Integrating social drivers of health screening into ambulatory cancer care.

e13692 Background: Despite the known impact of social drivers of health (SDOH) on cancer related outcomes, the integration of SDOH screens into routine oncology clinical practice is scarce and suboptimal. Recent findings indicate feasibility of integrating these tools, yet data is limited in how to develop and implement the screens to address unmet SDOH related needs. This study aims to provide an overview of the development and integration of a SDOH screener and referral system into clinical workflow and describe the patients who completed and didn’t complete the survey. Methods: The 17-item Quality of Life and Support (QOLS) survey was based on evidence-based SDOH questionnaires, co-created with our community board, and built into the Mount Sinai Tisch Cancer Center EHR, Epic. The survey is sent out via the patient portal 7 days prior to patients’ second oncology appointment, with repeat measures every 90 days. Surveys are available in English and Spanish and evaluate SDOH needs such as transportation, food insecurity, employment, social support, financial strain, stress, and depression. If survey answers indicate need for additional support the case is ‘escalated’ to social work, chaplaincy, or family care coordinator depending on the area of need. We used descriptive statistics to describe patients who completed versus didn’t complete the survey. Of those completed, we also describe the SDOH trigger and frequency of ‘escalation’. Results: Between June 2022 - December 2023, 10,655 patients were assigned 25,353 surveys across 5 sites. 37% of the assigned surveys were completed.A total of 6,179 individuals completed at least one survey. The average number of surveys completed was 2. Of the completed surveys, 43% were completed before the appointment date. Of completed surveys, 21% were escalated to social work, 8.5% to chaplaincy, and 1.3% to family care with the most frequent reasons for escalation being distress, financial strain, and transportation. A significant relationship was found between Race (Pearson chi 2 = 107.9 p < .000) and Ethnicity (Pearson chi 2 = 58.8, p<.000) and survey completion with differences due primarily to White and non-Hispanic White completion vs non-completion. Notably, Black and Hispanic individuals are completing the survey in the same proportion as those receiving it. Conclusions: This study shows successful integration of a SDOH screen into ambulatory cancer care which allows for systematic referrals to SDOH resources. Table: see text