Tag: sdoh

Last week, I spoke at the technology briefing of a national health plan group to give a presentation on the role of consumer data and patient identity in healthcare and how social determinants of health (SDOH) can help payers improve population health and lower costs. To illustrate the importance of leveraging consumer data for SDOH outcomes, I like to use the example of Vern. Vern is 78 years old, lives alone in a lower income apartment complex and hasn’t attended a wellness check in several years. Last month, he had an unexpected trip to the emergency room (ER) due to heart disease and continues to be readmitted for his condition. But why does he keep getting readmitted? Is it because he can’t afford his prescribed medication? Is he having a difficult time finding transportation? Or could it be that when it comes to healthy eating—buying fresh product on a weekly basis is challenging for him? These are some of the SDOH that could be contributing to Vern’s readmission—not solely his now heart disease. Had his care team known more about Vern, aside from his condition, they could have proactively addressed some of his barriers to care and prevented the ER admissions—saving them from costly care episodes and preventing negative outcomes for Vern. By utilizing SDOH insights, Vern’s care team can help ‘even the playing field’ for him by understanding his non-clinical barriers to health, what key things are driving those barriers, and what makes sense to address them.  All of this, of course, underpinned by an accurate identity (but, let’s talk universal patient identification another day!). With SDOH insights, Vern’s care team could have gotten him to his wellness checks, his condition would have been detected earlier and he would have received the services he needs proactively. This would save countless dollars in repeated readmissions, ER visits and other costs associated with a chronic condition that can’t get better when your members don’t have the luxury of prioritizing health over basic needs. To avoid these missed opportunities, many healthcare organizations are turning to consumer data to understand their patients or members better. Insights on SDOH are transforming the care experience for people like Vern, as well as saving money for patients and the healthcare industry. Here are three ways consumer data is driving improvements in population health and lowering healthcare care costs at the same time: Helping patients lead healthier lives Research shows that clinical care alone is not enough to safeguard a person’s health. Up to 80% of health outcomes are attributable to non-medical factors such as your financial situation, stability of living arrangements, access to transportation and healthful food options, amongst other things. Around 68% of Americans are affected by at least one of these SDOH, which can make prioritizing good health a challenge. When healthcare organizations are more informed of the SDOH impacting their patients or members, they can take steps to help prevent avoidable hospital visits, ED utilization, appointment no-shows and worsened conditions by encouraging and facilitating earlier intervention. For example, 1 in 8 Americans are food insecure.  If care teams are able to recognize when this is an issue for the people they’re caring for—they can look at partnering with community organizations, like a local food bank or meal delivery service, to address gaps in nutrition for better health outcomes. Reducing the financial burden of healthcare expenses In the U.S., healthcare has the world’s largest gross domestic product (GDP) spending (18%).  By helping your members overcome barriers to attending appointments and potentially discovering health issues sooner, the healthcare industry can reduce the costs of healthcare. For example, 3.6 million Americans miss out on medical care due to transportation problems. If care teams knew who they were and what specifically is impacting them ahead of time, they could step in to arrange transportation or offer alternative options, like telemedicine, so problems can be detected earlier. Not only is this better for the patient’s health, it’s better financially too—emergency room visits cost an average of nearly $2,000 while inpatient hospital stays come in at an average of $10,000. When 33% of ER visits are from those experiencing homelessness—the extreme condition of housing instability—it’s imperative that we consider more than a patient’s profile from a claims or clinical data perspective. Offering a better patient experience When healthcare organizations can see each patient as a whole person, they can offer better engagement plans that make prioritizing their health a smaller mountain to climb. Does your patient prefer information by phone, text or email? Do they use their patient portal? Are there other services they might benefit from, that can help improve their health in other ways? Armed with the right data, you can answer these questions and tailor your communications with each patient, ultimately helping them achieve better outcomes. What’s more, when you leverage consumer insights to improve your population health strategies, you’ll also create a better patient experience through improved care coordination, prompt referrals and timely information sharing—making the whole process better for everyone. Translating consumer data into intelligent business decisions With reliable consumer data sourced from Experian—an original-source provider and data steward when it comes to consumer privacy—you can learn more about your patients and make the right care management decisions to address the non-clinical barriers to health impacting the health of your members and your organization. Learn more about how to leverage consumer data to help improve outcomes for your patient population. Mindy Pankoke is a Senior Product Manager for Experian Health

