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Appl Clin Inform 2023; 14(05): 883-892
DOI: 10.1055/s-0043-1774819
CIC 2022

Social and Health Information Platform: Piloting a Standards-Based, Digital Platform Linking Social Determinants of Health Data into Clinical Workflows for Community-Wide Use

Anjum Khurshid
1   Department of Population Medicine, Harvard Medical School, Boston, Massachusetts
,
Matti Hautala
2   Department of Population Health, Dell Medical School at The University of Texas at Austin, Texas
,
Eliel Oliveira
2   Department of Population Health, Dell Medical School at The University of Texas at Austin, Texas
,
Vidya Lakshminarayanan
2   Department of Population Health, Dell Medical School at The University of Texas at Austin, Texas
,
Vishal Abrol
2   Department of Population Health, Dell Medical School at The University of Texas at Austin, Texas
,
Joshua Collier
2   Department of Population Health, Dell Medical School at The University of Texas at Austin, Texas
,
Justin Rosseau
2   Department of Population Health, Dell Medical School at The University of Texas at Austin, Texas
,
Linda Granado
2   Department of Population Health, Dell Medical School at The University of Texas at Austin, Texas
,
Shreya Nallaparaju
2   Department of Population Health, Dell Medical School at The University of Texas at Austin, Texas
,
Kanishka Mitra
2   Department of Population Health, Dell Medical School at The University of Texas at Austin, Texas
,
Rania Sohail
2   Department of Population Health, Dell Medical School at The University of Texas at Austin, Texas
› Author Affiliations Funding The SHIP development was funded by the Michael and Susan Dell Foundation through a multi-year grant to the University of Texas at Austin. We are also grateful to our collaborators and co-designers at Lone Star Circle of Care, People's Community Clinic, findhelp, Connxus, the United Way of Greater Austin's Navigation Center team, and many others in the community that helped lay the groundwork for SHIP and Model Community through decades of arduous cross-sector work.
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Abstract

Background Social determinants of health (SDoH)[a] are increasingly recognized as a main contributor to clinical health outcomes, but the technologies and workflows within clinics make it difficult for health care providers to address SDoH needs during routine clinical visits.

Objectives Our objectives were to pilot a digital platform that matches, links, and visualizes patient-level information and community-level deidentified data from across sectors; establish a technical infrastructure that is scalable, generalizable, and interoperable with new datasets or technologies; employ user-centered codesign principles to refine the platform's visualizations, dashboards, and alerts with community health workers, clinicians, and clinic administrators.

Methods We used privacy-preserving record linkage (PPRL) tools to ensure that all identifiable patient data were encrypted, only matched and displayed with consent, and never accessed or stored by the data intermediary. We used limited data sets (LDS) to share nonidentifiable patient data with the data intermediary through a health information exchange (HIE) to take advantage of existing partner agreements, technical infrastructure, and community clinical data.

Results The platform was successfully piloted in two Federally Qualified Health Clinics by 26 clinic staff. SDoH and demographic data from findhelp were successfully linked, matched, and displayed with clinical and demographic data from the HIE, Connxus. Pilot users tested the platform using real-patient data, guiding the refinement of the social and health information platform's visualizations and alerts. Users emphasized the importance of visuals and alerts that gave quick insights into individual patient SDoH needs, survey responses, and clinic-level trends in SDoH service referrals.

Conclusion This pilot shows the importance of PPRL, LDS, and HIE-based data intermediaries in sharing data across sectors and service providers for scalable patient-level care coordination and community-level insights. Clinic staff are integral in designing, developing, and adopting health technologies that will enhance their ability to address SDoH needs within existing workflows without adding undue burdens or additional stress.

Keywords

social determinants of health - digital platform - health information platform - population health - health information exchange

Protection of Human Subjects

This study was performed in compliance with federal regulations regarding personally identifiable health information, the University of Texas at Austin's Information Security Office (ISO) testing and review policies, and the University of Texas at Austin's Institutional Review Board (IRB) for Human Subjects Research (Protocol Number 2020–04–0067).


a Also known as “social drivers of health” or “non-medical drivers of health (NDoH).”




Publication History

Received: 20 March 2023

Accepted: 21 July 2023

Article published online:
08 November 2023

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