Health-related social needs screening across a large health system-not yet there, but closer

Health-related social needs (HRSNs), such as food insecurity, housing instability, and transportation barriers, are difficult to capture directly in the electronic health record (EHR). To identify who is experiencing social and economic strain, health systems have relied on structural and area-level proxies, such as insurance status or neighborhood indices like the Social Vulnerability Index or Neighborhood Deprivation Index. These measures are informative, but they are not modifiable, and they do not tell a care team which specific need a patient faces. Patel and colleagues, report a retrospective cohort study of an EHR-embedded HRSN screening program across Trinity Health, a large health system spanning 92 hospitals and more than 2100 outpatient practices in 22 states. The screening tool assessed 7 domains, including food insecurity, financial strain, housing instability, transportation barriers, health literacy, and desire for assistance social isolation. Among nearly 1.9 million eligible adults, 60% completed screening, although completion was substantially higher in outpatient (73%) than inpatient (23%) settings, and almost 30% screened positive for at least 1 HRSN.