A Missed Opportunity? How Health Care Organizations Engage Primary Care Clinicians in Formal Social Care Efforts

Fraze, Taressa; Beidler, Laura B.; Gottlieb, Laura M.

doi:10.1089/pop.2021.0306

Cited by 3 publications

(2 citation statements)

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“…In April–July of 2019, we conducted 33 semi-structured interviews with administrators at 29 health care organizations. 6 , 12 , 13 , 20 All interviewed organizations had already established programs to identify and address patients’ social needs, such as food, housing, transportation, utilities, or other needs related to economic insecurity. The local Institutional Review Board approved this study.…”

Section: Methodsmentioning

confidence: 99%

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“Because There’s Experts That Do That”: Lessons Learned by Health Care Organizations When Partnering with Community Organizations

2023

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Background Health care organizations’ partnerships with community-based organizations (CBOs) are increasingly viewed as key to improving patients’ social needs (e.g., food, housing, and economic insecurity). Despite this reliance on CBOs, little research explores the relationships that health care organizations develop with CBOs. Objective Understand how health care organizations interact with CBOs to implement social care. Design Thirty-three semi-structured telephone interviews collected April–July 2019. Participants Administrators at 29 diverse health care organizations with active programming related to improving patients’ social needs. Organizations ranged from multi-state systems to single-site practices and differed in structure, size, ownership, and geography. Measures Structure and goals of health care organizations’ relationship with CBOs. Results Most health care organizations (26 out of 29) relied on CBOs to improve their patients’ social needs. Health care organization’s goals for social care activities drove their relationships with CBOs. First, one-way referrals to CBOs did not require formal relationships or frequent interactions with CBOs. Second, when health care organizations contracted with CBOs to deliver discrete services, leadership-level relationships were required to launch programs while staff-to-staff interactions were used to maintain programs. Third, some health care organizations engaged in community-level activities with multiple CBOs which required more expansive, ongoing leadership-level partnerships. Administrators highlighted 4 recommendations for collaborating with CBOs: (1) engage early; (2) establish shared purpose for the collaboration; (3) determine who is best suited to lead activities; and (4) avoid making assumptions about partner organizations. Conclusions Health care organizations tailored the intensity of their relationships with CBOs based on their goals. Administrators viewed informal relationships with limited interactions between organizations sufficient for many activities. Our study offers key insights into how and when health care organizations may want to develop partnerships with CBOs.

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Section: Methodsmentioning

confidence: 99%

“…Additional details on the study sample and interview methodology can be found in prior publications. 6 , 12 , 13 , 20 …”

Section: Methodsmentioning

confidence: 99%

“Because There’s Experts That Do That”: Lessons Learned by Health Care Organizations When Partnering with Community Organizations

2023

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Two Questions Before Health Care Organizations Plunge into Addressing Social Risk Factors

Fichtenberg

Fraze

2023

NEJM Catalyst

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Clinician Awareness of Patient-Reported Health-Related Social Needs: There’s Room for Improvement

Nederveld,

Bertin,

Dickinson

et al. 2024

J Prim Care Community Health

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Introduction: People experiencing health-related social needs (HRSNs), such as transportation insecurity, are less likely to undergo preventive health screenings. They are more likely to have worse health outcomes overall, including a higher rate of late-stage cancer diagnoses. If primary care clinicians are aware of HRSNs, they can tailor preventive care, including cancer screening approaches. Accordingly, recent guidelines recommend that clinicians “adjust” care based on HRSNs. This study assessed the level of clinician awareness of patient-reported HRSNs and congruence between clinician perception and patient-reported HRSNs. Methods: We surveyed patients aged 50 to 85 years and their clinicians in 3 primary care clinics that routinely screen patients for HRSNs. Patients and clinicians reported the presence/absence of 6 HRSNs, including food, transportation, housing and financial insecurity for medications/healthcare, financial insecurity for utilities, and social isolation. Kappa statistics assessed the concordance of reported HRSNs between patients and clinicians. Results: Across 237 paired patient-clinician surveys, mean patient age was 65 years, and 62% and 13% of patients were female and Latinx/Hispanic, respectively. Concordance between clinician- and patient-reported HRSNs varied by HRSN, with the lowest agreement for food insecurity (kappa = .08; 95% CI: 0.00, 0.17; P = .01) and highest agreement for transportation insecurity (kappa = .39; 95% CI: 0.18, 0.59; P < .001). The other HRSNs assessed were housing insecurity (kappa = .30; 95% CI: 0.05, 0.55; P < .001), social isolation (kappa = .24; 95% CI: 0.03, 0.45; P < .001), financial insecurity for utilities (kappa = .21; 95% CI: −0.02, 0.45; P < .001), and financial insecurity for healthcare/medications (kappa = .12; 95% CI: −0.02, 0.27; P < .001). In particular, discrepancies were noted in food insecurity prevalence: patient-reported food insecurity was 29% whereas clinician-reported food insecurity was only 3%. Discussion: Clinician awareness of patients’ social needs was only modest to fair, and varied by specific HRSN. In order to adjust care for HRSNs, clinics need processes for increased sharing of patient-reported HRSNs screening information with the entire clinical team. Future research should explore options for sharing HRSN data across teams and evaluate whether better HRSN data-sharing impacts outcomes.

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A Missed Opportunity? How Health Care Organizations Engage Primary Care Clinicians in Formal Social Care Efforts

Cited by 3 publications

References 34 publications

“Because There’s Experts That Do That”: Lessons Learned by Health Care Organizations When Partnering with Community Organizations

“Because There’s Experts That Do That”: Lessons Learned by Health Care Organizations When Partnering with Community Organizations

Two Questions Before Health Care Organizations Plunge into Addressing Social Risk Factors

Clinician Awareness of Patient-Reported Health-Related Social Needs: There’s Room for Improvement

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