IOM recommended social and behavioral domains and measures for electronic health records

Determinants of health—like physical activity levels and living conditions—have traditionally been the concern of public health and have not been linked closely to clinical practice. However, if standardized social and behavioral data can be incorporated into patient electronic health records (EHRs), those data can provide crucial information about factors that influence health and the effectiveness of treatment. Such information is useful for diagnosis, treatment choices, policy, health care system design, and innovations to improve health outcomes and reduce health care costs.

With this goal in mind, an IOM committee was convened to conduct a two-phase study, first to identify social and behavioral domains that most strongly determine health, and then to evaluate the measures of those domains that can be used in EHRs.

In Capturing Social and Behavioral Domains in Electronic Health Records: Phase 1, the committee identified 17 domains that they considered to be good candidates for inclusion in EHRs. The second report, Capturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2, pinpoints 12 measures related to 11 of the initial domains and considers the implications of incorporating them into all EHRs. The 11 domains included in this list are: race or ethnic group, education, financial-resource strain, stress, depression, physical activity, tobacco use, alcohol use, social connection or isolation, intimate-partner violence, and neighborhood income.

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Download a PPT of the IOM Social & Behavioral Tools & Measures

Source: Institute of Medicine’s Committee on Recommended Social and Behavioral Domains and Measures for Electronic Health Records

Related publications:

Adler NE, Stead WW. Patients in context--EHR capture of social and behavioral determinants of health. N Engl J Med. 2015;372(8):698-701.

Giuse NB, Koonce TY, Kusnoor SV, et al. Institute of Medicine measures of social and behavioral determinants of health: a feasibility study. Am J Prev Med. 2017 Feb;52(2):199-206. doi: 10.1016/j.amepre.2016.07.033. Epub 2016 Sep 19.