Self-reported health-related social needs screening for new adult patients in an ambulatory oncology setting.

Abstract

194 Background: Health-related social needs (HRSN) are strongly associated with patient health outcomes, making screening for HRSN a critical component to providing patient-centered oncology care. In April 2023, the Dana-Farber Cancer Institute (DFCI) Patient Reported Data (PRD) Program led the deployment of an EHR-integrated HRSN screening tool. Embedded within our New Patient Intake Questionnaire, the screening supports early identification of and response to needs, informs care planning and delivery, and aims to improves outcomes. Methods: PRD, in collaboration with DFCI’s Patient & Family Advisory Council and others, elected to use an HRSN screening tool deployed across the Mass General Brigham healthcare system (with which DFCI shares an EHR). HRSNs assessed include transportation, housing security, food security, medication costs, utility costs, family and childcare, education, and employment. New adult oncology patients (and/or proxy) were offered the HRSN questionnaire in multiple languages on any internet-enabled device via the patient portal or on a tablet in clinic. Responses were immediately available in the EHR for care team review with needs highlighted to support clinical decision making. Aggregate data is available within the DFCI electronic data warehouse and disseminated for internal use via a Tableau dashboard. Results: Between April 23 and May 31, 2023, 1,842 patients completed the HRSN screening questionnaire. Of responders, 246 (13.4%) were non-white, 725 (39.4%) were male, 72 (4.0%) had a non-English preferred language, and the mean age was 57 years at time of response. 12.8% (251) reported at least one HRSN. Reported HRSNs are described in Table 1. Among those reporting at least one need, the most frequently reported HRSNs are food insecurity (38.7%), utility costs (33.5%), and employment (20.7%). Conclusions: Even when considering much of the population seen at our comprehensive cancer center are relatively well-resourced, we find a meaningful proportion (12.8%) of patients reported HRSNs, demonstrating the importance of screening patients to ensure patient-centered care. Future work will determine additional points for rescreening of HRSNs and focus on improving patient’s access and uptake of screening. We will continue socializing and analyzing HRSN data to improve clinical practice and support the development of interventions to connect patients with available resources.[Table: see text]