An evidence-based strategy to achieve equivalency and interoperability for social-behavioral determinants of health assessment, storage, exchange, and use.

The interoperable exchange of social-behavioral determinants of health data is challenging due to complex factors including multiple recommendations, multiple tools with varying domains, scoring, and cutpoints, and lack of terminology code sets for storing assessments and findings. This article describes a strategy that permits scoring by social-behavioral determinants of health domain to create interoperability and equivalency across tools, settings, and populations. The three-tier scoring strategy converts social-behavioral determinants of health data to (1) be used immediately at point of care by identifying social needs or social risk factors, (2) be consumed within analytics and algorithms and for secondary analysis, and (3) produce total scores that reflect social determinant burden and behavioral determinant burden across populations and settings within a healthcare system. The strategy supports the six uses recommended by the National Academy of Medicine, provides flexibility in choice of social-behavioral determinants of health tool, and leverages the power of social-behavioral determinants of health data in healthcare delivery.

Capturing health literacy assessment in the electronic health record through evidence-based concept creation: A review of the literature and recommendations for action.

Health literacy is the capacity to understand and act upon health-related information and navigate the healthcare system. Published evidence demonstrates a relationship between health literacy and health status. Because of this, there are increasingly calls for a health literacy assessment to be collected and stored in the electronic health record for use by the healthcare team. This article describes the results of a literature review of health literacy assessment instruments with the goal of formulating semantically interoperable concepts that may be used to store the interpretation of the health literacy assessment in the electronic health record. The majority of health literacy instruments could be stored in the electronic health record using a three-concept solution of inadequate, marginal and adequate health literacy. This three-concept solution fully supports semantic interoperability needs across the patient care spectrum.