Boston Medical Center's EHR-based screening tool identifies 16% of patients' social determinant needs  

Boston Medical Center's EHR-based screening tool for patients' social determinants of health needs identified only a fraction of patients who were at risk of having their utilities shut off, according to a Feb. 24 news release.

The health system implemented the EHR-based SDOH screening tool in 2018 to detect eight domains of potentially unmet SDOH needs: housing and food insecurity, inability to afford medications, utilities or transportation, need for employment or education and difficulty taking care of children or other family members.

For a recent study published in the Journal of Ambulatory Care Management, BMC researchers found that among patients who received a utility protection letter in 2018, 70 percent were screened for SDOH needs and only 16 percent screened positive for difficulty paying their utility bills.

"Patients experiencing difficulty paying utility bills may not be detected by systems of care that screen for SDOH, and this is concerning for at-risk populations," said Karen Lasser, MD, a general internist at BMC, according to the news release. "This research calls for better approaches to identify those needing assistance, to ensure better health outcomes for all patients."

Most states in the U.S. have laws that prohibit or delay utility companies from shutting off services to low-income households when occupants present a medical letter confirming a household member has a chronic or serious illness.

The research team concluded there were various reasons why patients may not be identified for utilities insecurity, including utility bills being difficult to pay based on the season; patients screened in warmer months may not identify it as a need compared to in the winter when heat becomes more of a necessity.

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