Evaluation of a clinic-based, electronic social determinants of health screening and intervention in primary care pediatrics

OBJECTIVE: Social Determinants of Health (SDOH) significantly affect individuals' health outcomes, yet universal electronic SDOH screening is not standard in primary care. Our study explores the implementation of an electronic SDOH screening in the Electronic Health Record (EHR) and follow-up intervention among primary care pediatric patients within an academic clinic.

METHODS: Beginning in August of 2022, patients and their families determined to have at least one SDOH need qualified for an in-clinic referral to a coordinated care team member. We assessed the overall efficacy and feasibility of the implementation.

RESULTS: Over the 4-month pilot, 1,473 of 2,064 (71.4%) eligible patients were screened, with 472 (32%) patients screening positive on at least one SDOH domain. Of the 472 screened positive, 48 (10.2%) declined a referral. 247 of the 424 (58.3%) received a referral to a care coordination team member.

CONCLUSION: This study demonstrates the feasibility of a universal electronic SDOH screening tool within the EHR within an urban, academic-based clinic.

WHAT'S NEW: This study contributes to research in health disparities by developing a social determinants of health screening tool integrated within the electronic health record and highlighting the importance of in-clinic coordinated care teams to provide timely, holistic, patient-centered care.