Today, most analytics teams are designed for retrospective analysis, not prospective. While the shift to prospective analysis is underway, the need for retrospective analysis continues. As we move forward, we need to focus our information stewardship responsibility to insure we all serve demands that we be worthy of the public’s trust.
This plea is for a Prospective Analytic Focus on Social Determinants of Health (SDOH).
Providers are focusing on understanding how SDOH data could be turned into insights. Providers want to better understand their markets’ health needs so that they can be responsive. An example was provided by a Health System Data Scientist who was exploring potential health insights from voter registration data.
The Payers are increasingly interested in measuring and enabling the effectiveness of SDOH initiatives to improve people’s health status. Insurers are less interested in “what” constitutes social determinants-related activity. The investment in said activities is not a major concern.
Google has applied for a patent on a technology that predicts individualized-at-the-point-of-care clinical outcomes by applying deep learning to records from millions of patients’ untapped Electronic Medical Record (EMR) data. Using stored, aggregated Electronic Health Record (EHR) data from diverse patients, including clinical notes where SDOH data may be lurking, Google’s technology is purported to predict one or more future clinical events and summarize pertinent past medical events related to the predicted event.
Could this work? To start, you need to focus on finding, acquiring and integrating publicly available data, syndicated SDOH, existing payer data and existing provider data. (No Problem….) Need an example of ‘easy’? Think for a second how easy it was for said Data Scientist to navigate the individual state laws on who can access what data elements of voter registration lists…..
But if health professionals better understand the pertinent factors in patients’ lives, then we can proactively focus on the specified target demographics to drive down healthcare costs and improve health outcomes. Everyone can win.
Governmental policies and community-based programs have a major impact on our physical environments. The quality of our drinking water, the housing available to us and our community’s transportation system are easy examples. Programs and Policies also play a major role in our social and economic factors. Employment opportunities, the safety of our community, education available to children and adults, as well as access to quality clinical care is are major drivers. Health behaviors and lifestyle choices such as tobacco use, exercise and sexual behavior, are all impactful.
Based on Research at the University of Wisconsin’s Population Health Institute, the four primary social determinants that drive our health outcomes are:
- 40% Socio-economic factors (education, employment, income, social and family support, community safety.
- 30% Health behaviors (tobacco use, diet & exercise, alcohol and drug use, sexual activity)
- 20% Clinical Care (access to, and quality of)
- 10% Physical environment (air and water quality, housing, transit)
So how to create insights that improve health outcomes and reduce costs from this information?. UW’s Institute for Research on Poverty has shed light on how existing health policies are incapable of responding to health needs of today’s US families. A Majority of U.S. children will not spend their entire childhood living with both biological parents.
Additionally, most children born to unmarried parents will live in complex family situations and experience family fluidity and parental multi-partnered fertility. Even with considering differences in resources at birth, father absence and family complexity and fluidity, there are numerous sub-optimal outcomes that can be directly tied to these populations, including greater mental and physical health problems as these children grow into adulthood.