Collecting and understanding social determinants of health (SDoH) is critical to the efforts of providers and health organizations seeking to improve care for the populations they serve. Methods of collecting SDoH data across providers lacks standardization, and organizations have struggled to find meaningful use for the disparate data gathered to drive patient-centered care.
Many organizations that have developed and implemented SDoH screening tools have not assessed the process' impact to determine how effective their efforts are at assessing, rather than perpetuating, inequities. To determine effectiveness, organizations must evaluate the end-to-end process within clinical settings to optimize their respective screening tools that collect SDoH data.
Our client, a large integrated health system, developed and piloted an SDoH screening tool at 3 clinical settings and then across the system to allow clinical teams to screen patients for social needs and generate referrals to federal, state, and community resources when appropriate. We evaluated the tool's impact on outcomes to better understand the utility of the SDoH screening tool in benefitting patient subpopulations and informing providers in clinical settings.
We used qualitative methods to assess the impact of the SDoH screening tool on patient outcomes and to generate useful insights to advance interventions. Collaborating with the client to identify key stakeholders and project leaders, RTI Health Advance interviewed each group to capture the implementation experience. Findings were synthesized and recurring themes were identified, allowing us to define key implementation and adoption findings to improve future deployment of the tool.
We discovered patients found value in the SDoH screening tool, although we also noted that length may deter some from fully completing all of the questions. The health system deemed the questions were effective in gathering relevant, actionable SDoH data.
Once the client gained key insights into program performance and ways to implement the program more efficiently and effectively at additional sites, the focus shifted to areas of success and opportunities to improve further use of the SDoH screening tool. Now our client can:
- Scale the SDoH screening tool and program implementation system‐wide
- Guide future decisions to screen for SDoH to optimize patient outcomes
- Strengthen community, state, and federal partnerships and the referral processes to connect patients to resources necessary to improve the health of communities