The presenters were:
- Eveyln Gallego, MBA, MPH, CHPHIMS – Chief Executive Officer EMI Advisors
- Linda Hyde, RHIA – Consultant
- Mary Mirabeli – Senior Vice President Content Strategy and Delivery, HFM
The presentation goes over impact, trials and tribulations of the Social Determinates of Health and the Gravity Project. It is noted through different studies that the US spends much more money on sick care than social care compared to other developed countries. The HFMA held a thought leadership retreat that focused on SDOH. They polled the group of attendees and asked them which SDOH they see as the largest influencer of cost and the top 2 answers were Nutrition (30%) and Housing (19%). They also asked their attendees which catalysts they think will be the most significant force for improving health outcomes with SDOH and the top 2 answers were Government (32%) and Health Systems (16%).
There are 4 interventions that have been identified that have evident ROI – Nutrition, Transportation, Housing and Home Modifications. An example of a Nutrition intervention is Geisinger’s Fresh Food Farmacy. The Fresh Food Farmacy identifies patients who have HBA1C levels greater than 8 and food insecurities. Geisinger then provides those patients clinical intervention including care management, diabetes education and consultations with dietitians and pharmacists. On average Giesenger feeds a house of 4, including children, and reduces participants A1C levels by 3 points, as well as reducing the overall patient cost by $23,000 a year.
The Gravity Project is a National Collaborative to Advance Interoperable Social Determents of Health Data. The goal of the gravity project is to help connect community based systems to the healthcare systems so we can share Social Determinants of Health data in healthcare settings. There have been tribulations with the current code systems in the healthcare settings and the lack of the codes and electronic systems in the community based setting. There are not enough codes in our current healthcare setting; for example we currently have 5 codes that relate to food insecurity and with a Gap analysis done by the Gravity project there should be 8 total codes. At the same time the community based setting may not be using any codes as they are mostly likely not documenting in a medical record system.
The Gravity project was established to develop structured data standards to reduce blockades to documentation and the exchange of Social Determinant of Health data across many enterprises and healthcare systems. The Gravity Project is firstly centering around 3 priority social domains: food security, housing and transportation. The Gravity project is also centered on facilitating payment for social risk data collection and intervention activities.
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