Safeguarding Social Determinants of Health Data at a Managed Health Plan.

Abstract

Background: Increased adoption of social determinants of health (SDOH) screening protocols by federal and state agencies to address health equity initiatives has led to an increase in the collection of new types of data by health care workers (HCWs). Although there is general consensus on the need for SDOH screening, issues such as a lack of standardization, patient distrust, and concerns over data security continue. Past studies have identified gaps in the methods of SDOH data collection, how the SDOH data is handled, training provided on collecting and safeguarding this type of information, and how to educate patients about how their information may be used. The authors designed this study to explore the perspectives and experiences of HCWs who access and use SDOH data to deliver care coordination for managed health plan members.

Methods: The authors used a mixed-methods methodology, quasi-experimental pre-post study to explore experiences and perspectives regarding data safeguards for SDOH data collected and accessed by HCWs at a managed health plan. Potential participants were selected from 2 divisions that provide care coordination and health-related service needs. The 18-item online survey contained both closed- and open-ended questions, with most using a Likert scale for responses.

Results: The survey response rate was 14.1% (50). The authors found that 78.0% of the respondents were actively accessing and using SDOH data in their role. Of the 39 respondents who actively accessed and used SDOH data in their role, 23 (59.0%) respondents had been trained on how best to collect and use SDOH data, 6 (15.4%) respondents were unsure of receiving training, and 10 (25.6%) respondents had not received training. A majority (33 of 44; 75.0%) of the respondents understood that their department was collecting data directly from individual members regarding their SDOH/health-related social needs. When asked "How certain are you that SDOH data is protected health information (PHI)?," there was an increase in mean and a decrease in standard deviation values when comparing the pre- and post-study answers to the same question. This indicates a shift toward higher numbers and less variability in results. The results showed that privacy and security training increased the level of confidence that HCWs have in safeguarding SDOH data.

Conclusions: According to the results of this study, HCW participants better understood how SDOH data is protected health information upon receiving training. The results also demonstrated that HCWs are eager and open to more training on safeguarding SDOH data. The findings of this study could be used to assess the current use of SDOH data, develop guidelines for best practices, and identify specific areas of training to ensure the privacy and security of SDOH data.