What are Social Determinants of Health (SDOH)?
Health encompasses many facets of our lives and is more than physical well-being. Health begins in our homes, neighborhoods, schools, communities, and workplaces and is influenced by a number of factors. According to the World Health Organization, “social determinants of health are the conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels.”
Why are SDOH and ICD-10-CM Coding for SDOH important?
SDOH data captures information at a level traditional health data sources cannot. By integrating SDOH insights into care plans, healthcare stakeholders can recognize the need for, and enable access to, additional services or interventions for individuals, such as programs related to accessing healthy food, providing reliable housing, or helping patients manage isolation and loneliness, ultimately driving better health and wellness outcomes. ICD-10-CM Z codes can be used to record this information, directly into patient records, offering deeper insights into factors impacting health. The eHealth Resource Center has a wealth of information on the benefits of SDOH, including eHI's paper on the importance of SDOH Data. Read eHI's ICD-10-CM Coding for SDOH project summary for a deeper understanding of the topic and eHI Explains ICD-10-CM Coding for SDOH for a brief overview.
ICD-10-CM Coding for SDOH Project
- What is the eHealth Initiative ICD-10-CM Coding for SDOH Collaboration?
eHealth Initiative and UnitedHealthcare’s (UHC) National Strategic Partnerships Division convened a collaborative meeting of leaders from payer organizations and other stakeholder groups to address the use of ICD-10-CM codes for capturing SDOH data. This meeting marked a significant milestone in the shift to value-based care. Despite the competitive nature of healthcare, the private sector is working together to address factors pertinent to patient care and well-being in a sustainable, scalable manner.
- What resources can I use to better understand ICD-10-CM Coding for SDOH?
ICD-10-CM Coding for SDOH project summary
eHI Explains ICD-10-CM Coding for Social Determinants of Health
Coder Tool - Transforming health care: Why including SDOH codes on claims is critical
Provider Tool - Using SDOH coding to transform health outcomes are available for use
- Who collaborated on the ICD-10-CM coding project?
Aetna, American Health Information Management Association (AHIMA), American Hospital Association (AHA), eHealth Initiative, Higmark Health, Humana, Kaiser Permanente, Missouri Hospital Association, National Committee for Quality Assurance (NCQA), OptumCare, UnitedHealthcare, UnitedHealth Group, URAC
- Where can I find the webinar slides?
The webinar slides are in the eHealth Resource Center and will the webinar recording will be added to this page as well, https://www.ehidc.org/resources/webinar-presentation-transforming-health-social-determinants-health-coding.
- What are industry stakeholders saying?
- “Using the Z codes for social determinants of health helps hospitals and health systems to better track patient needs and identify solutions to improve the health of their communities. The use of SDOH data from the electronic health record (EHR) for clinical, operational, and research purposes can facilitate tracking, identification, and referrals to social and governmental services. To assign ICD-10-CM codes for social determinants of health, coding professionals may use documentation from a physician or any other person authorized to document in the patient’s medical record, such as a nurse or social worker.”
-- Nelly Leon-Chisen, RHIA, Director, Coding and Classification, American Hospital Association
- “Social-needs gaps – such as isolation, loneliness and food insecurity – make it hard to have a happy, healthy, purposeful life, and that has a tremendous impact on overall well-being, “Standardized screening and code capturing can reveal these upstream impacts on health and create richer data that helps physicians, care managers, social workers and home health professionals meet our members’ needs more proactively. The result is better care and better health outcomes at a lower cost.”
-- Caraline Coats, Humana’s Vice-President of Bold Goal & Population Health Strategy
Guiding Principles for Ethical Use of Social Determinants of Health Data Project
- What are the Guiding Principles for Ethical Use of Social Determinants of Health Data and why are they necessary?
eHI's Guiding Principles for Ethical Use of Social Determinants of Health Data offers guidance on the evolving matter of Social Determinants of Health (SDOH) and its related data use for healthcare purposes. Using SDOH is unchartered territory in both policy and practice. eHI puts forth an ethical framework for SDOH data. As the benefits of addressing SDOH become further substantiated and data insights become more mainstream, it is important to ensure that data is collected and used with clearly defined ethical standards and transparency. Download the Guiding Principles.
- How were the Guiding Principles for Ethical Use of Social Determinants of Health Data developed?
The Guiding Principles for Ethical Use of Social Determinants of Health Data were developed as part of a SDOH collaborative. eHI is an independent, non-profit organization that convenes executives from various healthcare stakeholder groups to discuss, identify, and share best practices, which transform the delivery of healthcare. The work of the SDOH collaborative focused on educating and guiding industry stakeholders and policy makers on the value of leveraging SDOH data for maximum good in healthcare, while addressing SDOH privacy and security concerns. eHI rolled out the Guiding Principles document during a policy briefing on Capitol Hill and with a press release.
- Who was involved in the Guiding Principles eHI collaborative process?
The list of individuals who participated is long and inclusive. Organizations involved included: American Health Information Management Association (AHIMA), America’s Health Insurance Plans (AHIP), Allscripts, Amazon Web Services (AWS), American Cancer Society, American College of Cardiology, American College of Physicians, American College of Radiology, athenahealth BDO, Care Compass Network, CareSource, Cerner, Change Healthcare, CHRISTUS Health Cognizant, CRISP, eHealth Initiative, EHNAC, Epstein Becker & Green, George Washington University—Milken Institute School of Public Health, Google Cloud, HealthCore, HL7® International, Hogan Lovells, Inovalon, InterSystems, Johnson & Johnson, LexisNexis Health Care, LifeWIRE, Manatt Health, Marshfield Clinic, Mayo Clinic, Med Allies, Medical Group Management Association (MGMA), National Alliance of Healthcare Purchaser Coalitions, NextGen Healthcare, Noridian Healthcare Solutions, Ohio Health, Orion Health, Point-of-Care Partners, PwC, Providence St. Joseph Health, Salesforce, Solera Health, Sonora Quest Laboratories, Strategic Interests, University of Chicago Medicine, Updox, Validic, Verato, Welldoc, Wellmark, Zipnosis
- What did I miss at the SDOH Guiding Principals Policy Briefing?
This briefing featured the official release of eHI's Guiding Principles for the Ethical Use of Social Determinants of Health Data document on the value of leveraging SDOH data for maximum good in healthcare. Jennifer Covich Bordenick, CEO of eHealth Initiative, moderated a panel of leaders from consumer, provider, and payer groups who provided their perspectives on the value of SDOH data and its appropriate use. Speakers included:
- Leonard Lichtenfeld, MD, MACP, Chief Medical Officer (interim) at the American Cancer Society, who discussed how consumers understand and use SDOH for cancer treatment
- Bradley Wolters, Director, Federal Government Relations at Marshfield Clinic, who spoke about how providers use SDOH data for medical decisions and providing resources to patients in out-of-clinic care
- Karin VanZant, VP, Integrated Community Partnerships at CareSource, who discussed how payers hope to achieve a better understanding of risk, better patient engagement, and more effective use of existing treatment resource