Systematic health-related social needs screening and intervention in a large oncology practice: RESOURCE study findings

Abstract Background Health-related social needs (HRSNs) are recognized as health-outcome predictors with increasing importance in oncology. We implemented systematic HRSNs screening in a large ambulatory oncology academic medical center and determined impact of a HRSN-informed intervention on referrals to the resource specialist team. Methods May 2021 through July 2022, we implemented electronic-health record -integrated screening. Participants were randomized 1:1 to intervention or control arms. The intervention arm received automatic referrals to the resource specialist team after reporting HRSNs; the resource specialist team provided participants in the intervention arm with proactive follow-up to address their HRSNs. The control arm received standard of care access to the resource specialist team, requiring either clinician referral or patient self-referral. Our primary aims evaluated intervention impact on referrals to the resource specialist team. We also used the data to assess rates of HRSNs. Patients were sent the HRSN survey at baseline and 90-day follow up, consistent with the cadence of oncology care visits. Results The intervention was successful in nearly doubling referrals to the resource specialist team (though this finding was not statistically significant). Intervention feasibility was based on baseline (82% intervention, 86% control) and follow-up (65% intervention, 72% control) response rates. We found 45% reported HRSNs, most common being financial distress (29.4% baseline, 26.5% follow-up) and food insecurity (23.5% baseline, 23.5% follow-up). Analysis of referral timing suggested the majority were due to intervention. Conclusion Our multi-site prospective randomized clinical trial implemented systematic, repeat HRSN screening and increased referral rates.