Perspect Health Inf Manag. 2022 Mar 15;19(Spring):1g. eCollection 2022 Spring.
The use of the electronic health record (EHR) system to identify and address social determinants of health (SDOH) in vulnerable patients is still lacking, and examples for customizing the EHR to meet the workflows of clinical and administrative professionals are missing. We custom designed and built into the Epic EHR a SDOH screening tool integrated with a community resource network management (CRNM) software-as-a-service (SaaS) platform to systematically identify and address SDOH in Medicare and Medicaid beneficiaries across multiple clinical care settings. We further describe our workflow redesign and EHR implementation process to maximize SDOH screening and referral efficiency. The SDOH EHR solution has been operationally used over three years by staff to screen 111,486 Medicare and Medicaid beneficiaries, identify 7,878 SDOH, and refer 6,103 high-risk beneficiaries to community resources. Transforming an EHR into a catalyst software to support SDOH screening and referral in a clinical setting is an interdisciplinary process that benefits from various technical, administrative, and clinical experts that provide subject matter knowledge into all phases of the build.
电子健康记录（EHR）系统在识别和解决弱势群体的健康社会决定因素（SDOH）方面的应用仍有所欠缺，而且缺乏针对 EHR 进行定制以满足临床和行政专业人员工作流程的示例。我们专门为 Epic EHR 设计并构建了一个 SDOH 筛选工具，该工具与社区资源网络管理（CRNM）软件即服务（SaaS）平台集成，以系统地识别和解决医疗保险和医疗补助受益人在多个临床护理环境中的 SDOH 问题。我们进一步描述了我们的工作流程重新设计和 EHR 实施过程，以最大程度地提高 SDOH 筛选和转介效率。该 SDOH EHR 解决方案已经在临床环境中由工作人员操作使用了三年多，共对 111,486 名医疗保险和医疗补助受益人进行了筛查，确定了 7,878 项 SDOH，并向社区资源转介了 6,103 名高风险受益人。将 EHR 转变为支持临床环境中的 SDOH 筛选和转介的催化剂软件是一个跨学科的过程，需要各种技术、行政和临床专家提供主题知识，以涵盖构建的所有阶段。
