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For us, we will potentially need to adopt or modify the NACHC example workflow for Using Non-Clinical Staff Before or After the Clinical Visit. A local hospital has reached out to us about partnering to adopt their SDoH targeted referral system. If we pursue this opportunity, we may need to bring on additional staff to handle the collection of SDoH information from patients and to coordinate referrals to SDoH services.
With regards to agency-wide expansion of SDoH collection, continued testing of various workflows and methods of how to collect and report SDoH information from patients will enlighten what positions and roles we will need to modify to increase collection and action on SDoH information. Because so many staff touch SDoH information in various capacities, one of our overarching future needs will be to create communication workflows and policies to facilitate the sharing of SDoH efforts and knowledge of various staff and departments.
For the second question, the biggest challenges for La Clinica around this area is entering/coding the SDoH work that we’re doing in a manner that is reportable as part of claims work. We have built templates and databases to hold SDoH information but these spaces are not necessarily where claims information gets pulled from. We can create separate reports that track this information and send those to our health plan partners but that is time and staff intensive, especially as we work out kinks in the reports as we pilot and create them.
Tied to staff training, we are working on how to educate staff on how to use enabling codes to track the SDoH work that we are already conducting. A challenge for us will be how to track and report if patients are being referred for SDoH services and where that will be tracked. If this data is going to be tracked in our EHR system, then we will need to expand access to our EHR system to SDoH staff that has historically not had access to our EHR.
The best staff to address these issues is going to be our existing SDoH Committee and key stakeholders from billing and clinical operations that can work to modify existing workflows to best address these issues. The committee space will be the best space to work out potential conflicts and trouble shoot workflows.
Attached is La Clinica de La Raza’s HW worksheet. We’ve started an agency-wide project to update our public website that is touching many of these questions. This project can act as a means to facilitate side conversations to address how we can better utilize social media tools for the agency for both patient and staff recruitment and donations.
Thanks for these helpful guidelines.
Q1) How did you decide on the workforce needed to address SDoH?
For La Clinica it was a decision based on what staff and department both had capacity to additional work of collecting and cataloging SDoH data from patients and what staff had existing training do collect SDoH information from patients in a culturally competent manner. This led to our Community Health Education (CHE) department staff to take this on. Within our organization geographically, this has been dictated also by funding constraints. We have been fortunate to receive grants that have required specific SDoH data collection in certain service areas. This has focused our SDoH collection work at certain sites only at this point. Similar to many other responders though, a lot of care team staff collect bits of SDoH information from patients at various points, be it registration when we collect financial and insurance information or regular visits as part of medical, substance abuse, and behavioral health screens.1. Javier Alvarado
2. La Clinica de La Raza, Inc. (La Clinica)
3. Project Manager – assist SDoH and PCMH work for the agency, other projects as needed
4. How other groups work around scant resources, create workflows to incorporate SDoH work into clinical operations, and address staff burnout from exposure to SDoH concerns of patients
We have two specific training programs for new managers and new hires. In both areas there is potential to add information to educate staff about existing SDoH activities and future goals so everyone is aware and moving towards these agency goals.
We are also working to update our agency website. As that project moves forward with identifying what information should be on the website and publicly available and to whom that information should be geared towards, we have the opportunity to use this space to educate prospective staff and patients about our SDoH work.