Provenzano Anthony M, Syed Faiyaz, Platt Jodyn E, Piatt Gretchen A, Ackerman Mark S, Buyuktur Ayse, Klinkman Michael S
Department of Learning Health Sciences, Medical School, University of Michigan, Ann Arbor, MI, USA.
Michigan Primary Care Association, Lansing, MI, USA.
BMC Health Serv Res. 2025 May 9;25(1):666. doi: 10.1186/s12913-025-12821-7.
With new payment systems to prompt more sophisticated data activities, primary care practices are developing technological capabilities to manage patient care and information. One burgeoning capability is the collection of social determinants of health (SDOH) data and using that information to provide social care. This study describes the information infrastructure and technological capabilities developed by community health centers (CHCs) and examines the factors influencing SDOH data integration and management in primary care practice. It offers health care leaders insights and strategies to build capacity for managing social care and quality.
An observational design was used to examine the technological capabilities of CHCs in Michigan via a practice survey, and factors related to developing information infrastructure were qualitatively explored. The practice survey, semi-structured interviews, and national health center data were analyzed. Sociotechnical systems and organizational theories were used to develop the survey and interview guide. A sample of Michigan CHCs (n = 15) was recruited for the study. The practice survey was administered to CHC leaders, clinicians, and staff (n = 27). Semi-structured interviews (n = 25) were then conducted to explore infrastructural, organizational, and technological factors associated with managing social care and information.
Michigan CHCs developed capabilities to exchange patient information with state and local partners. Data were typically shared with maternal and infant health (n = 5, 33.3%), mental health (n = 5, 33.3%), substance use (n = 6, 40%), domestic violence (n = 6, 40%), and food assistance (n = 6, 40%) providers, but CHCs did not develop the same capabilities with all social services examined. The interviews revealed that CHCs leveraged health care and government investments in information technology (IT) as a strategy to share data and address quality. The survey results revealed that CHCs developed the ability to use SDOH data to manage population health and provide value-based care.
IT used to manage social care and address quality is necessary but insufficient in primary care settings. The technological capabilities developed to integrate SDOH data into practice and exchange health information support critical infrastructure and learning opportunities to improve care, quality, and outcomes.
随着新的支付系统促使开展更复杂的数据活动，基层医疗实践正在发展管理患者护理和信息的技术能力。一种新兴能力是收集健康的社会决定因素（SDOH）数据并利用这些信息提供社会护理。本研究描述了社区卫生中心（CHC）开发的信息基础设施和技术能力，并考察了影响基层医疗实践中SDOH数据整合与管理的因素。它为医疗保健领导者提供了有关建立管理社会护理和质量能力的见解和策略。
采用观察性设计，通过实践调查来考察密歇根州社区卫生中心的技术能力，并定性探索与开发信息基础设施相关的因素。对实践调查、半结构化访谈和国家卫生中心数据进行了分析。运用社会技术系统和组织理论来制定调查和访谈指南。招募了密歇根州社区卫生中心的一个样本（n = 15）用于该研究。对社区卫生中心的领导、临床医生和工作人员（n = 27）进行了实践调查。随后进行了半结构化访谈（n = 25），以探讨与管理社会护理和信息相关的基础设施、组织和技术因素。
密歇根州的社区卫生中心发展了与州和地方合作伙伴交换患者信息的能力。数据通常与母婴健康（n = 5，33.3%）、心理健康（n = 5，33.3%）、物质使用（n = 6，40%）、家庭暴力（n = 6，40%）和食品援助（n = 6，40%）提供者共享，但社区卫生中心在所有所考察的社会服务方面并未发展出相同的能力。访谈显示，社区卫生中心利用医疗保健和政府在信息技术（IT）方面的投资作为共享数据和解决质量问题的策略。调查结果显示，社区卫生中心发展出了利用SDOH数据管理人群健康和提供基于价值的护理的能力。
用于管理社会护理和解决质量问题的信息技术在基层医疗环境中是必要的，但并不充分。为将SDOH数据整合到实践中并交换健康信息而开发的技术能力支持了关键基础设施和学习机会，以改善护理、质量和结果。
