SIREN Coffee & Science Episode 1: NowPow’s Key Takeaways
At the center of every social care program is awareness — awareness of what socioeconomic needs and assets exist at both the patient and population level. Health systems are beginning to build this awareness with screening, but social risk screening is not always straightforward. What information should be collected? How should it be collected? And most importantly, how can we operationalize that information?
In the first episode of SIREN Coffee & Science, a biweekly podcast series about social interventions in health, Anand Shah, MD, vice president of social health at Kaiser Permanente, interviews Stacy Lindau, MD, MAPP, the chief innovation officer of NowPow, about the nuances of conducting social risk screening at scale. Dr. Lindau is a practicing physician, tenured professor and experienced principal investigator at the University of Chicago. In 2016, Dr. Lindau founded NowPow, a personalized community referral platform that connects patients to highly matched and validated community resources, with the goal of supporting whole person care.
The SIREN Coffee & Science podcast is organized around the National Academies of Sciences, Engineering and Medicine’s Five A’s Framework, which is used to define the ways healthcare organizations can integrate social care into clinical care. In this episode, Drs. Lindau and Shah dive into the first “A,” which is Awareness. Together they unpack the challenges of social risk screening in a medical context, discussing how to scale assessment efforts so they effectively leverage assets, support patients and build awareness.
“When [screening] goes well, it feels intuitive. It’s part of the conversation. It’s easy for the patient and the clinician to engage in a way that feels respectful for both parties and doesn’t add extra work,” Dr. Shah said. “We all know so many of these things don’t go that way routinely, especially when we try to make it more systematic and scale them. That’s the tension so many of us are feeling.”
Drs. Shah and Lindau cover some key strategies to navigate this tension:
- An “asset-based approach” is essential to scale social risk screening:Folding social care into healthcare requires caring for patients as whole people in the context of whole communities, the key word being “whole.” “[I] believe in not just understanding what people’s needs or deficits are, but also what their assets are, and that makes it easier to have a conversation that otherwise, not done right, could be stigmatizing,” Dr. Lindau said. NowPow’s work in Chicago began with an asset-based framework that hinges on understanding what’s already working well in systems, communities and individual patient lives.
- The most appropriate applications of social risk screening have an end goal in mind:“We have well-established, time-tested guidelines about when it’s appropriate to screen for something and when it’s not. One of the principles that sticks out to me is that there ought to be something to do about the problem we identify through screening,” Dr. Lindau said. While screening itself can be therapeutic when done right, conducting screenings for the sake of data collection can stigmatize patients and strain the patient-clinician relationship.
- Technology needs to be part of the solution: “We have to recognize that there’s an opportunity cost to everything we do,” Dr. Lindau said. “If we implement a 20-minute screening protocol, that’s 20 minutes of somebody’s time that’s not being spent doing something else.”SIREN research has shown a strong majority of patients and caregivers think it’s appropriate to be asked these questions and can engage with tech-enabled self-assessments. Most also feel comfortable including social risk data in electronic health records. Technology can help clinicians connect the dots between assessment and assistance, and do it at scale.
- Patients can also play a role in scaling social care efforts: Lindau discusses research that shows providing social needs assistance can have a ripple effect. “When our intervention is information — and information delivered in a way that anticipates it might be shared — the intervention can spread beyond the clinician delivering it, beyond the patient receiving it, and to good effect,” she said.
Listen to the full episode with Drs. Shah and Lindau here.
For more on awareness, check out the following SIREN discussions:
- March 5: “Building Accountability for Social Risk Screening into State Medicaid Programs” – Sarah Desilvey, FNP and Michael Bailit, MBA
- March 19: “Social Risks vs. Social Needs: Assessing Patients’ Interest in Assistance” – Minal Patel, PhD, MPH and Emilia De Marchis, MD, MAS