The American Academy of Nursing has released a policy brief that endorses the capturing of social and behavioral determinants of health in the electronic health record (EHR). The policy brief identifies several recommendations for health care industry leaders to foster standardization and promote interoperability.
The policy brief is published in the September/October issue of the Academy’s journal, Nursing Outlook.
“There is strong evidence that social and behavioral factors influence health; however, they may not be addressed in clinical care for shared decision-making. It is imperative that all stakeholders in health care collaborate to include this information in electronic records, including EHR vendors, health systems, providers and funders,” said Academy CEO, Cheryl Sullivan.
The policy brief states the Academy’s support for recommendations put forth by the Institute of Medicine (IOM) in a 2014 report, “Capturing Social and Behavioral Domains and Measures in Electronic Health Records (Phase 1 and Phase 2).” Identified barriers to the implementation of IOM’s phase 2 recommendations include:
- Lack of commitment to standardization of clinical practice, documentation and data.
- Lack of consistency and ease-of-use of clinical workflow within EHR technology.
- Need for increased patient empowerment and culture of trust.
These barriers prohibit the adoption of a standardized assessment panel of approximately 20 questions put forth by the IOM addressing: Alcohol use; Race/Ethnicity; Residential address; Tobacco use; Median household income; Depression; Educational attainment; Financial resource strain; Intimate partner violence for women of reproductive age; Physical activity; Social isolation; and Stress.
The policy brief states:
“…The recommended action steps of multi-stakeholders will begin to address the global changes that must be made in clinical practice to assure EHRs capture and permit sharing of contextual patient information, promote shared decision-making, enhance appropriate inter-professional planning/providing of health care services and facilitate monitoring of patterns of health and outcomes of care for entire populations.”
About the American Academy of Nursing
The American Academy of Nursing serves the public and the nursing profession by advancing health policy and practice through the generation, synthesis, and dissemination of nursing knowledge. The Academy’s more than 2,300 fellows are nursing’s most accomplished leaders in education, management, practice, and research. They have been recognized for their extraordinary contributions to nursing and health care.