We have initiated the action steps in this unique effort because:
- A national agenda focused on the Social Determinants of Health and Well-Being (particularly on “upstream” activities in communities nationwide) is long overdue. It should be a critical component of post-coronavirus rebuilding activities.
- Covid-19 has had a broad and deep impact throughout society, contributing to troubling public health, economic and social problems. Pointedly, the people most negatively impacted are those who already were underserved and under-resourced.
- The need to work more explicitly for equity, in health and more broadly, is clear. Interoperability is a critical way to pursue that goal by routinely providing the data needed both to understand the impact of racial/socioeconomic disparities and to address them.
- This is a historic opportunity to make fundamental, generational changes that will help to drive progress in many concrete ways.
Action Agenda Activities
- A webinar series focused on developing the Equity Action Agenda and integrating it into a national symposium (see next bullet). A critical part of this work was to identify which SDOH elements are of highest-value and most-achievable, as well as how best to advance them into policy and practice. These interactive discussions were led by Dr. Karen Smith, former Director of California’s Department of Public Health, joined by our colleagues from Stanford’s Center for Population Health Sciences and other prominent thought leaders, innovators, subject-matter experts and change agents nationwide.
- Stewards of Change’s National Action Agenda Symposium was held virtually on January 25-26, 2021, with over 150 participants from across the nation, Canada and Europe. Its focus included six NAA action recommendations devised by subject matter experts nationwide during the previous year, along with a preview of subsequent implementation efforts. This event was the culmination of all the integrated, strategic, step-by-step activities leading up to it; the symposium itself focused on crystalizing and launching specific, actionable steps forward in numerous ways.
- A Proof of Concept implementation, called Project Unify, designed to demonstrate that health-related data can be shared reliably and securely across Human Services and other domains critical to SDOH. The goal is to enable cross-domain interoperability of a kind and to an extent that hasn’t been done before. Our work on Project Unify is ongoing, because this type of data exchange is vital to accelerating progress on SDOH. A critical part of Unify, relating to consent, is summarized in the next bullet.
- Carrying out a key recommendation from the symposium: Modernize the process by which individuals provide consent to share their sensitive personal information. We strongly believe that doing so will significantly enhance care coordination, enable more-holistic, person-centered services, and broadly improve health and well-being. Our initial efforts in this area include – but are not limited to – a first-ever aggregation and examination of major consent-related initiatives nationwide to inform and accelerate progress; and, as part of Project Unify, the development, proof-of-concept testing and deployment of our Consent Service Utility (CSU), a technical solution to enable, facilitate and greatly extend information-sharing and interoperability across health, healthcare, human services and other relevant domains (ex., education, child welfare, justice, etc.).
- Outreach, advocacy and other ongoing activities by workgroups on the Collaboration Hub of SOCI’s National Interoperability Collaborative (NIC). The members of these diverse, multi-sector, multi-discipline groups helped to develop our webinar series and symposium, and they are currently focused on Project Unify (among other efforts). We are also extending all this knowledge in the first two courses of our InterOptimability Training and Certification Curriculum (ITCC), with more to come.
Action Agenda Goal and Objectives
Our overarching goal in pursuing this highly collaborative effort is to guide pragmatic, systems-level change across Healthcare, Human Services, Education, Public Health, Public Safety and other relevant programs, systems and domains. The urgency to conduct this work now is glaringly evident as we all see, every day, the structural problems we vitally need to address – from health disparities and racial injustice to better prevention, early detection and other upstream activities. Our Action Agenda’s specific, bottom-line objectives include:
- accelerating SDOH integration as an indispensable element of every domain’s work;
- focusing greater attention and resources on prevention, early intervention and other upstream activities;
- enhancing efficiency and reducing costs;
- furthering health equity; and
- improving outcomes for the populations being disproportionately hurt by both the pandemic and, even more deeply, by racial and socioeconomic inequities.
Thanks to Our Sponsors - and Request for More
Our unique, important efforts will continue into the future, so please support them if you can. The sponsors/contributors for the Action Agenda include the Mitre Corporation, the Michigan Health Information Network (MiHIN), the Robert Wood Johnson Foundation’s Data Across Sectors for Health (DASH), the California Mental Health Services Oversight and Accountability Commission, BrightHive Data Trusts and FEI Systems. And there are a growing number of additional supporters, such as the Pew Charitable Trusts, for which we conducted a court technology project that further broadened the Equity Action Agenda.
* Important note: We use "Social Determinants," as well as the acronym SDOH, because they are in common usage. Our belief, however, is that the factors they refer to are, in reality, highly influential but not necessarily determinative. So, we are currently considering how to revise that description while retaining broad understanding of its intent.