Dr Rachel Gold Discusses Best Practices for Helping Patients With Social Needs

September 24, 2018

After identifying patients with social needs, the best way to intervene and get them into needed resources is going to vary a lot, said Rachel Gold, PhD, MPH, investigator at the Kaiser Permanente Northwest Center for Health Research and lead research scientist at OCHIN.

After identifying patients with social needs, the best way to intervene and get them into needed resources is going to vary a lot, said Rachel Gold, PhD, MPH, investigator at the Kaiser Permanente Northwest Center for Health Research and lead research scientist at OCHIN.

Transcription:

What organizations identify patients with social needs, what are the best practices of getting those patients into local resources that can help them?

I don’t think we know what the best practices are yet. I think it’s going to really vary. I think sometimes giving the patients a list of food banks might be enough. In some cases, there’s going to be a need for a social worker or a patient navigator to help them navigate. Some patients, however, aren’t even going to be comfortable going to a food bank, so, maybe, they need someone from the clinic to help them think how to do that.

The one thing that, I think, is important that we found in our earlier study is, that when you’re screening patients for social needs, it’s important to ask them if they want you to intervene, or if they want intervention from the care team, and that’s a really important distinction. We found that only about 20% of the patients who had a positive screen for a social need actually wanted a clinic to intervene in some way, so I would strongly recommend that be considered best practice. Don’t just screen and then assume the patient wants some type of intervention. Ask them if they want an intervention. That is going to make a big difference for the healthcare team’s work burden and the workflows involved. You don’t want patients getting calls from the clinic that they don’t want. Someone might say, “yeah I’m housing insecure, but I’m sleeping on my sister’s couch, and I’m good. I don’t need you to intervene. I’ve got it covered.” So, that’s a practice that we really should be thinking about. It’s one thing to screen, and it’s another to take action. You need to ask the patient what their preference is.

I think the other answer to your question is, we’re trying to figure out what the best practices are, and we haven’t had enough patient-reported data in searchable forms that we’ve been able to do the analyses to say, “this thing looks like it works, and this thing doesn’t.” We have evidence to show, rather right now, what everyone is doing is just kind of trying stuff out and seeing what sticks. That’s okay, but it’s not what we need for long term. We need to have data on patient report. We need to be looking at patient reported social needs in conjunction with community level social factors, and we need to be looking at which kinds of patients need what screenings. Is it pediatrics, diabetes, or perinatal, and what intervention is needed to have some kind of outcome or benefit to their health, reducing utilization cost, etc. But, we can’t do any of that until we do these analyses to figure out what the data shows, and we haven’t been able to do that because we haven’t had the data. So, I’m hoping in the next few years that’s going to change. This field is changing rapidly, so I’m hoping in 5 or 10 years from now, we’ll be much clearer.