Enhancing cancer care: Leveraging technology for proactive psychosocial and social determinants of health screenings.

583 Background: Cancer diagnoses and their associated treatments cause many patients significant psychosocial distress. The psychological, social, spiritual, and financial burdens of cancer contribute to psychosocial distress throughout all stages of the cancer trajectory, with between 35-46% of patients reporting significant psychosocial distress. As such, the American College of Surgeons Commission on Cancer mandates psychosocial distress screening in cancer patients. Though this screening has been shown to reduce cancer related distress levels, barriers remain in sustained implementation. Additionally, even at locations with screening strategies in place, patient completion remains variable and inconsistent. To address these challenges, we created a customized screening tool, embedded in the electronic health record (EHR), that includes assessment for depression, social determinants of health (SDH) and spiritual care. Methods: The Quality of Life and Support (QOL&S) survey was created through an interdisciplinary review of evidence-based questions to proactively address supportive care needs for patients with cancer seen in the ambulatory setting. Survey questions, available in English and Spanish, were consolidated into a single survey, which was built into the EHR. Patients were prompted to complete the survey via the patient portal 7 days prior to their second medical oncology appointment, with a reminder sent if the survey was not yet completed 3 days before the appointment. Patients are automatically sent the survey again every 3 months. Based on responses, the survey automatically generated referrals to social work, chaplain and/or child life specialist. SDH responses are aggregated at a patient-level in a dedicated section of the patient’s chart. We used descriptive statistics to describe the rate of survey completion, patient demographics and referrals generated. Results: From June 22, 2022-May 31, 2023, 4,278 (37%) eligible patients have completed surveys. Among patients, the mean age is 59; 42% identify as White, 21% as Black; 89% have a primary language of English; 67% identify as Female, 33% as Male. Patients completed 75% of surveys prior to their appointment. Surveys completed by unique patients generated: 1,113 (26%) referrals to social work, 490 (11%) to chaplain and 82 (2%) to child life. Conclusions: Identification of those at risk of psychosocial distress enables practitioners to provide appropriate resources and alleviate the overall burden experienced by cancer patients. Using technology, we have increased completion of the screening tool while also reducing the reliance on staff to administer the survey. Future work includes expanding access to more languages, increasing patient response rates and identifying the highest SDH needs to develop meaningful interventions and programs.