Sally is a HIM professional who works at a hospital in a poor section of the city with a large number of patients who are homeless, who live in poverty, who are brought in for evaluation by
Social Determinants of Health, EHR Data, Coding and Report Development
Scenario:
Sally is a HIM professional who works at a hospital in a poor section of the city with a large number of patients who are homeless, who live in poverty, who are brought in for evaluation by children’s services, and similar situations. Unemployment is very high in this area.
Sally’s manager (Jen) was asked to provide regular data analyses to administration about the various vulnerable populations seen at the hospital. The data is currently not being collected systematically in the EHR. Jen knows Sally has recently completed a medical coding course and Jen knows that some of the code systems include codes related to social determinants of health. Jen asks Sally to research the options for collecting this data and producing reports. Jen wants Sally to produce a report of recommendations that Jen can use as talking points in her meetings with IT, administration, and others in the hospital that may need to provide support in the process.
To put together this report, Sally will need to recall information about structured and unstructured data in the EHR, as well as what Sally learned about medical coding.
Sally will need to complete the following while working on the report.
Locate the codes in the codebook that relate to social determinants of health.
Use brainstorming and research techniques to produce a list of situations that administration may want to see data on. Sally should set this up in a table format.
For each common life situation encountered by patients, Sally needs to identify the best place to record this data. For example, using ICD-10-CM code xxx.xx, using structured data field titled xxxx from the admission form, etc. If collecting the data from the EHR, Sally must determine where in the patient record it is best collected. (i.e., on admission, by nursing, on discharge. Etc.) These fields do not need to currently exist. Jen will work with the appropriate staff to have them added. Sally must add recommendations to the table for each entry.
Sally must then design a report format that includes each piece of data (at least 15 data elements) Sally recommended for collecting.
Besides an introduction and conclusion Sally must do the following in the report:
Explain here recommendations (i.e., provide justification)
Discuss patient engagement strategies to help patients take responsibility for their health, including use of the patient portal and how these reports can help with patient engagement strategy development.
Discuss the impact the additional data collection may have on organizational change.
Discuss how to collect this data while embracing cultural diversity.
Sally will need to be sure to address the following of AHIMA’s Competencies within the report:
AHIMA Competencies:
V.4 Identify the impact of policy on health care
VI.2 Identify the impact of organizational change
VI.6 Examine behaviors that embrace cultural diversity
VI.8 Describe consumer engagement activities
Helpful link:
AMA Recommendations: Use ancestry, ZIP Code or education for SDOH
https://www.fiercehealthcare.com/practices/use-ancestry-or-zip-code-not-race-when-considering-a-patient-s-risk-factors-ama-says?MessageRunDetailID=3727480883&PostID=22096144&utm_medium=email&utm_source=rasa_io
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