Achieving Health Equity Through Data
HealthEfficient, a Health Center Controlled Network supporting 36 safety net clinics, rolled out a program to capture, address, and perform analytics on Social Determinants of Health (SDoH) for their patient population. In this presentation, the speakers will explain how the program was implemented. This discussion will include the methods used to change clinic workflow and introduce new staff responsibilities to enable SDoH assessment and closing of the referral loop for a diverse population. They will also talk about how this program has changed clinic culture, challenging assumptions about the patient population, uncovering implicit bias, and allowing clinics to make better use of limited resources. They will show how the SDoH analytics tools and dashboards HealthEfficient has created work, including what the significant results have been to date, the potential impact on the existing definition of evidence-based care, and the planned next steps to expand the program’s depth to reach to more of the 1.2 million patients served by HealthEfficient’s clinics.
Learning Objectives
- List potential barriers to gathering Social Determinants of Health at a particular practice or clinic
- Explain implementation scenarios for gathering Social Determinants of Health, depending on the patient population and the clinic’s use of technology
- Describe methods for closing the loop when a patient is positive for a Social Determinant of Health
- Identify potential ways SDoH analytics can give new insight into patient care
Speakers

