Study sample
The study sample included Prisma Health patients, aged 18 years or older, engaged in ambulatory care and condition management, inpatient case management, or community health in South Carolina’s central (Midlands) and northwestern (Upstate) regions. This study population constitutes initial efforts to pilot the SDoH screening within the health system.
Data sources
Prisma Health is the largest non-profit health system in South Carolina and treats about 1.4 million patients annually. Its geographic footprint covers about half of the state’s total population [32]. Census data based on the system’s geographic coverage describes the areas served by the health system as predominantly White (63.4%) with the second most common racial or ethnic group being Black (26.7%). Of individuals in this geographic area, 29.0% have a bachelor’s degree or higher (versus 32.9% nationally), 13.8% would be considered persons in poverty (versus 11.4% nationally) and 13.2% are without health insurance (versus 10.2% nationally). Median household income is $54,864 versus $64,994 nationally and areas covered have population density of 332.6 per square mile (< 500 per square mile and less than 2,500 people being rural) [32].
The data for this study came from the health system’s piloting of a digital SDoH screening and referral platform in 2020, called NowPow. NowPow is a software program, embedded within the electronic medical record (EMR), that matches patients with SDoH-related needs to local resources based on their demographic information (e.g., distance from home).
This study uses three data sources: SDoH screening information from NowPow, electronic medical record (EMR) data and geocoded patient addresses. This study was reviewed by the Institutional Review Board (IRB) at Prisma Health (IRB# Pro00105482) and approved as human subjects exempt. Informed consent was waived by the IRB committee, and the study was conducted in accordance to all relevant IRB guidelines.
Data was collected for