Understanding, assessing, and improving social health resource referrals in healthcare organizations

OBJECTIVE: To describe and assess the utility and accuracy of Kaiser Permanente's self-service social service resource locator (SSRL), a community resource directory that can be integrated with electronic health records, using a modified asset mapping approach. 

STUDY SETTING AND DESIGN: We identified, described, and visualized the number and types of food insecurity resources within five miles of a large primary care clinic in Washington state. 

DATA SOURCES AND ANALYTIC SAMPLE: Analyses relied on (1) neighborhood and patient-level food insecurity data, (2) patient surveys and interviews, (3) SSRL abstraction, and (4) in-person walking assessment with qualitative coding of site photographs. Means and mean percentages of food insecurity were calculated and mapped for the US, WA state, and counties. Qualitative interviews were coded and analyzed using a rapid templated approach. For the SSRL, we abstracted the number and types of food resources, and the comprehensiveness of information in the database. Photographs of resource locations identified in Kaiser Permanente's database were coded for environmental barriers and facilitators. 

PRINCIPAL FINDINGS: Common barriers to accessing social services included eligibility criteria, a mismatch of services, or a lack of capacity among organizations. Of the 18 resources identified from the SSRL, 12 listed some eligibility criteria, and of 10 requiring an application, only three provided a hyperlink. In the walking assessment, five resources did not match their listing online or were unavailable. 

CONCLUSIONS: Modified asset mapping methods with existing data sources may be a pragmatic approach to understanding social needs, social health resources, and the patient experience of connecting with them. Inaccurate and inadequate information is a significant barrier to SSRL effectiveness. Improving the real-time accuracy of resource availability and eligibility in SSRL databases and filtering functionality is critical to ensuring successful resource connection.