title: Community Vital Signs: Taking the Pulse of the Community While Caring for Patients.
abstract: In 2014 both the Institute of Medicine and the National Quality Forum recommended the inclusion of social determinants of health data in electronic health records (EHRs). Both entities primarily focus on collecting socioeconomic and health behavior data directly from individual patients. The burden of reliably, accurately, and consistently collecting such information is substantial, and it may take several years before a primary care team has actionable data available in its EHR. A more reliable and less burdensome approach to integrating clinical and social determinant data exists and is technologically feasible now. Community vital signs-aggregated community-level information about the neighborhoods in which our patients live, learn, work, and play-convey contextual social deprivation and associated chronic disease risks based on where patients live. Given widespread access to "big data" and geospatial technologies, community vital signs can be created by linking aggregated population health data with patient addresses in EHRs. These linked data, once imported into EHRs, are a readily available resource to help primary care practices understand the context in which their patients reside and achieve important health goals at the patient, population, and policy levels.
authors.affiliation: From the Pennsylvania Department of Health, Harrisburg (LSH); the American Board of Family Medicine, Lexington, KY (RLP); OCHIN, Inc., Portland, OR (JED); Department of Family Medicine, Oregon Health & Science University, Portland (JED); and The Robert Graham Center, Washington, DC (AWB). laurenshughes@gmail.com.
authors.forename: Lauren S
authors.initials: LS
authors.lastname: Hughes
authors.affiliation: From the Pennsylvania Department of Health, Harrisburg (LSH); the American Board of Family Medicine, Lexington, KY (RLP); OCHIN, Inc., Portland, OR (JED); Department of Family Medicine, Oregon Health & Science University, Portland (JED); and The Robert Graham Center, Washington, DC (AWB).
authors.forename: Robert L
authors.initials: RL
authors.lastname: Phillips
authors.affiliation: From the Pennsylvania Department of Health, Harrisburg (LSH); the American Board of Family Medicine, Lexington, KY (RLP); OCHIN, Inc., Portland, OR (JED); Department of Family Medicine, Oregon Health & Science University, Portland (JED); and The Robert Graham Center, Washington, DC (AWB).
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: DeVoe
authors.affiliation: From the Pennsylvania Department of Health, Harrisburg (LSH); the American Board of Family Medicine, Lexington, KY (RLP); OCHIN, Inc., Portland, OR (JED); Department of Family Medicine, Oregon Health & Science University, Portland (JED); and The Robert Graham Center, Washington, DC (AWB).
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Bazemore
mesh_terms: D002908:Chronic Disease; D003467:Cultural Deprivation; D057286:Electronic Health Records; D020408:Health Insurance Portability and Accountability Act; D006801:Humans; D007256:Information Systems / Q000639:trends; D018802:Patient-Centered Care / Q000379:methods*; D011320:Primary Health Care / Q000379:methods*; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D064890:Social Determinants of Health; D012959:Socioeconomic Factors; D014481:United States
keywords: Population Characteristics; Public Health; Residence Characteristics; Social Determinants of Health