IOM report calls for more data elements in EHRs

The Institute of Medicine (IOM) has issued a report calling for 12 elements of standardized social and behavioral data to be included in EHRs as well as changes in certfication and Meaningful Use (MU) requirements based on the increase in data gathering.

"Patient electronic health records provide crucial information to providers treating individual patients, to health systems addressing the health of populations, and to researchers uncovering valuable details on determinants of health and the effectiveness of treatments," according to the report. "Over the past few decades, substantial empirical evidence points to the contribution of social and behavioral factors–-such as living conditions and physical activity levels--to functional status and the onset and progression of disease."

Four pieces of sociobehavioral information often are collected in clinical settings: race/ethnicity, tobacco use, alcohol use and residential address.

Since "the value of this information would be increased if standard measures were used in capturing these data," IOM recommends that the Office of the National Coordinator for Health IT and the Centers for Medicare & Medicaid Services include them in certification and MU regulations. More social and behavioral data from patients would "constitute a coherent panel that will provide valuable information on which to base problem identification, clinical diagnoses, treatment, outcomes assessment and population health measurement," specifically noting educational attainment, financial resource strain, stress, depression, physical activity, social isolation, intimate partner violence (for women of reproductive age) and neighborhood median household income.

Most of these data elements are collected by self-reporting but "EHR vendors and product developers lack harmonized standards to capture such domains and measures." That's why IOM suggests that the EHR certification process be "expanded to include appraisal of a vendor’s or product’s ability to acquire, store, transmit and download self-reported data germane to the social and behavioral determinants of health."

The report also recommends that the National Institutes of Health develop a plan for advancing research using social and behavioral determinants collected in EHRs and the Secretary of Health and Human Services should "convene a task force within the next three years, and as needed thereafter," to review the progress of the measurement of these determinants, and "make recommendations for new standards and data elements for inclusion" in EHRs.

Access the complete report.