Family Physicians Debate Social Determinants of Health

HealthLandscape has long recognized the value of Social Determinants of Health - the idea that socioeconomic and demographic characteristics play significant roles in influencing health outcomes. This idea has been gaining traction over the past few years, with organizations such as the Centers for Disease Control and Prevention releasing new guidelines on Health Outcomes and Determinants.

In their March/April 2016 issue, the Annals of Family Medicine ran three pieces discussing the integration of social determinants of health into primary care practice.

Alongside our colleagues at OHSU and OCHIN, Dr. Andrew Bazemore and Jené Grandmont represented the HealthLandscape team in the authorship of the main editorial article, "Perspectives in Primary Care: A Conceptual Framework and Path for Integrating Social Determinants of Health Into Primary Care Practice." This editorial discusses the importance of incorporating social determinants of health into the process of care. The article addresses the idea of standardizing the SDoH to be collected at the point of care, in line with the 11 domains recommended by the National Academy of Medicine in their 2014 report "Capturing Social and Behavioral Domains and Measures in Electronic Health Records." Further, the piece begins to explore an integration framework, considering how SDoH might best be used for practice and research.

The follow-up point/counterpoint section features two physicians debating the benefits of placing social determinants of health onto a primary care physician's already overloaded plate. While both writers recognize the value of incorporating patient and community data, opinions differ on what the physician's role in that process should be and how effectively a physician can use that information to help their patients.

It will be interesting to see where these conversations take us in the world of health care delivery, and we're excited to be a part of it.

Want more information about social determinants of health? Visit our Population Health Mapper to explore community characteristics and health outcomes in your area or check out the HealthLandscape Community Vitals API, a powerful tool that allows researchers and others to append extracts of the HealthLandscape community data pool to their de-identified clinical records in order to study the impact of social and behavioral factors on health outcomes.

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Esri Health Conference, 2015

Mark Carrozza, Dirctor of HealthLandscape, recently blogged about the idea that "Place Matters," especially when it comes to health and health care. It was fitting, then, that HealthLandscape had two presentations on the agenda at this year's Esri Health Conference, which was themed "Making Place Matter."

Our first presentation was an overview of two HealthLandscape tools - The Medicare Data Portal and Accountable Care Organization (ACO) Explorer. The aim of these tools is to help put the power of geographic visualization in the hands of researchers and policy makers. 

The Medicare Data Portal engages decision-makers and researchers with county and Hospital Referral Region (HRR) data from the Centers for Medicare & Medicaid (CMS) Geographic Variation database and the Chronic Conditions Warehouse. Users are able to visualize health outcome, cost, and demographic data for the Medicare population using maps, graphs, and trend charts. Users also have the ability to examine the relationship between two indicators (for example, Inpatient Costs and Diabetes) with side-by-side maps and a comparison tool that uses percentiles to visualize the relationship between variables. Users can choose from over 100 indicators across 6 categories, including Medicare Population data, Chronic Conditions, Utilization, Costs, Multiple Chronic Conditions, and Dartmouth Measures.

The ACO Explorer presents data for 211 Accountable Care Organizations, or ACOs. As part of the Affordable Care Act, new models of health care delivery have been developed, aimed at improving the quality of care while reducing costs. ACOs are being touted as potential solutions for the inefficiency and fragmentation of the U.S. healthcare system.  ACOs are made up of groups of doctors, hospitals, and other health care providers that coordinate care for Medicare beneficiaries. The tool allows users to visualize 33 quality metrics across five domains, which are compared against benchmarks set by CMS. Each point represents an accountable care organization. When you hover over or click on a specific site, flared rollover windows will appear that contain data about the quality measures included in each of the five domains, which will be colored red, yellow, or green based on their value respective to the thresholds. 

This set of tools can be accessed at www.healthlandscape.org/ACOExplorer/map.cfm. For more detailed information, check out our previous blog post, or sign up for an upcoming webinar.

In addition to the more traditional paper sessions, the conference plenary session featured a round of Lightning Talks, where each presenter had a strict 5 minute window in which to present their ideas. Mark presented the HealthLandscape GeoEnrichment API, a HIPAA-compliant Data as a Service (DaaS) solution that appends multiple geographic identifiers and small-area community characteristics to individual data. This project involves integrating social determinants of health data into patient level data to yield a broader view of the environmental and social risks specific to each patient by indicating whether patient lives in the presence of factors such as poverty, healthy food sources, walkable streets and parks, social capital, and much more.  

We're very excited about all of the possible applications of this simple, but powerful, tool, and we look forward to sharing our ideas and plans in future blog posts.

Jené Grandmont
Senior Manager, Application Development and Data Services
HealthLandscape

Report From Esri User Conference 2015

The Esri International User Conference takes place each summer in San Diego, California. The HealthLandscape application is built on the esri ArcGIS platform, so we regularly attend the conference to discuss our work and to stay current in esri technology and trends. It’s a great opportunity to mingle with other data geeks, learn some new tips and tricks, and see what kinds of new and exciting projects our peers are working on. As always, the agenda was packed full of interesting sessions, educational opportunities, and user group meetings.

This year, I had the opportunity to present two moderated session papers on behalf of the team. Both presentations discussed the importance of looking at patients in the context of their home communities, but from two very different perspectives; public health research and individual practitioners.

Accelerating Data Value Across a National CHC Network introduced the new HealthLandscape Geocode API, which allows organizations to append community and social determinants data to patient-level data: giving them a unique way to enrich their investigations of patient-centered outcomes. Appending these types of data will allow for the exploration of clinical and disease-oriented service areas, hotspots, and coldspots. The Community Context of Health Center Patients focused on how we can use population-based big data and geospatial technologies to understand the social and environmental influences on the health of a physician’s patient panel through the idea of Community Vital Signs - as patient vital signs provide a biometric snapshot of an individual’s health status, community vital signs provide an environmental health perspective. Taken together, we can improve the care that patients are receiving. Both of these projects will be featured as detailed blog posts in the coming weeks.

In addition to our paper presentations, HealthLandscape was once again recognized as one of the top three GIS applications in the User Conference Applications Fair. The HealthLandscape Population Health Mapper builds upon the idea of “Place Matters,” a concept discussed in a recent blog. Users can select county-level metrics from seven categories identified by the CDC as recommended Health Outcomes and Health Determinants, using a slider bar to set thresholds and easily identify counties that perform poorly compared to the national average. We've highlighted this tool on the blog and will be hosting a “Population Health Mapper” webinar on Wednesday, August 19th. Click here to register, or contact us by email for more information.

I always enjoy the time that I spend at the Esri User Conference and I never fail to return home with new collaboration opportunities, new skills, and new ideas. I’m thrilled to take home another HealthLandscape award this year, too.

Jené Grandmont
Senior Manager, Application Development and Data Services
HealthLandscape