Screening for Health-Related Social Resource Needs in Gynecologic Oncology

A new study showed that an electronic medical record (EMR)–integrated system for health-related social resource needs (HRSN) screening and referral improved patient reach, compared with a paper-based system, in patients at a gynecologic oncology clinic. Findings were reported in the journal JCO Oncology Practice.

The researchers conducting the study explained that a paper-based screening system for HRSN had previously been established at their clinic, but they identified limitations in its implementation. With the original system, they found that screening was completed by only 52% of patients, and among a subset who indicated having needs, only 36% indicated whether they preferred a referral. 

The multidisciplinary team sought to determine if using an EMR-integrated HSRN screening tool would improve patient completion. Researchers had goals of reaching a level of screening compliance and expressed referral preference of more than 90% in patients with HSRN needs. The primary study outcome was the reach of the program, measured as the percentage of eligible patients who completed the HSRN screening. 

The study period included 5 Plan-Do-Study-Act (PDSA) cycles from January 2021 to March 2023, with each cycle reflecting a different phase of the project. Implementation, expansion, and integration of tablets into workflow occurred in PDSA Cycles 1 to 3, and a maintenance phase occurred in PDSA 4 and ended at Week 120 of the project. During prelaunch, a variety of screening modalities had been tested, such as with the online patient portal prior to the appointment, a tablet provided during the appointment, and the help of a medical assistant.

A total of 1971 eligible encounters occurred during the study period. In comparison with a historical baseline rate of HRSN screening compliance of 52% among eligible patients, the rate during PDSA 1 was 65%. The rate rose to 89% in PDSA 2 (weekly range, 75% to 98%), and in PDSA 3 it was 91% (weekly range, 76% to 100%). In PDSA 4, the screening compliance rate was 97% (range, 85% to 100%). Also, in patients who reported a need, the rate of indicating a referral preference increased from 37% to 100% with the new system.

The use of the online patient portal to complete screening prior to an appointment had occurred at a rate of 17% during the prelaunch study phase. By PDSA 4, this rate had increased to 49%. 

“In conclusion, an EMR-integrated, multimodality HRSN screening and referral process successfully increased screening completion <90%,” the researchers wrote in their report. 

Disclosures: Some authors have declared affiliations with or received grant support from the pharmaceutical industry. Please refer to the original study for a full list of disclosures.