How to address social determinants of health with data

As much as 90% of health outcomes rely on social circumstances. Two patients with the same diagnosis, prescribed the same medical regime, and treated by the same doctor in the same hospital could have wildly different outcomes.

To address the disparity, you need a holistic view of the people you treat. It’s important to go beyond the clinical data in your chart. Examining your patients’ health within the context of their lives is critical. Working with them to overcome barriers has the potential to impact not only health outcomes but also patient trust and health equity.

Healthcare organizations are well aware of the importance of social determinants of health. But many are often at a loss as to how to incorporate those factors into the current healthcare system. How to address social determinants of health? Technology that supports collecting and integrating data across many systems may hold the key. Salesforce is helping address the issue with a three-pronged approach that enables organizations to:

  • Build a holistic health profile of patients
  • Improve outcomes with scalable next action steps
  • Drive patient engagement

How to address social determinants of health with a holistic profile

Compiling all contributing factors to a patient’s overall health, including social, environmental, financial, and educational, is not always easy to do. Not every system can seamlessly combine these various data sets into one actionable profile.  However, as social determinants of health data become more available, you need a way to connect this information with what you already know about your patients. 

You can then use this information to build a holistic health profile that captures patient-generated data (assessments, personal information and preferences, engagement insights held in a CRM), clinical data, and nonclinical data from outside sources.

Research shows that 71% of people want care that addresses the social, economic and environmental factors affecting their lives.

Having this information in one location lets nurses and other care managers easily understand the entirety of a patient’s situation. They can deliver individualized care that not only addresses health equity, but makes patients feel seen, cared for, and understood.

Research shows that 71% of people want care that addresses the social, economic and environmental factors affecting their lives. So much so that one differentiator between trusted providers and untrusted ones is whether or not they provide services that address the whole person. Delivering whole-person care sets the stage not only for better health outcomes but long-term patient relationships and, most importantly, more trust in the medical system.

AI helps create a proactive approach for patients 

How do you act on all of the data once you have it? Unify it with machine learning and AI in an integrated health platform. Together, they can recommend the next-best step based on what has worked for previous patients. For example, the system may recommend a virtual check-in for a patient flagged for missing hospital visits.

This type of a system allows healthcare professionals, like care coordinators, to stretch their resources and do more with less. Combining patient information with automated processes and AI capabilities not only increases efficiency, it improves intervention and patient engagement at scale.

Healthcare organizations can then run analytics across patient populations to determine which interventions have the most positive impact on health outcomes. This proactive approach assures that your care meets each individual’s specific needs.

How the right data can improve patient engagement

Understanding the circumstances of an individual’s life helps address the particular issues they may be facing. When you integrate data in one holistic health profile, you can  more intricately segment patient populations. Go beyond clinical conditions and use social factors to personalize communications, find solutions, and inspire action. For example, your team can find ride-assistance programs for patients who have trouble keeping appointments due to transportation issues. 

Shift your thinking around care management and best practices so that it focuses on health in the context of a person’s life.

Better segmentation leads to more relevant and actionable engagement. Let’s take patients with diabetes who also deal with food insecurity, for example. What if they live in a food desert and rely on food stamps? That might change the way you talk to them about proper diabetic nutrition. This level of personalization speaks to peoples’ real-life circumstances and helps a  healthcare system truly understand its patients.

Get started with a whole-person approach

Today’s healthcare organizations need to move beyond practicing care that focuses on clinical data alone. Here are some ways you can get started today:

  • Shift your thinking around care management and best practices to focus on health in the context of a person’s life. Doing this requires tools with the ability to connect and surface diverse data, act on it, and provide better care at scale.
  • Take a look at your existing systems and processes and assess how easily they connect to each other. If you can’t see all your data in one place, consider an integrated health platform to unify your data sources. You’ll have better data that gives you a clearer, more holistic picture of each of your patients and allows you to treat them accordingly. 

Implementing these tools and moving to a whole-person approach will play a significant role in helping society achieve health equity. This assures that people have access to the care they need when they need it, no matter who they are or where they come from.

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