Getting inside closed-loop referrals: Exploring the patient experience of finding and connecting to social care with a community resource referral system using a community-based participatory approach

Objective: To explore the experiences of patients who found and/or connected to social care via a community resource referral system named “Resourceful” (linked with FindHelp.org) linked to a health system's electronic health record.

Study Setting and Design: The mixed-methods study was co-designed and conducted using community-based participatory processes by a team of researchers at a multi-state health system (Minnesota, North Dakota, Wisconsin) and community members with lived experience addressing unmet social needs. Study participants were individuals referred to, connected to, or delivered social care through Resourceful in the health system's service area. Quantitative surveys were emailed to 780 patients and 38 healthcare workers (HCWs) tied to closed-loop referrals between 8/2022 and 2/2023. Qualitative interview invites were emailed to 19 patient survey respondents wanting to interview, and the five HCWs and 12 community-based organizations (CBOs) involved in their social care experience. Descriptive statistics analyzed sociodemographic and patient experience variables developed via the participatory process. We coded qualitative data using thematic analysis, extracting thematic factors informing survey responses.

Data Sources and Analytic Sample: We collected primary data from online surveys and semi-structured phone interviews.

Principal Findings: Usable survey responses from 62 patients and 14 HCWs were analyzed. Most respondents agreed on some level that their experience using Resourceful strengthened patient trust (patients:66%, HCWs:86%), improved communication about what patients need to be healthy (patients:61%, HCWs:57%), provided “helpful help” reducing social care barriers (patients:56%, HCWs:93%), and enhanced person-centeredness (patients:60%, HCWs:79%). Qualitative analysis yielded six thematic factors corresponding to 23 actionable takeaways potentially important for using CRRS to improve the seeker experience of social care: resource/service environment; platform access/usability/utilization; helper integration/coordination/continuity; helpful help; reliable sources/partnerships; responsive relationships.

Conclusions: Differences in the perceptions of patient experiences involving resourceful were observed between patients and HCWs/CBOs. Thematic factors clarified these differences and how to improve patient experiences with closed-loop referrals.