This month, I’ve invited a guest blogger to share her thoughts with us. Ruth Ann Craven is Hixny’s Manager of Programs and Outreach. In her role, she positions primary and specialty care practices for success in quality improvement and reporting. Ruth Ann has found success in helping providers transition from fee-for-service to value-based payment models.
The COVID-19 pandemic has highlighted the longstanding problem of health disparities, defined by Healthy People 2020 as “a particular type of health difference that is closely linked with economic, social, or environmental disadvantage.” While often viewed through the lens of race/ethnicity and socioeconomic status, health disparities occur across multiple dimensions, referred to as social determinants of health (SDoH)—including age, geography, language, gender and disability.
In his blog last month, Hixny’s CEO Mark McKinney discussed the ways we, as health information networks (HINs), can help close some of the gaps that result from SDoH to improve vaccination numbers. But how can we work together with providers to overcome the impacts of social and physical environments—especially right now when access to care is crucial not just for individuals, but for public health?
Part of the answer, and maybe the most critical, is to identify and document SDoH that may be creating barriers to receiving care. Without this, we are taking educated guesses as to the reason large populations aren’t getting the care they need—up to and including the COVID-19 vaccine.
Prior to January of this year, SDoH information may have been considered a “nice to have” for providers. While it was valuable information, there wasn’t a focus on encouraging identification and documentation. On January 21, however, new evaluation and management (E/M) codes took effect. The new codes allow providers to factor SDoH into medical decision making—increasing the dollars available to them. With new standard codes in place for diagnosis of SDoH, this information can easily be documented and shared across electronic health record (EHR) and HIN systems.
This information is no longer a “nice to have” but a “need to have.” Especially as we look forward in the pandemic. Informed and targeted outreach and engagement of persons who might not otherwise receive the COVID-19 vaccination is possible because SDoH information is available.
In fact, there are resources to help identify the broad categories of SDoH your community may struggle with that are impeding vaccination efforts. Using New York as an example, the COVID-19 Vaccine Coverage Index (CVAC) indicates the state overall has a “low” level of concern when it comes to vaccine access. However, there is variation from county-to-county, and there are areas within our region where SDoH include:
- Language barriers that limit awareness of the benefits of vaccination, who is eligible for immunization, how much they cost and how/where to be vaccinated
- Geographically rural areas without ready access to hospitals or pharmacies distributing the vaccine
- Economic hardship, limiting access to the internet and transportation
While the COVID-19 vaccination effort is a perfect example, the benefits of shared SDoH go far beyond the pandemic. As a community, we can work together to improve health equity and decrease disparity using the tools already available to us—and now is the time to begin that effort.
If you are a Hixny participant and would like to contribute SDoH to the HIN, we’ve created a resource to help you get started.