Social Determinants of Health: Screening in a Primary Care Clinic




Moorhead, Ava
Petrus-Jones, Michael
Ebert-Blackburn, Didi


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Purpose: Social determinants of health have increasingly become a focus in primary care. There is growing evidence that interventions in these areas may increase positive clinical health outcomes. The purpose of the current study is to increase documentation of, and emphasis on, these social determinants in a primary care clinic. The survey implementation process and the data which results will be used to address major social factors that may affect patients and that impact population health outcomes of the clinic. Methods: A modified version of a validated survey tool was incorporated into the clinic's EHR to track predetermined social health factors. ICD-10 codes were generated automatically into the patient chart based on survey responses. Qualitative analysis of administration environment and mode of survey delivery was conducted as well, including time for administration. Results: 28 surveys completed resulted in 11 new ICD-10 codes focused on social health factors. Survey timing was minimized in a face-to-face immediately prior to the provider encounter. Conclusions: The survey was found to be best administered in a face-to-face, private encounter which minimized administration time and enhanced communication of responses. This mode of delivery helped establish rapport with patients and gather culturally sensitive responses. ICD-10 Z-codes developed from social determinants of health will help guide providers to address such issues as part of each patient's health assessment and plan.