Dr. Ryan Bosch is a U.S. Air Force veteran and practicing physician who spent six years as the chief medical information officer at Inova Health, managing the health system’s Epic implementation across 11 hospitals and 300 clinics.

He knows what it means to integrate various kinds of health data to enhance care for patients and populations, and to deploy analytics to address social determinants of health for improved health outcomes.

A holistic approach

"Implementing Epic was a large endeavor – and it was my tenure running technology of the health system that taught me the techniques, tools and timing of deploying data to value analytics with a holistic approach," said Bosch, who today is executive vice president and chief health and informatics officer at Acentra Health, a care management and Medicare/Medicaid IT vendor. "My learnings began in the military during my internal medicine residency in the U.S. Air Force.

"There I was taught the patient-centered medical home model, which draws its foundation from the whole-person, whole-population approach that we use as the best practice today," he continued. "This model of care and corresponding data approach pulled in the then-called ‘non-specific healthcare determinants,’ the early name for SDOH."

Even then, informed clinicians focused on a holistic approach to data to deliver precise analytics in pursuit of improved health outcomes from better understanding the personal and community impact of social risk on these outcomes, he added.

"As I continued to practice medicine and lead informatics through the EHR revolution, I implemented and honed this same holistic model in academic medicine settings, industry consulting and finally Inova Health," he said. "I had a great deal of support at Inova to pull off the largest go-live of two regional systems that used the same EHR database and data model but were functional and fiscally independent entities. This galvanized my standard approach.

"Setting up this now-proven model of whole-person, whole-population care was at the center of technical, clinical and business success," he continued. "So my Inova Health experience is what brought it all together and what is the gold standard foranalytics today."

Clinical, behavioral and SDOH data

So how can integrating clinical, behavioral and social data improve care for whole patients and populations? Bosch achieved this goal.

"I was a chemistry major, so to me the integration of all three data domains and a fourth – the community factors – is both simple and powerful," he explained. "At the process center, it is essentially the Scientific Method, where you consider all the domain variables, not just some of them. Deploying the whole-person, whole-population model creates the repeatable engine of identifying risk, analyzing for the best intervention and being disciplined enough to measure it.

"Many times, it will take iteration and tweaking of the interventions on the group to find the best outcomes – reduced cost, better health, improved margins, better quality," he added.

Bosch offers a couple of ways to use advanced analytics to address social determinants of health and drive better health outcomes.

SDOH and analytics advice

"Immediately link socio-clinical susceptibility of the population to your enterprise outcome measures as a business," he suggested. "This guarantees value creation and matches ROI to investments. Let me give an example. Let us say hypothetically that your state just got an infusion of capital forRural Health Transformation with the need to quickly and efficiently put that money to work inside the current environment with both clear measurables and real impact on outcomes and dollars in 2026.

"You have a statewide non-emergency rideshare program or a food-as-medicine program for those with chronic diseases," he continued. "The interventions exist statewide as an opt-in program or by referral, but not as a precise push to a specific population with specific outcome measures, like better health or lower costs, each of which can bring financial and health benefits to the state residents."

Bosch also offers a couple of practical approaches to incorporate SDOH insights into healthcare workflows for public and private payers.

"Let’s take the aforementioned hypothetical one step further," he said. "What would you actually do? With the power of the whole-person, whole-population model, the state or entity can repeatedly identify socio-clinical susceptibility in their populations and precisely deliver and deploy resources – food, medicine, literacy, rides, access, housing, and care coordination – with both measurable and proven effectiveness.

"This reduces the cost of care through more precise programs directed at the subpopulations that benefit the most from the care," he concluded. "The private payers are ahead of the public markets here, but Medicaid is changing every day and evolving as the cost of care is devouring too much of the state budgets."

*Follow Bill’s health IT coverage on LinkedIn: *Bill Siwicki *Email him: *[email protected] Healthcare IT News is a HIMSS Media publication.

WATCH NOW: Managing government policy and regulation in healthcare AI adoption