Social Determinants of Health (Social Needs Screening) Use Case for Community

Use Case Summary, Implementation Guide and Supporting Documents


Social Determinants of Health (SDOH) Use Case Summary

Social Determinants of Health (SDOH) Use Case for Community Implementation Guide

SDOH file specification (updated on 3/6/24; changes are backwards compatible except for column headers on the file) 

 

About this Use Case

This use case begins to document the social care process from community generated sources with social needs screening data. Participating organizations screen patients in community settings for social need identification. This data is submitted to the Health Information Network (HIN), integrated with Active Care Relationship Services (ACRS)™ and Common Key (CK) ™ to allow for accurate person-care team relationships to be identified. This creates individual social need identifiers which can be used to move the individual level data to appropriate Clinical Quality Initiatives (CQIs).

“Social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.” [1]

In an effort to better understand the link between social needs and individual health and well-being, more data is needed across and within organizations caring for people in the community.

The MiHIN Social Needs Screening Use Case (SDoH) is a first step in building a knowledge infrastructure that streamlines the process of sharing needed and permissible information across communities and throughout the State of Michigan-and it continues to evolve as the national and regional landscapes do.

Learn more about our Cross Sector Data Sharing work here.

[1] “Social Determinants of Health,” healthypeople.gov, accessed October, 17, 2018, https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health#five

 

    FIGURE 2-2 Social Determinants of Health and Social Needs Model.
    SOURCE: Adapted from Castrucci and Auerbach, 2019.
    National Academies of Sciences, Engineering, and Medicine. 2021. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. Washington, DC: The National Academies Press. https://doi.org/10.17226/25982.