Physician Documentation of Social Determinants of Health: Results from Two National Surveys.

Abstract

Objective: We measured physicians' (1) perceived importance of having access to social determinants of health (SDOH) data received from external providers in the electronic health record (EHR); (2) internal SDOH documentation practices in the EHR, including whether physicians document SDOH in a structured format that may facilitate use; and (3) use of EHR SDOH data to identify community resources and make referrals on behalf of patients.

Approach: We conducted a secondary analysis of two national physician surveys.

Participants: Respondents from the American Board of Family Medicine Recertification Survey (ABFM, n = 4040), a survey of family physicians fielded 2021-2022, and the National Physician Health IT Survey (NPHIT, n = 3006), a survey of outpatient physicians across specialty areas fielded in 2022.

Key results: Under half of physicians felt that SDOH data were very important (ABFM: 44.8%, NPHIT: 30.8%). Although most physicians documented SDOH in the EHR (ABFM: 72%, NPHIT: 63.3%), fewer used structured documentation methods (ABFM: 56.3%, NPHIT: 33.2%). In both surveys, physicians who participated in value-based care initiatives, those for whom > 10% of their patient population was considered vulnerable, and those who felt that their clinic had the resources to address patients' social needs had higher likelihood of documenting SDOH. Sixty-two percent of family physicians reported using SDOH data for identifying resources and making referrals.

Conclusions: In 2022, most physicians documented SDOH data in their EHR, yet fewer used structured methods, limiting data exchange opportunities to address patients' social needs. Under half of physicians considered access to external SDOH data to be "very" important, suggesting greater reliance on data collected internally and missed opportunities to identify patients who need support. Variation in perceived importance of SDOH data access and SDOH documentation by physician characteristics indicate opportunities to support adoption of structured documentation tools facilitating SDOH data capture and exchange to improve patient-centered care.