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Suggested Citation:"Abstract." Institute of Medicine. 2014. Capturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2. Washington, DC: The National Academies Press. doi: 10.17226/18951.
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Abstract

Despite strong evidence of the influence of social and behavioral factors on health, these factors have not been well addressed in clinical care. The increasing emphasis on population health management is focusing more attention on the social and behavioral determinants of health, but the limited availability of information on these determinants impedes efforts to delay the onset and progression of disease and improve well-being. To provide better patient care, improve population health, and enable more informative research, standardized measures of key social and behavioral determinants need to be recorded in electronic health records (EHRs) and made available to appropriate professionals.

The Committee on the Recommended Social and Behavioral Domains and Measures for Electronic Health Records was asked to recommend core measures of social and behavioral domains for inclusion in all EHRs. It identified a parsimonious panel of measures that is comprehensive, interoperable, and efficient. These “psychosocial vital signs” include four measures that are already widely collected (race/ethnicity, tobacco use, alcohol use, and residential address) and eight additional measures (education, financial resource strain, stress, depression, physical activity, social isolation, intimate partner violence, and neighborhood median household income). While recognizing the additional time needed to collect such data and act upon it, the committee concluded that the health benefits of addressing these determinants outweigh the added burden to providers, patients, and health care systems. Advances in research in the coming years will likely point to additional measures that should be included in the panel, and periodic re-reviews should be undertaken to assess them.

Suggested Citation:"Abstract." Institute of Medicine. 2014. Capturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2. Washington, DC: The National Academies Press. doi: 10.17226/18951.
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Suggested Citation:"Abstract." Institute of Medicine. 2014. Capturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2. Washington, DC: The National Academies Press. doi: 10.17226/18951.
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Suggested Citation:"Abstract." Institute of Medicine. 2014. Capturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2. Washington, DC: The National Academies Press. doi: 10.17226/18951.
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Determinants of health - like physical activity levels and living conditions - have traditionally been the concern of public health and have not been linked closely to clinical practice. However, if standardized social and behavioral data can be incorporated into patient electronic health records (EHRs), those data can provide crucial information about factors that influence health and the effectiveness of treatment. Such information is useful for diagnosis, treatment choices, policy, health care system design, and innovations to improve health outcomes and reduce health care costs.

Capturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2 identifies domains and measures that capture the social determinants of health to inform the development of recommendations for the meaningful use of EHRs. This report is the second part of a two-part study. The Phase 1 report identified 17 domains for inclusion in EHRs. This report pinpoints 12 measures related to 11 of the initial domains and considers the implications of incorporating them into all EHRs. This book includes three chapters from the Phase 1 report in addition to the new Phase 2 material.

Standardized use of EHRs that include social and behavioral domains could provide better patient care, improve population health, and enable more informative research. The recommendations of Capturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2 will provide valuable information on which to base problem identification, clinical diagnoses, patient treatment, outcomes assessment, and population health measurement.

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