Several screening instruments can aid physicians in identifying social determinants of health in a primary care setting:
1. The National Association of Community Health Centers’ Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences tool (PRAPARE) includes 15 core questions and 5 supplemental questions. The data can be directly uploaded into many electronic health records as structured data. It is generally administered by clinical or nonclinical staff at the time of the visit, but a paper version can be given to the patient to self-administer.
2. The American Academy of Family Physicians offers a social determinants of health screening tool, available in short- and long-form in English and Spanish, as part of The EveryONE Project. The short-form includes 11 questions. It can be self-administered or administered by clinical or nonclinical staff.
3. The Centers for Medicare & Medicaid Services Accountable Health Communities’ 10-question Health-Related Social Needs Screening Tool (AHC-HRSN) is meant to be self-administered.
Rather than expecting physicians to add “just one more thing” to their daily practice flow, social determinants screening and follow up must not be the sole responsibility of the physician but rather a team-based effort integrated into the practice's care management workflows.
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