Results of integrating an automated electronic social determinants of health screening survey in a gynecologic oncology practice: a pilot study

OBJECTIVE: To assess the feasibility of implementing an automated social determinants of health screening survey for gynecologic oncology into the electronic health record. 

METHODS: From May 2022 to July 2023, patients at 5 academic gynecologic oncology practices received a social determinants of health screening survey as an electronic message through the patient portal before an in-person or telemedicine visit. Each patient was eligible to complete the survey once; new patients received the survey prior to their initial visit, whereas returning patients received it around a single encounter during the study period. We assessed descriptive statistics of respondents compared with non-respondents using χ2 tests. We used multi-variable regression analyses to examine the association between survey completion and social needs with patient characteristics. 

RESULTS: Of 4369 patients seen, 1592 patients completed the social determinants of health survey (36% response rate). The mean age of survey completers was 56 years; 63% identified as White, 26% as Black, 4% as Asian, and 7% as Other. Patients who were younger and had private insurance were more likely to complete the screening. Black patients were more likely to complete the screening than White patients (p =.01). Of the 1592 patients who completed the survey, 380 (24%) identified 1 or more social needs: 189 (12%) financial worry, 150 (9%) food insecurity, 136 (9%) housing needs, and 78 (5%) transportation needs. Patients identifying as Asian, Black, or a race other than White and patients with Medicaid or Medicare Advantage insurance were more likely to report social needs compared with White patients and those with private insurance. 

CONCLUSION: In gynecologic oncology practices, social needs were prevalent and easily collected from an automated survey embedded in the electronic health record, with 1 in 4 patients reporting social needs. Integration of an automated social determinants of health screening in gynecologic oncology can identify patients at risk for referral to supportive care services.