Robyn Golden, associate vice president of social work and community health at Rush University Medical Center in Chicago, knows her health system is in a unique position. Isolation and loneliness among patients is at an all-time high nationwide and much talked about in light of COVID-19, but it’s also not something providers en masse are tackling yet.
But it doesn’t have to be that way. There are low-cost options providers can use to help move the needle for these patients.
Rush started a few months ago screening patients for isolation and loneliness, a feature integrated into its electronic health record system. Rush originally added a social determinants of health screening in 2018. When a patient scores high on their screening, they’re assigned to a team that creates a plan for them, and they receive periodic check-in phone calls.
“It’s rare for a hospital to have a social services agency built in,” Golden said. “But social isolation doesn’t happen in isolation. Often people will have other comorbidities: depression, anxiety, increased risk of substance use and other health conditions.”
She added that some of Rush’s solutions do cost money for services that insurers usually don’t cover. But there is a tie to the bottom line: Providers can see progress in measures like readmissions, patient utilization and provider burnout, all which are directly connected to the social determinants of health, including isolation and loneliness. And often addressing one social determinant like isolation can also impact others; providers might find through interventions that a patient needs better access to transportation, food or housing assistance.
The solutions don’t have to break the bank. They can include low-tech phone calls or partnerships with community organizations to help those patients.
Golden and other experts say the pandemic has increased the imperative for health systems to address isolation and loneliness. More people are receiving care at home, including older adults after a hospital discharge, or others who seek virtual care to avoid potential COVID-19 exposure.
That shift can lead to isolation and loneliness, factors that can have the same negative health mortality and health cost impact as smoking 15 cigarettes a day, according to the federal Health Resources and Services Administration.
Historically, the task of targeting loneliness and isolation has been left to community senior centers and area agencies on aging. The growth in health systems providing patient solutions has mainly been within risk-based organizations, or academic medical centers and other integrated care providers.