{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T06:49:34Z","timestamp":1782456574352,"version":"3.54.5"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2021,9,21]],"date-time":"2021-09-21T00:00:00Z","timestamp":1632182400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"The Lisa & John Pritzker Family Fund"},{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["K12HS026383"],"award-info":[{"award-number":["K12HS026383"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["KL2TR001870"],"award-info":[{"award-number":["KL2TR001870"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Electronic Health Records (EHRs) increasingly include designated fields to capture social determinants of health (SDOH). We developed measures to characterize their use, and use of other SDOH data types, to optimize SDOH data integration.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>We developed 3 measures that accommodate different EHR data types on an encounter or patient-year basis. We implemented these measures\u2014documented during encounter (DDE) captures documentation occurring during the encounter; documented by discharge (DBD) includes DDE plus documentation occurring any time prior to admission; and reviewed during encounter (RDE) captures whether anyone reviewed documented data\u2014for the newly available structured SDOH fields and 4 other comparator SDOH data types (problem list, inpatient nursing question, social history free text, and social work notes) on a hospital encounter basis (with patient-year metrics in the Supplementary Appendix). Our sample included all patients (n\u2009=\u200927 127) with at least one hospitalization at UCSF Health (a large, urban, tertiary medical center) over a 1-year period.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We observed substantial variation in the use of different SDOH EHR data types. Notably, social history question fields (newly added at study period start) were rarely used (DDE: 0.03% of encounters, DBD: 0.26%, RDE: 0.03%). Free-text patient social history fields had higher use (DDE: 12.1%, DBD: 49.0%, RDE: 14.4%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Our measures of real-world SDOH data use can guide current efforts to capture and leverage these data. For our institution, measures revealed substantial variation across data types, suggesting the need to engage in efforts such as EHR-user education and targeted workflow integration.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Measures revealed opportunities to optimize SDOH data documentation and review.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocab194","type":"journal-article","created":{"date-parts":[[2021,9,8]],"date-time":"2021-09-08T11:36:27Z","timestamp":1631100987000},"page":"2608-2616","source":"Crossref","is-referenced-by-count":87,"title":["Documentation and review of social determinants of health data in the EHR: measures and associated insights"],"prefix":"10.1093","volume":"28","author":[{"given":"Michael","family":"Wang","sequence":"first","affiliation":[{"name":"Center for Clinical Informatics & Improvement Research, University of California, San Francisco, San Francisco, California, USA"},{"name":"Department of Medicine, University of California, San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew S","family":"Pantell","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA"},{"name":"Center for Health and Community, University of California, San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura M","family":"Gottlieb","sequence":"additional","affiliation":[{"name":"Center for Health and Community, University of California, San Francisco, San Francisco, California, USA"},{"name":"Social Interventions Research and Evaluation Network, University of California, San Francisco, San Francisco, California, USA"},{"name":"Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Adler-Milstein","sequence":"additional","affiliation":[{"name":"Center for Clinical Informatics & Improvement Research, University of California, San Francisco, San Francisco, California, USA"},{"name":"Department of Medicine, University of California, San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,9,21]]},"reference":[{"issue":"11","key":"2021120106305128500_ocab194-B1","first-page":"e393","article-title":"Health systems tackling social determinants of health: promises, pitfalls, and opportunities of current policies","volume":"22","author":"Chaiyachati","year":"2016","journal-title":"Am J Manag Care"},{"issue":"6","key":"2021120106305128500_ocab194-B2","doi-asserted-by":"crossref","first-page":"890","DOI":"10.3122\/jabfm.2019.06.190138","article-title":"The association between neighborhood socioeconomic and housing characteristics with hospitalization: results of a National Study of Veterans","volume":"32","author":"Hatef","year":"2019","journal-title":"J Am Board Fam Med"},{"issue":"11","key":"2021120106305128500_ocab194-B3","doi-asserted-by":"crossref","first-page":"1764","DOI":"10.1093\/jamia\/ocaa143","article-title":"Social determinants of health in electronic health records and their impact on analysis and risk prediction: a systematic review","volume":"27","author":"Chen","year":"2020","journal-title":"J Am Med Inform Assoc"},{"issue":"16","key":"2021120106305128500_ocab194-B4","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1056\/NEJMsa1103216","article-title":"Neighborhoods, obesity, and diabetes\u2014a randomized social experiment","volume":"365","author":"Ludwig","year":"2011","journal-title":"N Engl J