One other benefit of using Z-codes is that the IDC-10-CM official guidelines state providers can assign social determinant codes in ICD-10-CM based on documentation from any member of the care team, including non-physicians like social workers, case managers, nurses, and other allied staff. Since CHCs use care team models, this flexibility in the guidelines makes it easier for providers and support staff to document SDoH information.
To engage CHCs, CHPW first surveyed each organization about their current practices for collecting and managing SDoH data. We asked whether they were collecting any data, how they were collecting and documenting this information, and whether they were currently using the information to coordinate community services. Additionally, we asked about the assessment tools they were using to capture data from patients.
How to improve SDoH data capture The results of our survey revealed that only 20% of the CHCs routinely collected SDoH data on all patients. To increase the consistency and quality of data capture, we knew that we needed to implement a comprehensive training program with supporting tools and follow-up coaching.
First, we provided broader context for providers and staff about the impact of SDoH and the five critical benefits of data capture:
• Developing effective interventions to address SDoH barriers
• Program identification and improved access to care for patients
• Population health trend identification and monitoring
• Payment reform incentives for approaching health holistically and in an integrated fashion
• Panel management that recognizes providers serving complex patients
Next, we provided detailed training on ICD-10 Z-codes, along with guidance working with care team members other than the provider. We recognize that providers already have substantial workloads and documentation burdens, and wherever possible we want to work with our provider network to alleviate those burnout risks. Our trainers and clinical data integration team covers workflow design in our training program when working directly with the clinics.
We also stressed the importance of capturing Z-codes within the EHR so that documentation can be recognized by our plan. While each CHC has a different EHR instance, we discussed best practices that would be broadly applicable.
More comprehensive data leads to more resources to address homelessness CHPW has now engaged leaders at many of our CHCs and is using executive roundtable discussions to shape our SDoH strategy with input from our provider network. Enabled by our investment in a population health management platform from Arcadia, we have broad plans to use our SDoH data to shape our approach to community-based partnerships, population health assessments, risk stratification, and patient identification for programs, as well as risk adjustment.
