Social Determinants of Health (SDOH) like how people live, learn, work, play and age can have a major influence on the health of a population. Various components including the economic stability, neighborhood and physical environment, education, food, community, safety and social context have a massive impact on people’s health and well-being—including the mortality, morbidity, life expectancy, health status, healthcare expenses among the others.

Healthcare systems can integrate next-gen technologies including AI, automation and analytics into SDOH strategies and digital patient engagement solutions to accelerate Population health management.

Hospitals and Medical Practices can consider analytics and AI-enabled digital patient engagement solutions to create a transformative impact on population health. Healthcare insights strategically integrated with machine learning and automation solutions can help determine the underlying factors that cause care gaps and resulting ways to navigate through the issues.

Harnessing a combination of Electronic Health Records (EHR), Patient Generated Health Data (PGHD), Patient Reported Outcomes (PRO), Hospital Reported Outcomes (HRO) can provide more accurate data than surveys and findings. Advanced care coordination solutions integrate wearables and IoT strategies to gather essential patient generated data that facilitate real-time tracking and monitoring of patients’ health. These data are combined with their automated workflows to enable seamless interactions and frictionless collaboration among healthcare stakeholders.

From appointment reminders, patient scheduling, patient referrals, smart waitlists, patient feedback, patient recall, consent forms to, remote patient monitoring, pre, during & post-operative care—insight-driven healthcare can simplify healthcare experiences for patients, physician and the payors alike. When these large volumes of unstructured data are structured and streamlined, they provide actionable insights that can transform healthcare delivery for larger communities at scale.

Real-time data analysis and tracking also helps in virtual healthcare solutions. Real-time data facilitates remote patient monitoring and ensures that patients stay on top of their care journey. From patient health updates, medication adherence, patient education on care plans, post-surgical recovery and timely intervention—data-driven care coordination platforms help foster a cohesive healthcare environment.

Combined Cohort studies on healthcare communities reveal critical insights on the impact of Social Determinants of Health. For instance, material circumstances including living and working conditions, food and lifestyle, hunger and access to healthy options in a neighborhood could have a significant impact on type-2 diabetes.

Healthcare systems vary with different geographies and populations and this affects the population health as well. Key metrics would include the health coverage, provider availability, provider bias, provider cultural & linguistic competency and other functional limitations which have a significant impact on the health outcomes of a community.

Healthcare systems can leverage the capabilities of machine learning, automation and analytics solutions to effectively identify at-risk communities—in order to take preventive measures, orchestrate risk-mitigation strategies and design customized models of care for those communities. These targeted approaches help improve health conditions of minority groups, socioeconomically backward communities gain better access to quality care at an affordable price.

Also Read:

Social Determinants of Health: Broadening the Horizons with Data-Driven Healthcare

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Healthcare for Everyone: Achieving Affordable Healthcare through Population Health Management

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Leveraging Patient Generated Data to Deliver Rich Patient Experiences & Power-up the Marketing Mix

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The TripleAim Approach: Healthcare Insights that Boost Clinical, Operational and Financial Efficiencies

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Delivering Patient Trust in the Digital Era: Going Above and Beyond in Creating Positive PX

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To learn more about harnessing SDOH strategies to drive population health, talk to our team.