Form C1 Asynchronous Focus Group Questions-Clinicians and Health

Form Approved

OMB No. 0955-XXXX

Exp. Date TBD

Access, Exchange, and Use of Social Determinants of Health Data in Clinical Notes (SDOH)

Asynchronous Clinicians and Healthcare Professionals Focus Group:

Focus Group Guide

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Focus Group Interview Guide: Clinicians/Healthcare Professionals

Questions for Asynchronous (Message board style) groups

1. Defining Social Determinants of Health (SDOH)

[Introductory sentences: The Center for Disease Control and Prevention describes social determinants of health as the conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of life-risks and outcomes.

1. Have you heard of Social Determinants of Health (SDOH)?

2. How would you define Social Determinants of Health?

3. What are some examples of Social Determinants of Health? (Moderator give list of some that aren’t mentioned after participants share their thoughts)

2. Current Practices for Documenting Social Determinants of Health
   
   A. Talking to patients about Social Determinants of Health

1. Do you/your practice ask patients about Social Determinants of Health? Why or why not? Who asks the patients about Social Determinants of Health?

2. Do you explain to patients why you are asking about Social Determinants of Health? Do you call them Social Determinants of Health or something else?

3. Does your practice use an Electronic Health Record?

4. Do you/your practice document Social Determinants of Health information in the patient’s medical record? Why or why not? Who documents the Social Determinants of Health?

5. [if practice documents SDOH in the EHR] Do you tell patients that you are documenting Social Determinants of Health in their medical record? Do you explain to patients why you are documenting Social Determinants of Health?

6. Do you have any concerns about asking patients about or documenting Social Determinants of Health?

B. Social Determinants of Health Information Collection Practices

1. What Social Determinants of Health do you ask about? (Moderator give list of the following: race, ethnicity, preferred language, housing insecurity, food insecurity, social isolation, transportation access, sexual orientation, gender identify, intimate partner violence, veteran status, also option to say you don’t know and option to include additional items)

2. When do you collect Social Determinants of Health information (in clinic before, during, after visit; in waiting room; at patient’s home computer/tablet, other)?

3. How do patients respond (orally, on tablet, through patient portal, kiosk in waiting room, on paper form, other)?

4. Do you capture Social Determinants of Health information from any other sources besides the patient (e.g. social service/community-based organizations/first responders)? How are those documented?

5. Where do you document Social Determinants of Health information in the patient’s record (Notes? Assessments? In structured questionnaires? Other fields? Other?)

6. Is there any training provided to clinicians in your practice on how to ask about/discuss/document Social Determinants of Health information?

7. Do you (or your staff) routinely obtain social determinants of health information about your patients from any other sources (e.g., other providers, social services agencies)? If yes, from whom?

C. Using Social Determinants of Health Information

1. Do you/your care team utilize the collected Social Determinants of Health information? How do you utilize this information? Can you give any examples of specific instances where you have utilized it?

   1. When do you/your staff act on Social Determinants of Health information: during a visit, after a visit, not at all, etc.?

2. How does your practice/health system utilize this information (e.g. For population health data tracking? For research purposes? To coordinate an individual’s care? Other?) (Probe if doesn’t come up: Does your practice/health system use Social Determinants of Health information to identify health disparities and opportunities to reduce them at the individual and/or practice level?)

3. Have you heard any concerns from patients about using their Social Determinants of Health information?

4. Do you have any concerns about using Social Determinants of Health information provided by other clinicians or service providers in providing patient care or care coordination?
   
   

3. Preferred Practices for Documenting Social Determinants of Health Information

   1. What Social Determinants of Health information do you believe would be most useful to a patient’s care? Why do you believe these would be most useful?

   2. How would you like Social Determinants of Health information to be collected?

1. When? (in clinic before, during, after visit; in waiting room; at patient’s home computer/tablet, other)?

2. By whom? (for example, doctor, nurse, MA, social worker, other? Not by a person but via a form?)

3. How do you prefer patients share Social Determinants of Health information? (orally, tablet, patient portal, kiosk in waiting room, paper, other)?

4. What is your preference for documentation of Social Determinants of Health information in the medical record? Open-text field/notes/assessment vs. structured fields? Why?

4. Increasing Documentation and Use of Social Determinants of Health Information

   1. What do you think would lead to more documentation of Social Determinants of Health information in your practice/in health systems?

   2. What are barriers to collecting and documenting Social Determinants of Health information?

   3. What barriers are there to utilizing Social Determinants of Health information for a patient’s care?

   4. Are there policies/practices within a health system and in other entities (e.g. vendors, government, insurers, etc.) that could facilitate the documentation/utilization of Social Determinants of Health information? (Moderator ask if this didn’t come out in earlier questions in section IV or use this as probe.)

Parking Lot question (if have time):

Do you currently send Social Determinants of Health information to others or get requests for Social Determinants of Health information?