Predictive Modeling for Social Needs in Emergency Department Settings

Protocol for Evaluating the Effectiveness of a Clinical Decision Support System With Prediction Modeling to Identify Patients With Health-related Social Needs in the Emergency Department

The overall objective of this study is to support emergency department management of patients' health-related social needs. This study will measure the impact of a decision support system that informs clinicians about which patients are likely to screen positive for a health-related social need. The system uses statistical models to create a health-related social need risk score for each patient. The main questions, the study aims to answer are:

• Does providing emergency department clinicians with risk scores on health-related social needs increase screening and referral activities?
• Does providing emergency department clinicians with risk scores on health-related social needs change patients' use of healthcare services?

The decision support system with health-related social needs risk scores will be introduced for all adult patients at one emergency department. Screening rates, referrals, and subsequent healthcare encounters will be compared with emergency departments that did not have access to the decision support system.

Inclusion Criteria:

• Adults (>18 years old)
• Seeking care at Indianapolis, Indiana area emergency departments (EDs).

Exclusion Criteria:

• Children
• Encounters by patients that present with a critical illness/injury (e.g. severe trauma patients or those with Emergency Severity Index (ESI) classification level 1)
• Encounters by patients who have been transferred from another inpatient facility
• Patients that die during the ED encounter
• Encounters among patients who were ultimately admitted during their ED visits from our analysis