Study protocol: a pragmatic, stepped-wedge trial of tailored support for implementing social determinants of health documentation/action in community health centers, with realist evaluation.

Background: National leaders recommend documenting social determinants of health and actions taken to address social determinants of health in electronic health records, and a growing body of evidence suggests the health benefits of doing so. However, little evidence exists to guide implementation of social determinants of health documentation/action.

Methods: This paper describes a 5-year, mixed-methods, stepped-wedge trial with realist evaluation, designed to test the impact of providing 30 community health centers with step-by-step guidance on implementing electronic health record-based social determinants of health documentation.

Adoption of Social Determinants of Health EHR Tools by Community Health Centers.

Purpose: This pilot study assessed the feasibility of implementing electronic health record (EHR) tools for collecting, reviewing, and acting on patient-reported social determinants of health (SDH) data in community health centers (CHCs). We believe it is the first such US study.

Methods: We implemented a suite of SDH data tools in 3 Pacific Northwest CHCs in June 2016, and used mixed methods to assess their adoption through July 2017.

Patterns of Electronic Portal Use among Vulnerable Patients in a Nationwide Practice-based Research Network: From the OCHIN Practice-based Research Network (PBRN).

Background: Underserved patient populations experience barriers to accessing and engaging within the complex health care system. Electronic patient portals have been proposed as a potential new way to improve access and engagement. We studied patient portal use for 12 consecutive months (365 days) among a large, nationally distributed, underserved patient population within the OCHIN (originally created as the Oregon Community Health Information Network and renamed OCHIN as other states joined) practice-based research network (PBRN).

Testing health information technology tools to facilitate health insurance support: a protocol for an effectiveness-implementation hybrid randomized trial.

Background: Patients with gaps in health insurance coverage often defer or forgo cancer prevention services. These delays in cancer detection and diagnoses lead to higher rates of morbidity and mortality and increased costs. Recent advances in health information technology (HIT) create new opportunities to enhance insurance support services that reduce coverage gaps through automated processes applied in healthcare settings.