ONC develops toolkit to support communities, achieve health equity

The Office of the National Coordinator for Health Information Technology has developed a toolkit that gathers community engagement, health IT standards, infrastructure, interoperability and governance information to help support communities working to achieve health equity.

Why it matters
Non-uniform data collection, varied healthcare system designs and differences in information technology capacities can challenge SDOH service coordination.

ONC seeks to advance the use of interoperable, standardized data to represent social needs and conditions and in 2021, organized a panel of experts within the health and human service ecosystem to identify key considerations for interoperability and implementation of SDOH information exchange.

The toolkit is built around community readiness and stewardship, policy, financing, user support and learning networks.

ONC designed the SDOH Toolkit as a practical guide for collaborative assessment, design, implementation and governance of health IT systems, according to a new blog post announcing its availability.

Structured around 10 foundational elements, the toolkit includes questions for consideration that can aid community groups and healthcare organizations as they build or expand on SDOH data initiatives.

“We’ve designed this resource as a useful starting point for use across sectors, contexts and communities to support efforts to inform health equity and more informed care,” said ONC officials.

In March 2022, ONC also launched the SDOH Information Exchange Learning Forum to explore the foundational elements of SDOH. More than 1,500 people came together, sharing lessons learned, highlighting challenges and promising approaches and engaging in peer-to-peer learning.

Among other insights, the forum found that governance intersects across all foundational elements of the SDOH Information Exchange framework.

“Participants frequently mentioned the importance of representation from various entities in the community in governance processes, especially individuals receiving services, community-based organizations and social service providers,” ONC said in the toolkit.

SDOH information exchange efforts require time and investment to build capacity and trust to ensure community alignment, ONC says.

To that end, the toolkit contains case studies that highlight governance and implementation strategies. One of those case studies, HealthierHere in King County, Washington, is community-owned and governed by a 27-member governing board.

HealthierHere is creating a unified network infrastructure to provide shared access to data, such as longitudinal records and bi-directional closed-loop referrals that provide visibility into other organizations providing care.

“Using a collective action approach, HealthierHere addresses health equity, social determinants of health and delivery system reform by making sure the voices of community members, consumers, tribal healthcare providers and traditional medicine practitioners are embedded in health system transformation planning and decision-making efforts early and often,” according to the new SDOH toolkit.

The larger trend
Social determinants account for a substantial amount of health outcomes – as much as 80%, according to some researchers.

But big barriers remain to wider use of SDOH in clinical settings. For just one example, consider a recent report that showed how health equity is hindered by SDOH coding roadblocks.

Disparate and siloed data from multiple sources in the public and private sectors, each with its own structures, challenge communities to collect and react to SDOH data.

“The challenges can be overcome with digitization of the data, forming a longitudinal health record for the patient across different data sets for better predictive and risk score analysis, and by ensuring that data is shared in a secure and permissioned basis only,” said Rahul Sharma, CEO of HSBlox, an SDOH platform vendor.

Sharma told Healthcare IT News in 2021 that providers, community-based organizations, payers and other community stakeholders can work together to deploy collaborative technology that helps to optimize care coordination.

On the record
“Underpinning the information exchange efforts are the IT systems that collect, share and use SDOH data, which can include both community- and individual-level data on access to food, housing, education, transportation and other factors associated with health,” said ONC researchers in the new toolkit’s executive summary.

“With improved capacities to share electronic SDOH information, service providers can deliver coordinated, high-quality, person-centered care to improve the health of individuals and communities.” Healthcare IT News