Adding Social Determinants in the Electronic Health Record in Clinical Care in Hawai'i: Supporting Community-Clinical Linkages in Patient Care.

Social and behavioral determinants of health, such as poverty, homelessness, and limited social support, account for an estimated 40% of health burdens and predict critical health outcomes. Many clinical-community linkages specifically focus on addressing such challenges. Given its distinctive history, culture, and location, Hawai'i has unique social factors impacting population health.

Living Alone and Homelessness as Predictors of 30-Day Potentially Preventable Hospital Readmission.

Introduction: The effect of social factors on health care outcomes is widely recognized. Health care systems are encouraged to add social and behavioral measures to electronic health records (EHRs), but limited research demonstrates how to leverage this information. We assessed 2 social factors collected from EHRs - social isolation and homelessness - in predicting 30-day potentially preventable readmissions (PPRs) to hospital.