Universal screening of social determinants of health at a large US academic medical center, 2018

Universal screenings for social determinants of health (SDOH) are feasible at the health system level and enable institutions to identify unmet social needs that would otherwise go undiscovered. NewYork-Presbyterian Hospital implemented SDOH screenings together with clinical screenings in four outpatient primary care sites. Aligning SDOH screening with clinical screening was crucial for establishing provider buy-in and ensuring sustainability of screening for SDOH. Despite some challenges, universal screening for SDOH has allowed NewYork-Presbyterian Hospital to identify unmet needs to improve population health.

Health care systems have been called on to address the social needs of patients to increase health equity and achieve the triple aim of improving patient care, improving population health, and reducing costs. Models for implementing social determinants of health (SDOH) screening in clinical sites have emerged, and most involve use of waiting room time to complete screening. Concurrently screening patients for clinical conditions has become standard of care for primary care disciplines and has emerged as a priority for several regulatory agencies. However, most health care systems work under resource-constrained conditions and lack the infrastructure and incentive to establish universal screening for clinical and psychosocial needs.