The waiting rooms at OSF HealthCare’s clinics are pretty standard—magazines, TVs and chairs—except for one detail: iPads.
Patients who check in for primary-care appointments are encouraged to use the tablet to fill out a short 14-question survey that assesses their likelihood of facing challenges with 10 domains of social determinants of health, such as food, transportation or financial insecurity.
It’s not what many patients expect when waiting to see their primary-care doctor, particularly in rural Illinois, where many of OSF’s clinics are located.
But social determinants are as influential to a patient’s health as their vital signs, said Dr. Sarah Stewart de Ramirez, an emergency medicine physician and vice president for clinical innovation at OSF Innovation. That means they’re important to screen for—and the “cornerstone of any great screening strategy is to routinely offer it,” she said.
Results from the screening are delivered to the patient’s electronic health record. If a patient is identified as needing some type of social support—such as information about a local food pantry—a nurse or physician will offer to connect them to a care manager, as well as include information on relevant community-based organizations or hospital resources in the patient’s discharge instructions.
For now, that’s the bulk of the program, which is the challenge healthcare providers of all stripes face. While it’s one thing to know a patient is struggling with food insecurity, it’s another to actually address it—let alone track improvements over time.
OSF’s long-term vision is to create a tightly connected coordinated community care network that links healthcare providers and community groups—allowing them to more closely refer and send updates on patients to one another—but they’re still in the early stages of better identifying those who need help, Stewart de Ramirez said.
Screening for social determinants offers a “touch-point,” added Dr. Michael Petersen, social determinants of health and health innovation lead for Accenture’s health practice. “Then the question is: What do I do with this information?”