Most healthcare consumers spend only a tiny fraction of their lives in the clinical world of medical appointments and procedures. Where and how they spend the rest of their time has a far bigger impact on their health and well-being. So why are some providers still relying primarily on clinical data to devise their care plans? Clinical data is crucial when it comes to a patient’s diagnosis and treatment options, but it tells you nothing about their ability to stick to a care plan when they get home. How do their living situation and lifestyle habits play into the physician’s treatment recommendations? Consumer data is the missing piece of the healthcare jigsaw. When providers have insights into their patients’ social and economic circumstances, they’re better placed to spot the factors that might hinder access to care, and offer a more holistic, tailored and effective support plan. The predictive power of consumer data Let’s imagine a single mom of two small kids, working two jobs. Her daily life is a race to get everything done on time, give her children what they need and still make ends meet within her weekly budget. When a reminder for her annual wellness appointment flashes up on her phone, she adds it to her mental to-do list. But by the time the appointment comes around, the stress of taking time off work and scraping together the cash for gas or bus fare means she puts it off. She doesn’t go. Six months later, she ends up in the emergency room with symptoms of a serious illness. Had her provider known about the barriers in advance, they could have supported her to get to her appointment and discover her illness sooner. As Dr. David Berg, co-founder of Redirect Health says, “the most important part of getting good results is not the knowledge of the doctors, not the treatment, not the drug. It’s the logistics, the social support, the ability to arrange babysitting.” Consumer data, such as car ownership, employment status, income level and family information can give you these insights early enough to take action. You’ll know whether your patients can get to their appointments easily, whether they can afford childcare, and a whole host of other factors that might affect their ability to stick to a care plan. And once you know those things, you can offer tailored support to give them the best chance of success. How to gather non-clinical insights According to PwC, around 78% of providers lack the data to identify patients’ social needs. Many have basic demographic information on their patient populations, but are missing the more sophisticated insights that could help them better support patients. It doesn’t have to be complicated, but there are a few considerations healthcare providers should vet as they gather and use consumer data to help drive care plan compliance: Evaluate the pros and cons of patient surveys The obvious way to find out more about your patients’ needs is to ask them directly. A survey at the point of registration can help you understand what barriers may prevent them from attending appointments, taking prescriptions or following other medical advice. However, surveys can be time-consuming and expensive to administer, and recording answers by hand can lead to errors. How a patient interprets the questions and how your team interprets the answers may affect the usefulness of the survey data. And a patient’s circumstances may change between completing the survey and trying to follow the care plan. This approach also only includes patients who manage to attend an appointment in the first place. Those without access to care such as the mom in the example above, would be omitted from the survey, so you would miss out on discovering how to help them. Tap data vendors to deepen your consumer insights A third-party data vendor can give you access to data on your patient population’s income, occupations, length of residence and other social and economic circumstances. When this data is packaged up for your care managers, it can be used to inform proactive, preventative conversations with your patients, to solve any non-clinical gaps in care. It’s more cost-effective than patient surveys and removes the risk of personal bias and interpretation. Ensuring the reliability and integrity of your data vendor can be a challenge. Data brokers often use consumer data collected in retail and other industries, which may not be completely relevant to your activities or collected in a way that meets the requirements for use in healthcare settings. It’s crucial to be able to verify the source of the data and confirm that individuals were told how their data would be used and given the choice to opt out. Always ask your vendor if they are an “original source compiler." Working with a data vendor in the health space, such as Experian Health, can help avoid these pitfalls, as they will have expertise in the appropriate use of consumer data in healthcare. Understand permissible use of consumer data to stay compliant To use consumer data successfully, you must have confidence in both its accuracy and your ability to safeguard patient privacy. For example, are your data collection processes compliant with the General Data Protection Regulation (GDPR) and the California Consumer Privacy Act 2018 (CCPA)? Working with a data management partner who collects data directly from consumers means you can verify that all privacy requirements and opt-outs are in place. They’ll also help you scrutinize hundreds of public and proprietary data sources, so you use only the most relevant, up-to-date data to inform your decision-making. By evaluating and understanding these three areas, you’ll be able to leverage consumer data to tailor your patient engagement and support and make it easier for your patients to comply with their care plan. The more you are able to see and treat each patient as a whole, individual person, the better their health outcomes are likely to be. Consumer data lets you do that.

