Capturing Social and Behavioral Domains and Measures in Electronic Health Records Phase 2 (2014) / Chapter Skim
Currently Skimming:
5 Recommended Core Domains and Measures
5 Recommended Core Domains and Measures
Pages 227-236
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 227... ...
To recommend core measures of social and behavioral domains for inclusion in all electronic health records (EHRs) , the committee sought to identify a parsimonious panel of measures that would be complete, interoperable, and efficient.
|
From page 228... ...
• Best ways to interviews change behavior in subgroups Behavioral • Stress: • Take into account • Service planning • Direct effects on § General • Screen and follow up literacy in • Characterize disease onset, § Childhood history • At entry management of population progression, (ACES) patients and response to • Negative mood and • Reduction in risk treatment affect level
|
From page 229... ...
treatment • Benefit of group • Interaction with visits genetic factors Individual-Level Social Relationships and Living Conditions • Patient address • Verify every visit • Identify • Identify resources • Role of built and • Use address to geocode • Update on address individual's access and hazards social environment median household change to resources affecting on health income and racial/ and exposure to populations behaviors and on ethnic composition hazards disease onset and (census-tract) progression Neighborhoods and Communities 229
|
From page 230... ...
The use of social and behavioral information made accessible in the EHR varies by level and domain. Assessing the risk associated with the patient's profile should inform diagnosis and enable more effective treatment plans that set goals with patients for promoting health and reducing disability that take into account the patient's social context, behaviors, and psychosocial risks (HealthIT.gov, no date)
|
From page 231... ...
However, it is worth noting that the direct and indirect pathways connecting some domains to health have been subject to extensive scientific investigation, whereas other domains remain to have the key processes identified. Perhaps most proximal to health are the identified behavioral domains, which directly affect biological pathways affecting disease onset and progression.
|
From page 232... ...
NOTE: Q = question(s) ; bolded items = measures routinely collected.
|
From page 233... ...
In addition to identifying individual measures with the most favorable combination of usefulness and readiness, the committee aspired to construct a coherent panel that, taken together, would minimize overlap and fill gaps in knowledge about patients and populations. Rather than maximizing the usefulness of each individual measure, an ideal panel
|
From page 234... ...
. The committee makes direct analogy between the physiologic vital signs and the psychosocial vital signs intending to create a parsimonious panel of characteristics that are easy to measure and broadly applicable to all individuals.
|
From page 235... ...
Candidate Domains Applied criteria: strength of 17 Domains Selection association with health; and clinical, population health, and research usefulness Measure Identification Domain workgroups 17 Domains/31 Measures conducted literature reviews of measures Measure set identified based on psychometric properties Parsimonious Applied criteria: readiness 11 Domains/12 Measures Measurement Panel (standard measure, Construction feasibility, lack of sensitive information) ; usefulness for inclusion in the EHR; and overall committee judgment NOTE: EHR = electronic health record; SBD = social and behavioral determinants.
|
From page 236... ...
Recommendation 5-2: The Office of the National Coordinator for Health Information Technology and the Centers for Medicare & Med icaid Services should include in the certification and Meaningful Use regulations addition of standard measures recommended by this com mittee for eight social and behavioral domains: educational attainment, financial resource strain, stress, depression, physical activity, social isolation, intimate partner violence (for women of reproductive age) , and neighborhood median-household income.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.