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How partnership, data and analytics can help supercharge SDOH outcomes (part 2 of 2)

In the first part of this blog, we discussed the “Discover” phase of working with community-based organizations to address social determinants of health. Next we’ll discuss the other steps in the Discover-Plan-Act cycle.

In planning SDOH strategies, hospitals and health systems, guided by their Community Health Needs Assessments, are often best able to identify and convene key partners to address SDOH. The CHNA process brings neighboring healthcare providers and community-based organizations together to:

  • learn from one another;
  • gain commitment;
  • share expertise;
  • understand public policy efforts; and
  • leverage technical and hands-on assistance.

But, are these efforts sufficient? The recent HealthLeaders Social Determinants NOW Summit highlighted the conversations needed to identify, solve and scale collaborative SDOH programs with CBOs. The summit showed the importance of identifying, expanding and improving existing CBO wish list programs. In other words: leverage, scale, improve and sustain. 

However, there are real and perceived barriers to overcome. A January 2022 article from the Journal of the American Medical Association notes, “Such efforts will require overcoming challenges with addressing upstream [SDOH], including … the lack of clarity about who should pay for the interventions, and disincentives to cross-sector collaboration.” 

In many cases, these disincentives simply include things that haven't been done before. Hospitals and health systems can lead here, paired with shared governance so that each partner is empowered to do what it does best. 

The HealthLeaders summit also noted that many providers and CBOs are already locked into specific funding and contract cycles. And while this is a very real constraint, not every SDOH program needs a new legal/contracting component. The parties should look for opportunities to formally commit to initiatives and not assume obstacles that may not exist.

How do you feel about your data and healthcare analytics?

Data-sourced analyses — created by using primary data from community surveys and from public and privately curated sources — can help hospitals, health systems and CBOs find the rationale they need to support strategic and programmatic initiatives. SDOH data are often the “missing piece,” providing information not found in electronic health record and claims data, covering: 

  • finance;
  • food;
  • housing;
  • transportation;
  • health literacy; and 
  • digital.

DataGen is able to license these SDOH data and analytics from its partner, Socially Determined. DataGen can free up your resources by integrating Socially Determined’s social metrics with your data, analyzing and interpreting their combined intelligence. In doing this, we deliver deeper, more customized insights to help you improve outcomes at the individual and community health levels. 

Taking action: Your next steps

There is a clear need for better data sharing between providers and CBOs to address SDOH in a more integrated way and to apply analytics for design, implementation, measurement and adjustment. Even with an analytics-first approach, providers and CBOs must take care that they match programs to populations. To avoid big changes in the early stages of this work, SDOH partners must be willing and able to listen to the needs of individuals and, if necessary, pivot from what the data-only story is telling.

As much as hospitals may want to make up for lost time, sustainable SDOH outcomes cannot be rushed. Initiatives are often not about quick wins but learnings, progress and return on investment over time as layers of need are peeled back, understood and operationalized. 

As noted in The Innovator's Prescription, intuitive medicine (treatment based on specialist-only understanding) may have defined healthcare's origins, but it will take the entire healthcare village — and the right data and analytics — to usher in healthcare's new century and a new level of success for hospitals and their partners.


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