Southcentral Foundation, Research Department, Anchorage, AK, USA.
Int J Circumpolar Health. 2021 Dec;80(1):1943983. doi: 10.1080/22423982.2021.1943983.
Social, environmental, and behavioural factors impact human health. Integrating these social determinants of health (SDOH) into electronic health records (EHR) may improve individual and population health. But how these data are collectedand their use in clinical settings remain unclear. We reviewed efforts to integrate SDOH into EHR in the U.S. and Canada, especially how this implementation serves Indigenous peoples. We followed an established scoping review process, performing iterative keyword searches in subject-appropriate databases, reviewing identified works' bibliographies, and soliciting recommendations from subject-matter experts. We reviewed 20 articles from an initial set of 2,459. Most discussed multiple SDOH indicator standards, with the National Academy of Medicine's (NAM) the most frequently cited (n = 10). Common SDOH domains were demographics, economics, education, environment, housing, psychosocial factors, and health behaviours. Twelve articles discussed project acceptability and feasibility; eight mentioned stakeholder engagement (none specifically discussed engaging ethnic or social minorities); and six adapted SDOH measures to local cultures . Linking SDOH data to EHR as related to Indigenous communities warrants further exploration, especially how to best align cultural strengths and community expectations with clinical priorities. Integrating SDOH data into EHR appears feasible and acceptable may improve patient care, patient-provider relationships, and health outcomes.
社会、环境和行为因素会影响人类健康。将这些健康的社会决定因素（SDOH）整合到电子健康记录（EHR）中可能会改善个人和人群的健康状况。但是，这些数据是如何收集的，以及它们在临床环境中的使用情况仍不清楚。我们回顾了美国和加拿大将 SDOH 整合到 EHR 中的努力，特别是这种实施如何为原住民服务。我们遵循了既定的范围综述过程，在适当的主题数据库中进行迭代关键字搜索，审查已确定的作品的参考文献，并征求主题专家的建议。我们从最初的 2459 篇文章中审查了 20 篇文章。大多数文章讨论了多个 SDOH 指标标准，其中国家医学院（NAM）被引用最多（n=10）。常见的 SDOH 领域包括人口统计学、经济学、教育、环境、住房、社会心理因素和健康行为。有 12 篇文章讨论了项目的可接受性和可行性；8 篇文章提到了利益相关者的参与（没有专门讨论与少数民族或社会少数群体的参与）；6 篇文章适当地将 SDOH 措施调整到当地文化中。将 SDOH 数据与 EHR 相关联，以涉及原住民社区，这需要进一步探讨，特别是如何最好地将文化优势和社区期望与临床重点结合起来。将 SDOH 数据整合到 EHR 中似乎是可行且可以接受的，可能会改善患者护理、医患关系和健康结果。
