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.
