IOM Report: Social and Behavioral Data in the EHR



The social and behavioral determinants of health such as smoking status and depression are significant factors attributed to risk and functional outcomes for patients with chronic disease. Despite this importance, most electronic health records (EHRs) do not capture this patient information. An EHR that captures this data would be a great asset to integrated behavioral health care.

A select committee of leading researchers and population health experts, funded by the Institute of Medicine (IOM), was tasked to identify these core domains to facilitate future use of EHR data for improved care delivery and research alike. In the first stage of this report, Capturing Social and Behavioral Domains in Electronic Health Records: Phase 1, six criteria were chosen to more clearly identify domains with high priority for inclusion in EHRs. These include: “1) strength of the evidence of the association of the domain with health; (2) usefulness of the domain, as measured for the individual, population, and research; (3) avail­ability and standard representation of a reliable and valid measure(s) of the domain; (4) feasibility for the patient and clinician and in terms of administrative time and cost of interfaces and storage; (5) sensitivity, such as for revealing personal information; and (6) accessibility of data from another source.”

Using the first two criteria, the committee has currently established 17 pertinent domains including sociodemographic, psychological and behavioral factors, sexual orientation, education, stress, and dietary and physical activity patterns. The Phase 2 report plans to use all six criteria to establish a more targeted set of domains. Inclusion of social and behavioral determinants in EHRs will provide useful information to providers and patients, and lead to improved assessment and treatment approaches for American patients.

A summary of the report may be found at:

To read the report, please visit: