Addressing the Challenge of Collecting SDOH Information

Colin Hung of Healthcare IT Today interviews Bobbi Weber, VP of Product Marketing and Customer Success at QliqSOFT, on why SDOH capture lags: the questions are uncomfortable. Social determinants of health, which shape 80% of the life decisions and actions that impact health, include whether someone is homeless, has food insecurity, has transportation needs, or feels safe at home, and ACO REACH programs now require capturing them.

The problem is the setting. Asked out loud, "Do you feel safe when you are home?" is a question many patients will not answer honestly in public. QliqSOFT's chatbot changes the setting: sent as part of the engagement process, it probes these questions in a dignified way, privately, so patients can be comfortable being honest, and the answers feed to the healthcare professional before the visit rather than through a clipboard conversation.

Working with a federally qualified health center, the questions are co-designed: the robust no-code tools let each organization capture everything CMS requires or only the subset it can act on. One FQHC chose care coordination, food, transportation, and insurance, because those are the needs it can actually help with.

What the FQHCs do with the answers is the brilliant part: captured responses trigger a message to social services, and someone reaches out to address the need outside the clinical visit workflow. The most requested help was unexpected: scheduling visits. In recent chatbot interviews, 58% of patients identified social determinant areas where they wanted help, and a third wanted help with care coordination and scheduling.

The common mistake: collecting SDOH in the office as part of the visit workflow. It is the wrong people asking the questions, and they cannot do anything with the answers. Thinking through the "and then what?" leads to a different solution. What customers do well: scripting the chatbot conversation with frontline staff and social workers so questions are teed up in a way that makes people want to share.

The same approach extends to value-based care broadly: only 10% to 20% of patients schedule routine visits on their own, leaving 80% to 90% of an at-risk population unaddressed, so chatbot outreach educates and schedules Medicare wellness visits. It also extends to SOGI data, sexual orientation and gender identity, and patient-reported outcomes: captured directly from the patient outside the visit, respectfully, in ways that make people want to engage with the health system.