Tracking Psychosocial Factors in Electronic Records Could Lead to Better Overall Health, Panel Suggests

Electronic medical records have been touted as an easy and effective way of keeping track of all the little things doctors check at routine visits — blood pressure, weight and so forth — as well as preventing treatment errors in emergency situations and increasing the efficiency of medical administration (by about 6% annually). But there’s currently no agreement on what social data should be viewed as medically relevant and therefore included in EMRs.

A panel convened Nov. 13 by the Institute of Medicine of the National Academies is seeking to change that, however, by releasing a set of 12 behavioral and social factors it believes should be included on patients’ electronic records in a standardized fashion.

“The inclusion of social and behavioral data routinely into electronic health records can lead to real transformations in the ways in which doctors use information to diagnose and treat patients, and is also of enormous value for understanding the health of populations and what we can do to improve health for all,” said Ana Diez Roux, who served on the committee and is the dean of the Drexel University School of Public Health, in a statement released by the university.

In other words, the goal of such standardization is to both improve individual clinical decisions and to collect data for evidence-based policy decisions.
Psychosocial Aspects of Health

These social and behavioral factors are called “psychosocial vital signs,” and measure health and risk in a broader way than purely physical indicators of health.

The panel, which weighed factors of medical relevance, research significance and practicality of collection, recommends that medical personnel record the following information about each patient:


  • Residential address


  • Race and ethnicity


  • Education


  • Census tract-median income


  • Alcohol use


  • Tobacco use and exposure


  • Depression


  • Financial resource strain


  • Intimate partner violence


  • Physical activity


  • Social connections and social isolation


  • Stress


Clinical Focus

Only four of these psychosocial vital signs (race, address, alcohol use and tobacco use) are currently routinely recorded in clinical settings.

According to the official brief, the committee was created with the intention of moving such psychosocial analysis into everyday medical settings, rather than leaving it to public health officials alone.

“Research and interventions on social and behavioral determinants of health have largely fallen under the purview of public health,” the report reads. “[U]ntil recently, these determinants have not been linked to clinical practice or health care delivery systems.” The committee hopes that encouraging medical personnel to record such information will cause those with direct contact with patients to consider such factors more deeply.


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