As health systems work to address social determinants of health, they should focus on seniors who are experiencing social isolation or loneliness because they may face a higher risk of mortality, heart disease, and depression, according to a new report from the National Academies of Sciences, Engineering, and Medicine. Technology plays a role in the report’s recommendations for how the healthcare system can do a better job of addressing the health impacts of social isolation and loneliness.
The NASEM report, sponsored by the AARP Foundation, notes that despite the profound health consequences — and the associated costs — the healthcare system remains an underused partner in preventing, identifying, and intervening for social isolation and loneliness among adults over age 50.
Dan Blazer, M.D., Ph.D., is the J.P. Gibbons Professor of Psychiatry Emeritus and professor of community and family medicine at Duke University, and chair of the committee that wrote the report. “Loneliness and social isolation aren’t just social issues — they can also affect a person’s physical and mental health, and the fabric of communities,” he said in a prepared statement. “Addressing social isolation and loneliness is often the entry point for meeting seniors’ other social needs — like food, housing, and transportation.”
The recommendations in this report represent a vision for how the health care system can identify people at risk of social isolation and loneliness, intervene, and engage other community partners.
The report recommends that health systems include social isolation in electronic health records. If a patient is at risk for or already experiencing social isolation, providers should include assessment data in clear locations in the EHR, the report says.
The report notes that the inclusion of this information in the EHR may vary according to clinical setting (primary care, inpatient, emergency department), and “decisions about its use in EHRs will need to take into account the purpose of the information, how it is used, how to track it over time, and how to ensure it is easily viewable and extractable. Some EHRs have modules for the social determinants of health that enable structured documentation and presentation of the data.”
To highlight the clinical significance of loneliness and isolation in the EHR, a best practice includes adding loneliness or isolation to problem lists with their corresponding ICD-10 codes, the report says.
Among the report’s findings are that a key aspect of selecting a tool for use in clinical settings is standardization within a specific organization so that everyone within the organization uses the same tool or set of tools. It notes that predictive analytics also may be of value for identifying individuals at risk for isolation and loneliness.
