AMA, UnitedHealthcare Tackling Social Determinants of Health

UnitedHealthcare and AMA are launching a collaborative effort to more effectively identify and address social determinants of health.   

By Kate Monica

April 02, 2019 - AMA and UnitedHealthcare announced a new collaborative initiativeintended to standardize the collection, processing, and integration of social determinants of health (SDOH) data.

Through the initiative, the organizations hope to more efficiently address SDOH to improve access to care for different patient populations and improve patient health outcomes.

The initiative builds on existing work by UnitedHealthcare centered on addressing social and environmental factors that may contribute to patient treatment.

“UnitedHealthcare and the AMA share a common goal of expanding the health care system’s perspective to consider the whole person – not just medical care – by placing as much emphasis on people’s social needs as on their clinical needs,” said UnitedHealthcare Clinical Services President Bill Hagan.

“By working together to leverage data, technology and the incredible expertise of our network physicians, we can more effectively address the social factors that limit access to health care,” Hagan added.

SDOH data quantifies nonmedical issues including diet, housing, transportation, economic status, and other factors that may influence patient health. UnitedHealthcare and AMA will work to develop a consistent, organized way to capture SDOH data and incorporate this information into each patient’s treatment plan.

Additionally, the organizations will support the development of nearly twenty-four new ICD-10 codes related to SDOH. The codes will combine medical data with self-reported SDOH to trigger referrals to social and government services capable of addressing the diverse needs of patients.

“The AMA is excited to work with UnitedHealthcare through the continuing efforts of our Integrated Health Model Initiative (IHMI) to foster collaboration around innovative data and technology-driven processes for incorporating social determinants of health into routine medical care,” said Tom Giannulli, AMA IHMI CMIO.

“The collaboration reinforces the importance of social and environmental factors in patient care, and will shape IHMI’s efforts to support clinical decisions with useful and valid data to achieve broad improvements in health and greater health equity,” Giannulli continued.

By providing a set of standardized SDOH data, UnitedHealthcare and AMA plan to equip healthcare organizations with the information necessary to connect patients with local resources.

ICD-10 codes are typically used to classify and record diagnoses, symptoms, treatments, and procedures. The data model developed by UnitedHealthcare focuses on standardizing SDOH-related data.

UnitedHealthcare currently partners with national and local community-based organizations focused on expanding access to social services for patients across the country. So far, UnitedHealthcare has facilitated more than 700,000 social service referrals for patients in its Medicare Advantage plans using the data model.

AMA’s integrated health model initiative (IHMI) is dedicated to improving health data exchange standards to achieve semantic interoperability and support health IT innovation. The initiative focuses on market-driven needs and develops common data exchange standards to improve health data sharing and boost patient health outcomes.

In addition to promoting the standardization of SDOH data, AMA is also taking steps to streamline health IT implementations for healthcare organizations.

In October 2018, AMA released a Digital Health Implementation Playbook offering providers recommendations for navigating each phase of the EHR vendor selection and implementation process.

The guidance outlines steps, best practices, and resources for providers and hospital staff looking to streamline the adoption and scale of health IT solutions across care settings.

The playbook includes three parts and addresses aspects of the EHR implementation process including EHR integration, implementation, and optimization.

“Align your goals to the quadruple aim of healthcare,” wrote AMA. “By focusing on health outcomes, improving the patient experience, and reducing cost and/or increasing provider satisfaction, you will inevitably impact the end user, care team or patient in a positive way.”

Following recommendations in the playbook may help healthcare organizations get the most out of their health IT investments.

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