Addressing Social Determinants While Social Distancing: The Development of an Evidence-Based Social Needs Screening for a Telehealth Setting

Effectively addressing social determinants of health in clinical care can be challenging, and screening for such social needs is often overlooked. The COVID-19 pandemic has exacerbated health disparities and the impacts of social determinants of health, increasing the importance of both effective screening and intervention to address social needs. In response, the student-run free clinics at Stanford University sought to meet this need amongst our patient population by developing an evidence-based social needs screening (SNS) and referral protocol and integrating it into our novel telehealth model. The new protocol was implemented significantly more consistently compared to our previous checklist-based SNS, and more need was identified amongst our patient population than with the checklist-based, pre-pandemic screen. The new screening and referral protocol facilitated comprehensive patient care that addresses the social determinants of health in the clinical setting by improving our ability to identify patient social needs and refer such patients to community organizations. In describing the development, design, and implementation of this SNS, we hope to provide an example strategy for addressing social determinants of health within a student-run free clinic setting, and to encourage other student-run clinics and/or free clinics to similarly expand locally relevant social needs services.