Integration of social determinants of health information within the primary care electronic health record: A systematic review of patient perspectives and experiences

BACKGROUND: Social determinants of health (SDOH) are the non-medical factors that impact health. Although geographical measures of deprivation are used, individual measures of social risk could identify those most at risk and generate more personalised care and targeted referrals to community resources. We know SDOH are important to healthcare, but it is not yet known whether their collection via the electronic health record (EHR) is acceptable and useful from the patient perspective. AIM: Synthesise relevant literature to explore patient perspectives on integrating information about SDOH into primary care EHRs and the opportunities and challenges of its implementation in a General Practice setting. DESIGN AND SETTING: Systematic review of primary care based qualitative and mixed method studies using thematic framework analysis. METHOD: Key databases searched for articles reporting patient perspectives of SDOH collection within the primary care EHR. Qualitative and mixed methods studies written in English were included. A framework analysis was conducted to identify themes. RESULTS: From 14 included studies, identified themes included privacy concerns, the provider-patient relationship and the benefits and drawbacks of different screening approaches. CONCLUSION: Integration of information on SDOH into the EHR appears acceptable to patients. This review adds to the discussion of whether and how to implement SDOH screening and referral programmes into UK primary care systems.