Integrating Social Determinant of Health Data with Regional Quality Data Reporting
by Heidi Christman, Director of Communications, HCGC
Central Ohio providers continue to be open and transparent with one another about how they perform on specific quality measures with an eye on improving health and healthcare delivery across the region. HCGC is pleased to release our second regional quality report of 2019 with data on nine clinical quality measures from11 healthcare organizations representing over 140 primary care practice sites that are caring for more than 640,000 patients across Central Ohio. Our Quality Improvement Learning Group (QILG) hosts quarterly work sessions for practices and quality improvement system leaders to evaluate regional performance, set goals, and align improvement activities at a system and practice level.
Since 2014, the report has been released twice a year, providing benchmarking, trends and important insights to help as practices strive for continuous improvement. Over the years, HCGC has increased the number of practices from just over 80 reporting in 2014, to 159 in the report released earlier this year. The number of quality measures has also increased as a result of the collaborative work of the QILG.
For the first time, the most current report includes social determinant of health (SDOH) data. HCGC is excited to add this important data to our regional quality reporting, as we feel as though it will inform, expand and improve the clinical data we will continue to collect in conjunction with the traditional regional quality report. We have been able to add SDOH data because of our work with the Central Ohio Pathways HUB (the HUB.) Patient level data has been collected on both risks and outcomes that have addressed client needs in real time through the outstanding work of community health workers (CHWs) identifying, meeting with, and serving clients around central Ohio. The CHWs work at 10 care coordination agencies (CCAs), and are able to find, treat and measure client progress and SDOH data via the HUB’s information technology system. The current report focuses on HUB adult (18+ y/o males & 45+ y/o women) clients to align with the clinical data in the quality report. In this section of the report, we have highlighted hypertension data, again, as a way to align with the Controlling High Blood Pressure measure in the traditional quality report. The two sets of data are not exact comparisons in terms of reporting and collection. The HUB data is self-reported by clients, while the clinical quality transparency data is currently self-reported at the practice level. While we realize that this is just a start, and not yet actionable, we are hopeful that adding SDOH data will provide the building blocks to start gathering, analyzing and one day, acting upon this important information. In the future, we hope to add other SDOH measures that align with the clinical data, including depression/PHQ-9, breast health, pregnancy and infant mortality and diabetes/A1C.
The HUB continues to grow rapidly in terms of clients, services and agencies participating. This growth provides potential for the SDOH data to add further insight to the regional quality report as a whole regarding service delivery, trends, and gaps.
HCGC’s vision for continuing to add this data is to have a functioning integrated data system with multi-level reporting that can be contributed to and shared with providers and community partners to inform connections, performance and improvement work. It is our hope that integrating social and clinical data at a regional level will drive a cultural change in transparency and improvement, not just from a clinical and cost perspective, but also as a way to impact social and public health at a community level.
If you have questions, or would like to participate in our Quality Improvement Learning Group or the Central Ohio Pathways HUB, please contact David Brackett at firstname.lastname@example.org or Carrie Baker at email@example.com.