Informatics can help providers incorporate context into care.

Area of Science:

• Health Informatics
• Public Health
• Healthcare Systems

Background:

• Determinants of health often stem from social contexts outside the traditional U.S. healthcare system.
• Healthcare providers lack a comprehensive understanding of patient challenges beyond clinical encounters.
• The shift to value-based care and widespread Electronic Health Record (EHR) adoption present opportunities to integrate contextual health factors.

Purpose of the Study:

• To address the challenge of incorporating social determinants of health (SDOH) into patient care.
• To propose the development of an informatics infrastructure to support the integration of contextual data into EHR systems.
• To outline strategies for transforming healthcare into a more proactive and preventive system.

Main Methods:

• Discussion of the "chicken-and-egg" dilemma hindering SDOH data integration: lack of evidence versus lack of infrastructure.
• Argument for prioritizing informatics infrastructure development to enable data utilization.
• Exploration of system design considerations for effective integration.

Main Results:

• Building an informatics infrastructure is crucial for leveraging contextual data in healthcare.
• EHR systems, supported by robust infrastructure, can provide clinicians with necessary tools and data.
• This transformation can shift U.S. healthcare from episodic and reactive to preventive and proactive.

Conclusions:

• Establishing an informatics infrastructure is a prerequisite for integrating social determinants of health into clinical practice.
• Prioritizing data domains, developing interoperability standards, and ensuring seamless workflow integration are key design considerations.
• The proposed infrastructure can empower clinicians to deliver more effective, proactive, and preventive healthcare.