People with disabilities can be any age, face chronic health conditions or mental illness, be racial or ethnic minorities, experience low income or housing insecurity, have limited English proficiency, or a combination of many of these conditions. To better understand the effect of health inequities and the manner in which they affect Social Security Administration’s (SSA) disability programs, the National Academies hosted a public workshop in April 2024 that examined the variety of different experiences of individuals with disabilities and the consequences of those experiences on an individual's health status, medical record, and SSA disability determinations.

Contents

• The National Academies of SCIENCES • ENGINEERING • MEDICINE
• PLANNING COMMITTEE FOR THE WORKSHOP ON HEALTH DISPARITIES IN THE MEDICAL RECORD AND DISABILITY DETERMINATIONS
• BOARD ON HEALTH CARE SERVICES
• Reviewers
• Acknowledgments
• Acronyms and Abbreviations
• 1. Introduction
• 2. Overview, Concepts, and Framing
  • DEFINITION OF DISABILITY
  • OVERVIEW OF SSA’S DISABILITY DETERMINATION PROCESS
  • BASICS OF HEALTH DISPARITIES
  • THE PURPOSE AND FUNCTION OF THE MEDICAL RECORD
• 3. Social Determinants of Health and Their Effects on Care
  • ADDRESSING SOCIAL DETERMINANTS OF HEALTH FOR PEOPLE WITH DISABILITIES
  • PERSPECTIVE OF A COMMUNITY OUTREACH COORDINATOR
  • REIMAGINING EHRs TO INCLUDE THE SOCIAL SIDE OF HEALTH
  • AN INTEGRATED AND PATIENT-CENTERED CARE MODEL
  • Q&A WITH THE PANELISTS
• 4. Disparities and Bias in Evaluative Testing and Recording of Medical Information
  • GUIDING PRINCIPLES TO ADDRESS THE EFFECT OF ALGORITHM BIAS ON DISPARITIES IN HEALTH AND HEALTH CARE
  • HEALTH INEQUITIES THROUGH THE LENS OF A PERSON WITH DISABILITIES
  • DATA COLLECTION AND IDENTIFICATION OF DISABILITY STATUS: NECESSARY TOOLS TO IMPROVE CARE ACCESS AND REDUCE HEALTH CARE DISPARITIES FOR PEOPLE WITH DISABILITIES
  • BARRIERS TO INITIATE PARTICIPATION IN INTERACTING WITH THE SYSTEM
  • Q&A WITH THE PANELISTS
• 5. Health Disparities and the Disability Application Process
  • USING DATA TO ADVANCE HEALTH EQUITY FOR PEOPLE WITH DISABILITIES
  • A PATIENT’S STORY
  • PEOPLE WHO ARE UNHOUSED WITH DIAGNOSES OF MENTAL ILLNESS
  • Q&A WITH THE PANELISTS
• 6. Mitigating the Effect of Health Disparities in the SSA Disability Determination Process
  • HELPING CLINICIANS HELP THEIR PATIENTS
  • ISSUES WITH THE EHR
  • INCORPORATING PATIENT VOICES IN RESEARCH
• 7. The Health Record in Depth
  • CURRENT STATE OF CLINICAL DOCUMENTATION IN THE EHR
  • BIASES IN EHR DOCUMENTATION AND ITS EFFECT ON CLINICAL CARE
  • CAPTURING SOCIAL DETERMINANTS WITH HEALTH INFORMATION TECHNOLOGY
  • THE IMPORTANCE OF FREE TEXT IN EHRs AND THE ROLE OF ARTIFICIAL INTELLIGENCE
  • Q&A WITH THE PANELISTS
• 8. The Relationship Between the Medical Record and Health Disparities
  • DISABILITY STATUS IN EHRs
  • THE EHR AND WHAT IT DOES NOT TELL US
  • SOCIAL DRIVERS OF HEALTH IN THE MEDICAL RECORD
  • STANDARDS AND OPPORTUNITIES
  • Q&A WITH THE PANELISTS
• 9. Approaches to Advancing Medical Records to Address Disparities in Disability Determinations
  • CAPTURING FUNCTIONAL INFORMATION
  • ENABLING BIDIRECTIONAL COMMUNICATION WITH COMMUNITY PARTNERS
  • PROVIDING EVIDENCE-BASED, DISABILITY-FRIENDLY CARE
  • Z CODES AND DOCUMENTING SOCIAL DETERMINANTS OF HEALTH
  • IDENTIFYING BIAS
  • ABOVE ALL, ASK
  • IMPROVING THE DISABILITY DETERMINATION PROCESS
  • THE ROLE OF AI
  • THE IMPORTANCE OF TRUST
• 10. Concluding Remarks
• Appendix A. References
• Appendix B. Statement of Task
• Appendix C. Workshop Agenda
• Appendix D. Biographical Sketches of Planning Committee Members and Speakers

Suggested citation:

National Academies of Sciences, Engineering, and Medicine. 2024. Health disparities in the medical record and disability determinations: Proceedings of a workshop. Washington, DC: The National Academies Press. https://doi.org/10.17226/27909.

Digital Object Identifier: https://doi.org/10.17226/27909

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