Real-world integration of the protocol for responding to and assessing patients' assets, risks, and experiences tool to assess social determinants of health in the electronic medical record at an academic medical center

Carrie R Howell, Heather Bradley, Li Zhang, John D Cleveland, Dustin Long, Trudi Horton, Olivia Krantz, Michael J Mugavero, Winter L Williams, Alesha Amerson, Andrea L Cherrington

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

OBJECTIVE: To describe the real-world deployment of a tool, the Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences (PRAPARE), to assess social determinants of health (SDoH) in an electronic medical record (EMR).

METHODS: We employed the collection of the PRAPARE tool in the EMR of a large academic health system in the ambulatory clinic and emergency department setting. After integration, we evaluated SDoH prevalence, levels of missingness, and data anomalies to inform ongoing collection. We summarized responses using descriptive statistics and hand-reviewed data text fields and patterns in the data. Data on patients who were administered with the PRAPARE from February to December 2020 were extracted from the EMR. Patients missing ≥ 12 PRAPARE questions were excluded. Social risks were screened using the PRAPARE. Information on demographics, admittance status, and health coverage were extracted from the EMR.

RESULTS: Assessments with N = 6531 were completed (mean age 54 years, female (58.6%), 43.8% Black). Missingness ranged from 0.4% (race) to 20.8% (income). Approximately 6% of patients were homeless; 8% reported housing insecurity; 1.4% reported food needs; 14.6% had healthcare needs; 8.4% needed utility assistance; and 5% lacked transportation related to medical care. Emergency department patients reported significantly higher proportions of suboptimal SDoH.

CONCLUSIONS: Integrating the PRAPARE assessment in the EMR provides valuable information on SDoH amenable to intervention, and strategies are needed to increase accurate data collection and to improve the use of data in the clinical encounter.

Original languageEnglish
Pages (from-to)20552076231176652
JournalDigital Health
Volume9
DOIs
StatePublished - Jan 1 2023
Externally publishedYes

Keywords

  • Social risks
  • clinical care
  • social care
  • electronic medical record data

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