Moving Electronic Medical Records Upstream Incorporating Social Determinants of Health
Moving Electronic Medical Records Upstream Incorporating Social Determinants of Health
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DOI：
10.1016/j.amepre.2014.07.009
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发表时间：
2015-02-01
影响因子：
5.5
通讯作者：
Sandel, Megan T.
中科院分区：
文献类型：
--
作者：
Gottlieb, Laura M.;Tirozzi, Karen J.;Sandel, Megan T.
背景资料：在过去25年中，人们对社会因素与健康之间的生物学途径和机制的了解呈指数级增长，但在大多数临床环境中，围绕健康的社会决定因素进行筛查和干预并不是标准临床护理的一部分。电子病历为临床环境中评估和管理社会需求提供了新的机会，特别是为弱势群体服务的社会需求。目的：说明在电子病历中捕获与健康的社会决定因素相关的信息并促进干预措施的可行性。方法：三个案例研究，其中电子病历已被用来收集数据，并解决社会健康决定因素的临床结果：从这些案例研究中，我们确定了电子医疗记录可以执行的多种功能，以促进将健康的社会决定因素整合到临床系统中，包括筛查、分诊、转诊、跟踪和数据共享。如果与激励、培训和隐私相关的障碍能够被克服，电子病历系统可以改善将健康的社会决定因素纳入保健服务系统的情况。在建议广泛采用之前，需要更多的证据来评估这种整合对医疗保健结果的影响。(C)2015年美国预防医学杂志
Background: Knowledge of the biological pathways and mechanisms connecting social factors with health has increased exponentially over the past 25 years, yet in most clinical settings, screening and intervention around social determinants of health are not part of standard clinical care. Electronic medical records provide new opportunities for assessing and managing social needs in clinical settings, particularly those serving vulnerable populations.Purpose: To illustrate the feasibility of capturing information and promoting interventions related to social determinants of health in electronic medical records.Methods: Three case studies were examined in which electronic medical records have been used to collect data and address social determinants of health in clinical settings.Results: From these case studies, we identified multiple functions that electronic medical records can perform to facilitate the integration of social determinants of health into clinical systems, including screening, triaging, referring, tracking, and data sharing.Conclusions: If barriers related to incentives, training, and privacy can be overcome, electronic medical record systems can improve the integration of social determinants of health into health care delivery systems. More evidence is needed to evaluate the impact of such integration on health care outcomes before widespread adoption can be recommended. (C) 2015 American Journal of Preventive Medicine