Use of Technologies in Social Determinants of Health (SDOH)
Social determinants of health (SDOH) are not new concepts. They were formally established in March 2005. Former Director-General of WHO set up the Commission on Social Determinants of Health (CSDH) to address the social factors leading to illness and health inequities. The Commissioners were global experts on politics, academia, and advocacy. It was a global process of hundreds of researchers and practitioners from universities and research institutions, government ministries, and international and civil society organizations. The Commission demonstrated social factors caused health inequities. The commission report stated, where a person is in the social hierarchy affects the conditions in which they grow, learn, live, work, and age, their vulnerability to ill health, and the consequences of ill health.
In the US, Healthy People, managed by the Office of Disease Prevention and Health Promotion (ODPHP) at the Department of Health and Human Services (HHS), provides science-based 10-year national objectives for improving the health of all Americans. The objectives are the result of a multiyear process from a diverse group of individuals and organizations. Healthy People 2020 highlights the importance of addressing SDOH by including “create social and physical environments that promote good health for all” as one of the four overarching goals for the decade.
Now that we know individual zip code plays an important role in people health status and health outcomes. What should we do to address the Social Determinants of Health?
First, we need to look at the people as a whole person. People's health status changes from healthy to illness gradually in a place, an environment she/he was born, lives, educate, work, and age. Besides looking at a patient’s signs and symptoms, healthcare providers need to care for the patient as a person. Physician practices and hospitals need to have a system in place to screen for social determinant factors such as food, housing, utility, transportation, and interpersonal violence.
Second, we need to remove the barrier for people to access healthcare. Telemedicine is the answer to this demand. It not only benefits the patient. It also benefits the providers. According to Mordor Intelligence, the telemedicine market was valued at USD 21,446.33 million in 2018, and it is estimated to be valued at USD 60,448.47 million by 2024, witnessing a Compound annual growth rate (CAGR) of 18.50%. The major factors for the growth of the telemedicine market include the rising healthcare costs, technological innovations, increasing remote patient monitoring, and growing burden of chronic diseases.
Third, we need to build a support system for the patient and for their caregivers in the community. The partnership is the key. Many healthcare systems are now working with local partners and consumer-facing technologies to provide the service to their patients and their caregivers. As people's lifestyle changes, healthcare service is no longer starts at the gates of healthcare facilities but at the points where people gather healthcare information. The new starting points for health care services are wearable devices, search engines, eCommerce, social media sites, local pharmacies, local groceries, and more.
Today many technology providers have come up with a lot of innovated solutions to meet the challenges of Social Determinants. Followings are some of the examples that were presented at HIMSS ePatient Summit 2019:
Heal is an innovative health care system that brings physicians to people house. This application was created to facilitates doctor house calls. The patients can contact physician online and schedule doctor visit at the comfort of their own homes. It is not only convenience but also allows the physician to see the living environment of the patients. It can help the physician to offer medical advice and treatment options that address the patient's SDOH needs.
HealthTap a Telemedicine application that works with Employers to provide healthcare to the fingertips of their employees. If their employees get sick at work, on the road, or need to get trustable medical advice 24 X 7, they can open the HealthTap app to access personal symptom evaluators for guidance or a virtual visit with the board-certified doctors.
Many consumer-facing technologies are now working with the healthcare system to provide support to patients and their caregivers. Uber Health is one of them. It works with healthcare organizations to transport patients seamlessly. Uber Health provides the integrated dashboard to systems of healthcare organizations so healthcare organizations can use Uber Health as one of the steps in the continues of care. Royal Ambulance is another transportation service to work with the healthcare system to transport patients. It is not just transportation service, it is the transportation with the licensed healthcare professionals who are well trained to provide exceptional human experiences.
To improve the overall health outcome, we not only need to address illness and provide sick care, we also need to look into people’s needs in the community where they born, live, education, work, and age. We need to provide support service, not only the patients but also to support services to the caregivers. Collaborations between healthcare systems and consumer-facing technology companies are a great way to target SODHs.