ID (publisher-id): JAMCM
                Title: The Journal of Ambulatory Care Management
                Publisher: Wolters Kluwer Health, Inc.
                ISSN (Print): 0148-9917
                ISSN (Electronic): 1550-3267
                Publication date (Print): January 2018
                Publication date (Electronic): 04 October 2017
                Volume: 41
                Issue: 1
                Pages: 2-14
                Affiliations
                Mailman School of Public Health, Columbia University, New York (Ms LaForge); Kaiser Permanente Center for Health Research, Portland, Oregon (Drs Gold and Mss Bunce and Hollombe); OCHIN, Inc, Portland, Oregon (Drs Gold and Cottrell and Ms Dambrun); Oregon Health & Science University, Portland, Oregon (Drs Cottrell, Cohen, and Clark); and National Association of Community Health Centers, Bethesda, Maryland (Dr Proser).
                Author notes
                [*] Correspondence: Kate LaForge, MPH, School of Nursing, Oregon Health & Science University, 3455 SW US Veterans Hospital Rd, Portland, OR 97239 ( laforge@ 123456ohsu.edu ).
                Article
                Accession ID: jamcm4101p2
                DOI: 10.1097/JAC.0000000000000221
                PMC ID: 5705433
                PubMed ID: 28990990
                SO-VID: 6a186b1a-c025-410e-970c-bd0770ca98ff
                Copyright © © 2018 The Authors. Published by Wolters Kluwer Health, Inc.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

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                Categories
                Subject: Original Articles
                Custom metadata
                OPEN-ACCESS TRUE

                Keywords: ambulatory care,community health centers,data collection,electronic health records,patient-reported outcome measures,primary care,screening,social determinants of health
                Data availability:
                Keywords: ambulatory care, community health centers, data collection, electronic health records, patient-reported outcome measures, primary care, screening, social determinants of health

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