Social Determinants of Health Analytics To Improve Patient Outcomes

Expert Interview

Tim Suther, senior vice president of data solutions at Change Healthcare, discusses a new Social Determinants of Health Analytics resource.

Hi, I'm Gabrielle Ientile with Drug Topics® and today I'll be speaking with Tim Suther, senior vice president of data solutions at Change Healthcare, about the company's new Social Determinants of Health (SDOH) Analytics, and its application in the pharmacy setting.

First, here's the latest news from Results of an interim analysis for AstraZeneca’s coronavirus disease 2019 (COVID-19) vaccine, AZD1222, demonstrated that the vaccine candidate met the primary efficacy end point of preventing COVID-19 infection.

The United Kingdom-based study evaluated 2 dosing regimens. The first, in which the vaccine is administered as a half dose followed by a full dose at least 1 month later, showed 90% efficacy; the other regimen – 2 full doses at least 1 month apart – demonstrated 62% efficacy. Overall, investigators reported an average vaccine efficacy of 70%, with all results deemed statistically significant.

And that's the latest news from Now, here's my interview with Tim Suther.

Drug Topics®: So to get us started on the topic today, what are SDOH and what are some of the ways that they inform health disparities in the United States?

Suther: It's a great question. I'm delighted to be with you here this afternoon and hope you and yours are safe and healthy in these challenging times. So social determinants are, frankly, life circumstances. So much of healthcare is about the care that is rendered by your doctor or the prescription that your pharmacy provides to you. But the reality is that 80% of your health and wellness, in fact, people's health and wellness, is determined by these life circumstances.

That is what happens outside the doctor's office, what happens outside the pharmacy, and they include things like our health, literacy, our income, our wealth, our access to care, whether or not we are caring for a loved one, or whether or not we're a single parent – all those things affect our health and wellbeing.

And the challenge is that healthcare overall does not really do a great job of collecting that information. And that's the problem we set out to solve, how do we connect what happens in the doctor's office to life circumstances, which is what happens to us when we're out living our lives. I look forward to talking to you about it today.

Drug Topics®: Now with these disparities are also showing themselves with the COVID-19 infection rates and outcomes, can you talk about that a little bit more?

Suther: Indeed, so when the pandemic was first declared in March, we began immediately isolating COVID encounters. So today, we see about 40% of the positive COVID diagnoses in America the day after a clinician makes that diagnosis. So we see tests, we see diagnoses, we see when people are admitted into the hospital, we see their discharge status.

And in March, we made a decision. It’s said that if you want to go fast, go alone. If you want to go far, go together. And we elected to go together with the brightest health care minds in America. And we began making it available to academic medical centers. And right now over 70 academic medical centers are using our data to better understand COVID: how the disease progresses, whether interventions work and the impacts on the overall healthcare system.

And the reality is that each of us experience healthcare differently. And in this time, also of social unrest, most of the research and our data supports, it indicates that People of Color, whether African American or Latinx, they are experiencing COVID on a per capita rate far more intense than those that are Caucasian and those that are Asian, Asian American. And if you want to do something about that, you got to have data to understand it. And that's been our role.

Drug Topics®: So you touched upon why Change Healthcare decided to create this resource. How does current practice utilize SDOH in treating patients now? Is there a widespread understanding of the critical need for addressing SDOH in creating more equitable health outcomes?

Suther: Well, sadly, the health care system does not do a great job of capturing that information organically. There's just too much friction in the process.

I spent a lot of my career in financial services and in the advertising world. And when I got into the health care business about 4 years ago, I was shocked to find out that information that was so crucial in determining our health outcomes just was not available in the health care system.

We set out about a year ago to begin to identify the best sources for that data, and then to integrate it with our claims data. And that actually was harder to do than you might imagine. I felt like Thomas Edison. I’d found all 10,000 ways not to invent the light bulb, until we did.

