I spend a lot of time with healthcare executives and payers, along with their respective business strategists and data analysts, who have been conditioned to develop their strategic and operational plans based on clinical, financial and, sometimes, Customer Relationship Management (CRM) data. But those metrics, which just capture the number of medical interventions performed and services offered to them based on their medical needs, tell only half of the story. The other 50 percent of data that is meaningful to track is determined by social determinants of health or SDoH.
What Are Social Determinants of Health?
“Social Determinants of Health” is a healthcare industry buzz phrase that describes non-medical factors that contribute to the overall health of people living in that community. According to the U.S. Centers for Disease Control and Prevention, these include the social, economic and environmental factors that influence how people access and use healthcare services. Examples of SDoH include the average yearly salary of residents, the types of jobs available, the quality of primary and secondary education offered, the availability of public transportation and food security within a community.
The government-mandated shift toward value-based healthcare from the traditional volume-based care model has forced healthcare stakeholders to think about these social determinants of health. After all, payment models and healthcare reimbursement structures, based on quality metrics, now depend on keeping people healthy and out of doctors’ offices and hospitals. So, evaluating SDoH and minimizing their negative impacts on the overall health of a community has become paramount to these stakeholders’ bottom lines. Despite this new reality, providers and payers have fallen short of addressing the entire problem. Instead, they have only been able to address the last mile of a patient’s journey. Let’s take a closer look at why.
Outdated Tools Drive Misguided Strategies
Essentially these stakeholders have been developing their strategic and operational plans around the concepts of expanding their services to improve access to prevention programs and to minimize healthcare disparities within the communities they serve. Ultimately, the goal is to reduce the utilization of healthcare services by keeping people healthy.
While noble in theory, this reactionary approach, adopted by 92 percent of healthcare organizations in 2019, according to the “Social Determinants of Health Survey” conducted by the Healthcare Intelligence Network, is driven by the value-based care policy and uses legacy software and data systems as the foundation for the approach. These outdated tools don’t track the factors needed to complete the picture of why a population needs and seeks care. If we are going to have true innovation and impact deteriorating population health and rising healthcare costs, we need to collect, understand and address the data that show how individuals live, work and play in their communities. We need to think differently.
Spatial Determinants of Health
Enter Spatially Health and our Spatial Determinants of Health® model. Instead of looking just at clinical and financial data and guessing the connection between those numbers and SDoH, our proprietary model uses location intelligence, machine learning, and artificial intelligence to identify, measure and evaluate the effects of SDoH on behavior patterns in healthcare delivery. We use our clients’ clinical and financial data and give access to additional information about their patients, members or populations of interest. This additional information includes demographics, along with the social, cultural, recreational, retail, commercial and housing attributes of specific geographic locations. In other words, we give context to the numbers.
With this real-world modeling, we paint a more accurate picture of the population than what providers and payers see through a lens focused solely on clinical and financial data. We address the human-spatial relationship or how these individuals access healthcare services, food, and employment, for example, and uncover what factors are positively and negatively impacting their lives. It’s looking at the person plus the place in which they reside which gives us a micro insight into the existing macro methodology of evaluating these factors. Furthermore, our approach is scalable, so we’re able to help clients across the healthcare spectrum put it to use in various applications.
Spatial Determinants of Health® allow stakeholders to fully analyze individuals, patient populations and operations with real, enhanced data. We turn evaluating social risks from a conceptual practice to an operational one.
Spatial Risk Score
Through our robust analysis of the Spatial Determinants of Health® impacting a population within a geographic area, we also provide a Spatial Risk Score®. This metric, available only through Spatially Health’s platform, measures how the Spatial Analyitcs® affect health outcomes for individuals and entire populations and how those outcomes translate to costs for providers and payers.
This Spatial Risk Score® helps providers and payers predict service needs and usage patterns based on real measurements. It minimizes the current tendency to enact solutions that have worked in some locations but that may not address the needs of individuals living and working in another location. Examples of these solutions include making sure patients have rides to medical appointments, addressing sub-standard housing, providing healthy meals and offering financial assistance to pay for healthcare services. While these solutions may address the needs of some of the people living in an area, there may be a far greater need that has gone unnoticed with existing analytical tools. As a result, money spent on these solutions may be having little impact on the health problems facing the population of a certain community.
By giving healthcare stakeholders a score of the overall risk a population holds as a result of environmental factors that exist in a geographic location, Spatially Health can give measurable information that helps with cost analysis, benchmarking and strategic planning. The Spatial Risk Score®, combined with the evaluation of Spatial Determinants of Health®, gives a roadmap to address the patient journey from before one ever needs medical care.
Addressing the First Mile of the Patient Journey
While most providers and payers have adopted SDoH as a basis for enacting innovative programs that potentially address health problems occurring in those communities, they fall short of solving the issues and impacting overutilization and rising costs. That’s because they’re basically throwing solutions at a problem they haven’t thoroughly identified.
Spatially Health takes the guesswork out of pinpointing the problems that need to be addressed to effect change in utilization and costs. And we do this upfront, in the first mile of the patient journey, before anyone needs care or services.
First, we analyze patient accessibility to providers to help stakeholders align benefits programs with different segments of their population. It’s no longer necessary to waste time and money by copying and pasting a benefits program from one market to another, guessing that the population will benefit. Spatially Health gives context to know what a particular community needs. This more-targeted approach will be more effective and efficient and increase the acquisition of individuals into these programs and drive their engagement and positive outcomes.
Next, we build valuable profiles of targeted populations and provider networks. Instead of merely filling a roster of providers based on tried-and-true ratios of providers to populations, Spatially Health helps payers build a smart provider network. For example, a geographic location may not need 10 obstetricians offering services to an aging, post-menopausal population. Spatially Health would identify the need for more cardiologists in this hypothetical example, ensuring the availability of the right providers, serving the right members and controlling costs.
Finally, we measure the dynamic Spatial Risk Score® to predict service needs and usage patterns. By combining existing clinical and financial data with Spatially Health’s non-clinical and contextual data, provided by analyzing the Spatial Determinants of Health®, we can show providers and payers where future needs lie, so they are better prepared with cost containment strategies and relevant service offerings at the forefront of those needs.
A Complex Solution Made Simple
In a world of increasing healthcare costs, where financial viability depends on keeping patients healthy, providers and payers must adjust their approach to how they look at their data. It’s no longer enough to use clinical and financial data alone to develop sustainable strategic and operational plans. Like a stool with only two legs, this approach lacks the balance provided by contextual data, now available when location intelligence, artificial intelligence, and machine learning generate additional, valuable data.
Spatially Health provides healthcare stakeholders with the contextual and measurable data that adds the third, stabilizing leg to the stool. And while this new approach may seem complex to many who have been conditioned to focus on data metrics generated by legacy software, we have simplified it to paint a clear picture of what’s needed and who will benefit when these tools are used. It’s a complex solution made simple and moves data to another dimension — from social to special.