{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T22:21:04Z","timestamp":1787696464189,"version":"build-2784847793"},"reference-count":33,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T00:00:00Z","timestamp":1675209600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Population Health Management"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:p>There is increased acceptance that social and behavioral determinants of health (SBDH) impact health outcomes, but electronic health records (EHRs) are not always set up to capture the full range of SBDH variables in a systematic manner. The purpose of this study was to explore rates and trends of social history (SH) data collection\u20141 element of SBDH\u2014in a structured portion of an EHR within a large academic integrated delivery system. EHR data for individuals with at least 1 visit in 2017 were included in this study. Completeness rates were calculated for how often SBDH variable was assessed and documented. Logistic regressions identified factors associated with assessment rates for each variable. A total of 44,166 study patients had at least 1 SH variable present. Tobacco use and alcohol use were the most frequently captured SH variables. Black individuals were more likely to have their alcohol use assessed (odds ratio [OR] 1.21) compared with White individuals, whereas White individuals were more likely to have their \u201csmokeless tobacco use\u201d assessed (OR 0.92). There were also differences between insurance types. Drug use was more likely to be assessed in the Medicaid population for individuals who were single (OR 0.95) compared with the commercial population (OR 1.05). SH variable assessment is inconsistent, which makes use of EHR data difficult to gain better understanding of the impact of SBDH on health outcomes. Standards and guidelines on how and why to collect SBDH information within the EHR are needed.<\/jats:p>","DOI":"10.1089\/pop.2022.0209","type":"journal-article","created":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T13:31:45Z","timestamp":1673011905000},"page":"13-21","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Trends and Patterns of Social History Data Collection Within an Electronic Health Record"],"prefix":"10.1177","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1758-9822","authenticated-orcid":false,"given":"Elyse C.","family":"Lasser","sequence":"first","affiliation":[{"name":"Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA."},{"name":"Johns Hopkins Center for Population Health IT, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly A.","family":"Gudzune","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA."},{"name":"Department of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harold","family":"Lehman","sequence":"additional","affiliation":[{"name":"Pediatrics Department, Johns Hopkins School of Medicine, Baltimore, Maryland, USA."},{"name":"Johns Hopkins Biomedical Informatics and Data Sciences, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hadi","family":"Kharrazi","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA."},{"name":"Johns Hopkins Center for Population Health IT, Baltimore, Maryland, USA."},{"name":"Johns Hopkins Biomedical Informatics and Data Sciences, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan P.","family":"Weiner","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA."},{"name":"Johns Hopkins Center for Population Health IT, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,2,14]]},"reference":[{"key":"e_1_3_6_2_2","unstructured":"Institute of Medicine (US). Committee on the Recommended Social and Behavioral Domains and Measures for Electronic Health Records. Capturing social and behavioral domains and measures in electronic health records: phase 2. National Academies Press: Washington DC; 2014. Library of Congress #: 2014959444."},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2016.0723"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2017.1252"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2016.03.150172"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocv088"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-019-05447-z"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.ogx.0000465303.29687.97"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2019.07.014"},{"key":"e_1_3_6_10_2","unstructured":"University of San Francisco California. Social Interventions Research & Evaluations Network. 2022. Available from: https:\/\/sirenetwork.ucsf.edu\/ [Last accessed: August 1 2020]."},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2017.01.170046"},{"key":"e_1_3_6_12_2","first-page":"227","article-title":"A multi-site content analysis of social history information in clinical notes","volume":"2011","author":"Chen ES","year":"2011","unstructured":"Chen ES, , Manaktala S, , Sarkar IN, et al. A multi-site content analysis of social history information in clinical notes. AMIA Annu Symp Proc, 2011; 2011:227\u2013236. 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Available from: https:\/\/www.hopkinsacg.org\/documents\/version-12-0\/ [Last accessed: December 8 2022]."},{"key":"e_1_3_6_21_2","doi-asserted-by":"publisher","DOI":"10.1177\/0165025413515405"},{"key":"e_1_3_6_22_2","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2008.365"},{"key":"e_1_3_6_23_2","unstructured":"CMS. Medicare & Medicaid EHR Incentive Program: Meaningful use stage 1 requirements overview. Available from: https:\/\/www.cms.gov\/Regulations-and-Guidance\/Legislation\/EHRIncentivePrograms\/downloads\/mu_stage1_reqoverview.pdf [Last accessed: August 1 2020]."},{"key":"e_1_3_6_24_2","unstructured":"CMS. Stage 2 Eligible Professional Meaningful Use Core Measures Measure 5 of 17. 2012. Available from: https:\/\/www.cms.gov\/Regulations-and-Guidance\/Legislation\/EHRIncentivePrograms\/downloads\/Stage2_EPCore_5_RecordSmokingStatus.pdf [Last accessed: August 1 2020]."},{"key":"e_1_3_6_25_2","unstructured":"Centers for Medicare & Medicaid Services. Electronic Clinical Quality Measures Basics. 2020. Available from: https:\/\/www.cms.gov\/Regulations-and-Guidance\/Legislation\/EHRIncentivePrograms\/ClinicalQualityMeasures [Last accessed: August 1 2020]."},{"key":"e_1_3_6_26_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13722-020-00198-3"},{"key":"e_1_3_6_27_2","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000004071"},{"key":"e_1_3_6_28_2","doi-asserted-by":"publisher","DOI":"10.1111\/add.14234"},{"key":"e_1_3_6_29_2","doi-asserted-by":"publisher","DOI":"10.1080\/00952990.2019.1676433"},{"key":"e_1_3_6_30_2","doi-asserted-by":"publisher","DOI":"10.1177\/1062860619833306"},{"key":"e_1_3_6_31_2","doi-asserted-by":"publisher","DOI":"10.1089\/pop.2020.0043"},{"key":"e_1_3_6_32_2","doi-asserted-by":"publisher","DOI":"10.1177\/1077558712466293"},{"key":"e_1_3_6_33_2","unstructured":"United States Census Bureau. Quick Facts Maryland. 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