Med"},{"issue":"11","key":"2021120106305128500_ocab194-B5","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1038\/nrcardio.2009.163","article-title":"Socioeconomic status and cardiovascular disease: risks and implications for care","volume":"6","author":"Clark","year":"2009","journal-title":"Nat Rev Cardiol"},{"issue":"6","key":"2021120106305128500_ocab194-B6","doi-asserted-by":"crossref","first-page":"e206445","DOI":"10.1001\/jamanetworkopen.2020.6445","article-title":"Effects of in-person navigation to address family social needs on child health care utilization: a randomized clinical trial","volume":"3","author":"Pantell","year":"2020","journal-title":"JAMA Netw Open"},{"issue":"2","key":"2021120106305128500_ocab194-B7","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1089\/pop.2020.0043","article-title":"Assessing the impact of social needs and social determinants of health on health care utilization: using patient- and community-level data","volume":"24","author":"Hatef","year":"2021","journal-title":"Popul Health Manag"},{"key":"2021120106305128500_ocab194-B8","year":"2019"},{"key":"2021120106305128500_ocab194-B9","author":"Adler","year":"2016"},{"issue":"3","key":"2021120106305128500_ocab194-B10","doi-asserted-by":"crossref","first-page":"e13802","DOI":"10.2196\/13802","article-title":"Assessing the availability of data on social and behavioral determinants in structured and unstructured electronic health records: a retrospective analysis of a multilevel health care system","volume":"7","author":"Hatef","year":"2019","journal-title":"JMIR Med Inform"},{"issue":"2","key":"2021120106305128500_ocab194-B11","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1111\/1475-6773.12670","article-title":"Hospital readmission and social risk factors identified from physician notes","volume":"53","author":"Navathe","year":"2018","journal-title":"Health Serv Res"},{"issue":"12","key":"2021120106305128500_ocab194-B12","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1097\/MLR.0000000000001418","article-title":"Utilization of social determinants of health ICD-10 Z-codes among hospitalized patients in the United States, 2016-2017","volume":"58","author":"Truong","year":"2020","journal-title":"Med Care"},{"issue":"5","key":"2021120106305128500_ocab194-B13","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1370\/afm.2275","article-title":"Adoption of social determinants of health EHR tools by community health centers","volume":"16","author":"Gold","year":"2018","journal-title":"Ann Fam Med"},{"key":"2021120106305128500_ocab194-B14","doi-asserted-by":"crossref","first-page":"S65","DOI":"10.1016\/j.amepre.2019.07.014","article-title":"Variation in electronic health record documentation of social determinants of health across a National Network of Community Health Centers","volume":"57 (6 Suppl 1","author":"Cottrell","year":"2019","journal-title":"Am J Prev Med"},{"issue":"2","key":"2021120106305128500_ocab194-B15","doi-asserted-by":"crossref","first-page":"e13849","DOI":"10.2196\/13849","article-title":"Incorporating social determinants of health in electronic health records: qualitative study of current practices among top vendors","volume":"7","author":"Freij","year":"2019","journal-title":"JMIR Med Inform"},{"issue":"11","key":"2021120106305128500_ocab194-B16","doi-asserted-by":"crossref","first-page":"833","DOI":"10.7326\/M14-2308","article-title":"Considering the role of socioeconomic status in hospital outcomes measures","volume":"161","author":"Krumholz","year":"2014","journal-title":"Ann Intern Med"},{"key":"2021120106305128500_ocab194-B17"},{"key":"2021120106305128500_ocab194-B18"},{"issue":"17\u201318","key":"2021120106305128500_ocab194-B19","doi-asserted-by":"crossref","first-page":"E474","DOI":"10.1503\/cmaj.160177","article-title":"Taking action on the social determinants of health in clinical practice: a framework for health professionals","volume":"188","author":"Andermann","year":"2016","journal-title":"CMAJ"},{"key":"2021120106305128500_ocab194-B20","doi-asserted-by":"crossref","first-page":"S133","DOI":"10.1097\/MLR.0000000000001029","article-title":"Implementing an EHR-based screening and referral system to address social determinants of health in primary care","volume":"57 (Suppl 6 Suppl 2","author":"Buitron de la Vega","year":"2019","journal-title":"Med Care"},{"issue":"5","key":"2021120106305128500_ocab194-B21","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1093\/jamia\/ocaa010","article-title":"Unmet information needs of clinical teams delivering care to complex patients and design strategies to address those needs","volume":"27","author":"Cohen","year":"2020","journal-title":"J Am Med Inform Assoc"}],"container-title":["Journal of the American Medical Informatics Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jamia\/article-pdf\/28\/12\/2608\/41325309\/ocab194.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jamia\/article-pdf\/28\/12\/2608\/41325309\/ocab194.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T10:00:54Z","timestamp":1638352854000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jamia\/article\/28\/12\/2608\/6373497"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,21]]},"references-count":21,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2021,9,21]]},"published-print":{"date-parts":[[2021,11,25]]}},"URL":"https:\/\/doi.org\/10.1093\/jamia\/ocab194","relation":{},"ISSN":["1527-974X"],"issn-type":[{"value":"1527-974X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,12,1]]},"published":{"date-parts":[[2021,9,21]]}}}