Boston Medical Center develops EHR tool to screen for patients' social needs

Boston Medical Center implemented an EHR-based tool that serves as a social determinants of health screener to identify patients' unmet needs, according to a study published in Medical Care.

For the study, researchers developed a single-page screener, which patients filled out in the waiting room before their appointment. The screener, called Thrive, asked patients questions related to eight SDOH factors: homelessness and housing insecurity, food insecurity, lack of transportation to medical appointments, inability to afford medications, caregiving, utilities, educational aspirations and unemployment.

Thrive also asks patients whether they would like assistance with any of the SDOH needs they indicated during the screening. Once the patient completes the screener, a medical assistant enters his or her responses into the EHR. If a patient requested assistance with an SDOH need, the EHR alerts the provider to address any SDOH issues the patient indicated during the visit. Additionally, the EHR will automatically print a referral guide for the patient resources information from BMC and in the nearby community.

Researchers analyzed data from 1,696 new BMC patients who used Thrive between August 2017 and January 2018. Results showed that 26 percent of patients indicating having one or more SDOH needs. The most prevalent needs among screened patients were employment (12 percent), food insecurity (11 percent) and difficulty affording medications (11 percent).

BMC now uses Thrive to screen all patients in its ambulatory primary care clinics. To date, the medical center has screened more than 57,000 patients. Of all the screened patients, 28 percent have reported at least one SDOH need and 19 percent requested help, according to the study.

To access the full report, click here.

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