As the social determinants of health continue to take center stage, organizations must consider the tools that enable SDOH and social services referrals.
– Considering EHR integration, use by community health partners, and how to measure return on investment (ROI) will be essential for healthcare organizations looking to tap new patient engagement technology to manage social determinants of health referrals, according to three separate reports from KLAS Research.
The data, obtained via email, looks at the strengths and weaknesses of three different patient engagement technology vendors focusing on the social determinants of health (SDOH). These tools are emerging technologies in the healthcare space, KLAS pointed out, and so benefit from significant opportunity for early learning.
SDOH, although a long-recognized aspect of public health, are just recently being revered as essential to the patient healthcare experience. As value-based care continues to take hold, more medical professionals recognize the role that social health risks play in positive outcomes.
But the path to actually integrating SDOH into medical care is only now beginning to be paved, according to Mike Davis of KLAS Research.
“Currently, many healthcare networks have not established the communication and data-sharing partnerships that facilitate the efficient treatment of these patients,” Davis wrote in an August 2019 blog post. “Most provider networks have few interactions with community health centers or social services, and when they do interact, these relationships are informal at best.”
Technology is starting to step in to formalize those relationships, Davis observed.
“In some cases, organizations are looking at self-developing SDOH data collection and analysis,” he explained. “The in-house solution is best suited for healthcare organizations that have robust application development, database administration, and data scientist skill sets. Healthcare organizations that do not have this level of IT capability are best suited for evaluating and implementing turnkey commercial solutions that are supplied by several vendors.”
As healthcare organizations begin to consider either off-the-self or in-house SDOH technology solutions, they will have to consider how the tool integrates with the EHR, how it demonstrates ROI, and how it engages the community health partners on which SDOH interventions rely.
Through a series of KLAS Spotlight reports, the research firm looked at both the strengths and challenges of emerging patient engagement and SDOH technology and what that says about purchasing considerations going forward.
Each of these technologies offer providers with an SDOH screening and analytics function to understand patient social needs, as well as referral functions to help connect patients with social services.
Most recently, KLAS published its report on Healthify, which yields a 50 percent customer approval rate. Tool benefits include insights into care gaps and intuitive user interface. Healthify users told KLAS that they are optimistic about the tool’s use into the future.
But the technology also faces challenges with EHR integration, avenues to assessing ROI, and user demand for more features.
“Continued success will be impacted by Healthify’s ability to build out a more sophisticated referral data schema to identify more detailed information on service activities and outcomes associated with the referral service,” the KLAS report authors said. “Healthify will also need to extend their mobile device connectivity for tablets and smartphones to true mobile application solutions.”
What’s more, healthcare organizations will need to consider how they will use the SDOH technology to assess their own ROI for social services programming. Specifically, organizations may consider looking at reduced emergency department readmissions or medication adherence as measures for SDOH program success.
Ultimately, KLAS said it sees success for Healthify once more social services organizations adopt the technology. Widespread adoption paired with industry need for connectivity could lead more healthcare organizations to adopt the tool or stick with the tool in the long-term.
KLAS also looked into a similar product, Aunt Bertha, in another recent report.
Aunt Bertha boasts a low price tag, strong community partner and provider relationships, and tech support. But the technology likewise struggles with EHR integration, staff adoption, and clarity around community engagement during product go-lives.
“We could have been better prepared for the whole process of build and rollout. We learned a lot of lessons and shared them with Aunt Bertha because we felt like we could have been better informed about some things,” one anonymous user said. “If we had been better informed, the process to get the site up would have been quicker, and curating our resource list would have been simpler. The vendor’s project management could have been improved from our initial start-up.”
Leadership at Aunt Bertha said it does offer EHR integration.
“We offer three Epic integrations and soon, a fourth will be on its way,” Aunt Bertha CEO Erine Gray said in an email statement. “We were also the first vendor in this space to be approved by CMS to report on the Accountable Health Communities grant projects across the nation. In addition, we have a nonprofit product team supporting closed-loop referral tools for nonprofits as well. Because of our holistic approach, customers and users see value on day one.”
“Our customers choose us because we put the Seeker, the person in need, at the center of all we do,” Gray continued. “This focus has brought more than 240 customers and 3 million users to the Aunt Bertha network, aligned in the mission to provide dignity and privacy with self-navigation and referrals. Because we work within, and also outside of healthcare, our customer integrations and data sharing collaborations span education, workforce, state government and other sectors. We’re proud that 100% of respondents would choose us again.”
Organizations tapping this technology or others like it will need to remember the community partners the tool will also affect. In addition to giving providers a referral tool, these technologies impact community partners by introducing a new patient or client management system.
“What relationships currently exist with these community services? How can relationships tied to key services be expanded? What key data needs to be shared, and what are the most efficient ways to share that data?” KLAS posited. “Without knowing the answers to these questions, it will be difficult to successfully choose and implement a social network solution.”
Healthcare organizations should communicate with community health partners during the implementation of this technology to understand what considerations will need to be made on their end. Specifically, healthcare entities and community partners should discuss the extent to which they will need to exchange and view data and how to integrate the tool into respective EHRs or content management systems.
Finally, KLAS looked at NowPow, a health technology that performs many of the same functions as Healthify and Aunt Bertha. The tool allows providers to collect and assess patient SDOH data and make community health referrals from there.
NowPow is highly-regarded for its executive leadership and receptiveness to user feedback. The technology is also reportedly easy to use, leaving users optimistic about it moving forward.
However, users also reported implementation challenges, desire for more functionality, and a push for EHR integration.
“Our customers are early adopters and innovators in the field of community referral technology, and we view their feedback as a gift,” NowPow’s CEO Rachel Kohler wrote in an email. “Our team has worked hand in hand with them to overcome initial hiccups, add new functionality like tracked referral longitudinal notes and milestones, and drive toward seamless integrations. I believe this collaboration is why 100% reported to KLAS they would buy again.”
Kohler also noted that NowPow expanded its solution on the Epic App Orchard last year. The platform securely integrates with EHR, HIE, telehealth, CRM and many other types of systems using the FHIR standard, Kohler said.
“SDoH solutions will be more successful if they are integrated into the EHR patient care workflows,” the KLAS researchers wrote. “Interoperability between EHR and SDoH solutions should be conducted with FHIR standards. Mobile device platforms should span iPhone and Android environments.”
It will be important for SDOH tools to help, not burden, the medical professionals using them. While these patient engagement tools offer the opportunity to help providers refer patients to key social services, they also introduce the risk of clinician burnout similar to EHR use has.
Organizations will have to assess these tools before purchase or in-house buildout to ensure they truly deliver on the promise of improved patient care, Davis concluded in his blog post.
“ We expect SDOH applications to be a critical component for healthcare organizations who are moving to higher levels of at-risk or capitated contracts for present and future patient populations,” he said. “Strategies for evaluating, implementing, and assessing SDOH applications in initial controlled environments will enable higher levels of success for healthcare organizations with this emerging environment.”
Editor’s Note 4/28/2020: This article has been updated with quotations from NowPow CEO Rachel Kohler and Aunt Bertha CEO Erine Gray.