SONNET Projects: Davis
Evaluating social needs among members with missing race data in Kaiser Permanente’s Electronic Health Record (EHR)
Project team
Teaniese “Tina” Davis, PhD, MPH, Principal Investigator, KP Georgia Center for Research and Evaluation
Project summary
Research indicates Black patients whose race was not documented in the electronic health record (EHR) were significantly older, male, and less likely to have commercial health insurance. They also had a higher average number of entries on the problem list compared to patients of known Black race based on their health record. Hispanic patients of unknown race in the EHR were significantly more likely to be older and have a higher number of entries on the active problem list – and were less likely to have commercial health insurance.
Natural language processing has been used to extract key terms from charts to successfully identify patient race and ethnicity. Relying on EHR data when examining race and ethnicity can result in underestimating group membership and inaccurate study conclusions. Imputation has been used to address non-randomly missing race and ethnicity data in the EHR using U.S. Census data.
The goal of this study is to examine differences in social needs among members with unknown versus known race and ethnicity. This examination will be complimented by interviews with stakeholders engaged in capturing and documenting patients’ race and ethnicity, as well as experts currently exploring strategies for addressing missing race and ethnicity data.
Digital social needs screening evaluation
Project team
Teaniese “Tina” Davis, PhD, MPH, Principal Investigator, KP Georgia Center for Research and Evaluation
Project summary
Kaiser Permanente’s Care Management Institute (CMI) reported on member needs related to social health screenings, highlighting the low percentage of physicians and hospitals that screen for key social risks (16% and 24%, respectively.) Low screening is complicated by hesitancy among patients and providers about the potential utility and harm of screening for social needs in a health care setting. Recognizing that members have unmet needs, less is known about how to adjust workflows and engage care teams in screening for social needs and linking members to care.
The CMI report noted some key recommendations for social needs screenings, including: 1) implementation considerations, such as having training and workflows to support care teams in identifying social needs and to build confidence in their ability to identify these needs; and 2) engaging patients to develop buy-in for assessment questions and training the care team to elicit social needs from patients.
Led by KP Digital, the Digital Social Needs Screening program is now in development and is based on findings from the CMI report. Dr. Davis is working with CMI and KP Digital to evaluate the Digital Social Needs Screening tool that will be implemented in fall 2021. This evaluation will include determining the sampling plan with the evaluation sites (KPNW and KPCO), designing the evaluation tool, overseeing recruitment, data collection, and reporting the evaluation findings.
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