So today, we've got this great data set that links deidentified claims with the most important SDOH. And then we make it available to payers and providers alike in a portrait service that allows them to understand for their local area, what SDOH matter most for their at risk population. And then we offer the ability to supply needed SDOH to providersand payers and pharmacies. And likewise, we've created a unique analytic environment for those that have data scientists to be able to do really rich, deep compliant analytics.

So we're serious about making a dent here.

Drug Topics®: So can you take us a little bit step by step of how SDOH Analytics works?

Suther: Yeah, there's 3 products.

The first thing is that you have to understand, for your patient population, or if you're a health plan your members, which social determinants matter most. Oftentimes, social determinants feels like an abstract concept and there are so many choices. So how do you choose?

Well, the first thing that we do is we offer a portrait service. So give us a population that matters to you and we will go do the analysis for you. We’ll tell you whether it's health care literacy, or access to health care, food vulnerabilities. Whether it's broken down by ethnic disparities, no matter what the life circumstance is, we’ll go identify it for you.

And then armed with that, you can prioritize your initiatives to do something about it. So we think that's the initial gateway service. And oftentimes that can lead to, “Oh, great, I understand that it's really healthcare literacy that matters most.” So we can supply that information to a payer or provider to be able to fill that information gap that they have about their patients or members.

And then for certain customers who have the necessary analytic expertise, and they want to do their own unique analysis, we have a secure compliant environment exactly for that purpose.

Drug Topics®: And then in pharmacy specifically, how can pharmacies that are expanding into corporate retail clinics utilize this resource?

Suther: The pharmacies that are doing that are making a strong statement about the importance of population health. And understanding the totality of your customers life beyond the perceptions that he or she picks up is vitally important.

Having the ability to connect to other information about that customer, whether that be information that is from a clinical experience, or information that is about as social determinant of health, just provides a vital information platform for those who want to have a population health oriented mentality to their customers.

Drug Topics®: And are there other resources like this currently out there?

Suther: I don't really think so. There are certainly data sets that are available, there are geo demographic data sets. But the hard part of this is actually taking it and linking it to HIPAA regulated data. It’s my Thomas Edison example again. That is really hard to do. And to be able to connect what happens in a clinical setting with life circumstances reliably at scale is a serious technological challenge.

And we've solved that. The second part is, generally we're dealing with deidentified data. And 1 of the things that you need to be careful with is that when you take clinical data that has been deidentified and you start to add other descriptive information about those customers, you can very easily late end up reidentifying people. And that's a really bad outcome.

So we built this secure, always on compliance environment for those who want to do advanced analytics. And they can do that knowing that the system will be checking every query, every output, to make sure that you remain on side with that with HIPAA. Because the last thing you want, as you're trying to do something that is really impressive progressive in serving customers, last thing you want to do is to create an environment, a situation where you accidentally reidentify someone. That would be not a good outcome.

Drug Topics®: And what does Change Healthcare hope that this resource will lead to?

Suther: Well, our country right now spends about twice per capita on health care of any other developed country. We ranked number 43 in the world in life expectancy.

So we're spending a lot of money and are not getting our money's worth. So what do I hope it comes to? I want our health care system to be more affordable for Americans, I want our loved ones to live healthier lives, and longer with us. Our mission at change health care is to inspire a better health care system. And we hope that this service will enable payers and providers alike to do exactly that.

Drug Topics®: And what do you see as the key takeaways on this topic?

Suther: It's the ability to convert SDOH from an abstract concept into specific steps that you can take to do something about it. That's what the portrait analysis will do.

It will help you remove the abstraction of social determines, the confusion of social determinants, and to prioritize which of them actually had the most significant impact on your patients, your members, your customers.

And armed with that, then you can prioritize the programs that are likely to make a difference. And where you have information gaps, we can help you fill those, and where you have desires to do advanced analytics in the social determinants space, we can help you do that as well.

Drug Topics®: Tim, thank you so much for taking the time to speak with me today. Really appreciate it.

Suther: Gabrielle, I'm so happy that we've spent time together and we look forward to the success of this program across health care in America, so thank you.

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