It’s a puzzle many healthcare providers are still working to solve: when over 80% of health outcomes are influenced by non-medical factors, how can health systems help their patients achieve better outcomes? From affording time off work so they can attend an appointment, to accessing healthy food, childcare or transport, your patients’ ability to engage with and benefit from health services can be heavily influenced by a host of social and economic dynamics Understanding these social determinants of health (SDOH) gives you a more complete picture of your patients’ health and life circumstances. You can anticipate their needs, coordinate their care more effectively, and ultimately give them a better healthcare experience. What’s more, harnessing the right data on SDOH leads to smarter investment and operational decisions, yielding advantages for your health system as a whole. That’s why many providers are starting to use non-medical consumer data in their care management planning. Here we look at some of the top use cases for SDOH data. 5 top use cases for data on social determinants of health     Reduce missed appointments No-shows cost providers an average of $200 each (plus a lot of wasted physician time). Often these are down to lack of access to transportation or childcare. SDOH data can help you anticipate where these challenges might occur, so you can offer additional services like a free shuttle bus or crèche. You’ll make the experience a little easier for the patient, and potentially prevent an unchecked health issue from becoming something more serious.     Save costs from preventable health events Unfortunately, life circumstances can lead to many people using health services in a way that could be avoided. Missed appointments or difficulty following a care plan can lead to escalating medical issues, entailing more treatment and readmissions. Patients might also fall back on emergency services because they can’t easily access appropriate alternatives. SDOH data helps you understand the circumstances that might lead to this kind of patient behavior. For example, if you can spot patients who may be likely to dial 911 because they have no other way to get to the health services they need, you can offer alternatives that avoid an unnecessary visit to the ED. This could help you save up to $2000 per Emergency Department visit and around $10,000 for each hospital stay (which often can’t be fully reimbursed if the patient ends up being readmitted).     Increase care plan compliance A patient’s living situation can often determine whether or not they’ll be able to stick to their care plan. For example, specific dietary advice can be a real challenge for a diabetic patient if they have a limited food budget, lack of time to shop and prepare food, or a plain lack of options of where to buy it. An SDOH needs assessment can flag this in advance so clinicians can help patients find a plan that will work for them. Similarly, pharmacies might use consumer data to help minimize abandoned prescriptions or situations where a patient fails to follow dosage directions, which is estimated to cost the industry $290 billion per year.     Save administrative and clinical time Analyzing consumer data can help your operations run more efficiently, which benefits your patients through well-coordinated care, timely information sharing and prompt referrals. Many providers are taking advantage of automated solutions for leveraging SDOH data, saving massive amounts of administrative time for care managers by pre-populating patient data and automating SDOH needs assessments. Consumer insights solutions like Experian Health’s ConsumerView analytics can optimize operational efficiencies and ensure your care managers use their time well.     Investing in relevant community health programs One of the most impactful use cases for SDOH data is to gain a richer understanding of your member base, so you can invest in the most relevant community health programs. For example, a 2018 pilot project by Atrium Health in North Carolina screened for food insecurity in older patients who may have been at risk of readmission. Emergency food services were provided where needed, and as a result, readmissions dropped by 60%. Your purchasing power can also be a force for change. The Cleveland Clinic outsourced its laundry service to Evergreen Cooperative Laundry, a local collaborative working to combat poverty. Ralph Turner, executive director of patient support services at the Cleveland Clinic says: “Establishing the foundation for people to stabilize their incomes and become part owners in a business… in itself generates health and wellbeing in our community.” Leveraging consumer data to improve patient outcomes These examples show some of the varied ways screening for social determinants of health can open the door to understanding your patients and creating truly person-centered care services. Who knows what opportunities are hidden in the SDOH data for your patient population? Are there gaps in your data? Could you combine different data sets for a fuller picture? What exactly is your consumer data telling you, and how do you turn it into meaningful management decisions? At Experian Health, we have comprehensive data assets and analytics platforms to help you answer these questions and more, and leverage consumer data most effectively.