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Screening for social determinants of health (SDOH) is increasingly done in primary and specialty care settings. Payers and health care organizations have recognized the importance of these determinants not just to clinical outcomes but also to cost and use of services. Toward that end, both clinical and financial cases have been made for an expanded focus on SDOH for many, if not all, patients. Which patients should be screened, how to screen them, and how to incorporate these data in medical records and care plans remain unclear. Harmonizing documentation of social determinant of health data—for health care organizations, community-based organizations and payers—is critical to ensure SDOH assessment and mitigation are standardized, trackable for individuals and populations, and formalized in health reform efforts.
Health care institutions seeking to implement SDOH as part of a routine medical visit have historically faced three major systems challenges: