{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:54:32Z","timestamp":1789779272763,"version":"4.0.1"},"reference-count":45,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T00:00:00Z","timestamp":1765929600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T00:00:00Z","timestamp":1765929600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["K01DA054328"],"award-info":[{"award-number":["K01DA054328"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Services Research"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Accurate, efficient identification of housing\u2010related needs, including homelessness or housing instability, is crucial for health systems addressing health\u2010related social needs (HRSN). We developed and validated a novel, pragmatic electronic health record (EHR)\u2010based algorithm to identify patients with housing\u2010related needs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design and Setting<\/jats:title>\n                    <jats:p>We retrospectively evaluated sensitivity and specificity of the housing\u2010related needs algorithm within our safety\u2010net hospital, Boston Medical Center (BMC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources and Analytic Sample<\/jats:title>\n                    <jats:p>The algorithm included six EHR structured data elements tailored to BMC operations, including HRSN screening results. We assessed each element's performance, alone and combined, using 12\u2009months of BMC EHR data among two reference groups: (1) 433 patients with verified housing\u2010related needs at housing program enrollment (2019\u20132023), and (2) a stratified random sample of 400 patients (200 adult, 200 pediatric) with \u2265\u20091 primary care medical visit (2022), whose charts we manually reviewed to verify housing status. We calculated algorithm sensitivity in both groups and specificity in the primary care group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Principal Findings<\/jats:title>\n                    <jats:p>With all data elements included, algorithm sensitivity was 62% (95% CI: 57%\u201366%) among housing program enrollees and 81% (95% CI: 68%\u201391%) among primary care patients. Among primary care patients (13% with chart review\u2010verified housing\u2010related needs), specificity was 97% (95% CI: 95%\u201398%). HRSN screening yielded the highest single\u2010element sensitivity, but screening alone remained limited: 57%\u201362% of those with verified housing\u2010related needs were detected via screening. Patient address information and diagnostic codes had low single\u2010element sensitivities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pragmatic EHR algorithms leveraging structured data elements tailored to local context present an accessible, efficient method for health systems to identify patients with housing\u2010related needs. This is the first study to validate such an algorithm in a safety\u2010net setting; we found it had moderate sensitivity and high specificity. The algorithm identified more housing\u2010related needs than diagnostic codes alone, demonstrating the value of integrated clinical and administrative data. Further algorithm improvements require changes to HRSN screening and EHR documentation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1475-6773.70076","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T14:24:04Z","timestamp":1765981444000},"page":"1-9","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Validation of an Electronic Health Record Algorithm for Identifying Housing\u2010Related Needs in a Safety\u2010Net Health System"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4916-4319","authenticated-orcid":false,"given":"Nicole C.","family":"McCann","sequence":"first","affiliation":[{"name":"Department of Health Law, Policy, and Management Boston University School of Public Health Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1789-1009","authenticated-orcid":false,"given":"Stephanie Ettinger","family":"de Cuba","sequence":"additional","affiliation":[{"name":"Department of Health Law, Policy, and Management Boston University School of Public Health Boston Massachusetts USA"},{"name":"Children's HealthWatch, Boston Medical Center Boston Massachusetts USA"},{"name":"Boston University Chobanian &amp; Avedisian School of Medicine Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Hofman","sequence":"additional","affiliation":[{"name":"Research Informatics, Boston Medical Center Boston Massachusetts USA"},{"name":"Clinical Data Warehouse, Boston Medical Center Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler","family":"Pauly","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Boston Medical Center Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Ashe","sequence":"additional","affiliation":[{"name":"Clinical Data Warehouse, Boston Medical Center Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youssef","family":"Younossi","sequence":"additional","affiliation":[{"name":"Boston University Chobanian &amp; Avedisian School of Medicine Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Stein","sequence":"additional","affiliation":[{"name":"Department of Health Law, Policy, and Management Boston University School of Public Health Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0654-5821","authenticated-orcid":false,"given":"Paul R.","family":"Shafer","sequence":"additional","affiliation":[{"name":"Department of Health Law, Policy, and Management Boston University School of Public Health Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather E.","family":"Hsu","sequence":"additional","affiliation":[{"name":"Boston University Chobanian &amp; Avedisian School of Medicine Boston Massachusetts USA"},{"name":"Clinical Data Warehouse, Boston Medical Center Boston Massachusetts USA"},{"name":"Department of Pediatrics Boston Medical Center Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,17]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"The U.S. Department of Housing and Urban Development \u201cThe 2024 Annual Homelessness Assessment Report (AHAR) to Congress \u201dDecember 2024 accessed February 14 2025 https:\/\/www.huduser.gov\/portal\/sites\/default\/files\/pdf\/2024\u2010AHAR\u2010Part\u20101.pdf."},{"key":"e_1_2_9_3_1","unstructured":"U.S. Department of Health and Human Services: Office of 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