The Social Determinants of Health Platform

The Social Determinants of Health platform is designed for use by community clinics, hospitals, and public health agencies

Use the Social Determinants of Health platform to:

Identify SDH patients
Facilitate SDH-related interventions
Improve patient care
Prolong lifespan
Mitigate unnecessary ER visits and hospitalizations
Rein in costs associated with high-utilization patients
Earn valuable PCMH recognition points

How It Works

Radiant Interactive’s Social Determinants of Health platform enables FQHCs, hospitals and public health agencies to electronically screen patients for social determinants of health using our 16-item SDH survey. The SDH survey quickly identifies patients who are challenged by social factors that adversely impact long-term health and drive healthcare costs. These factors include:

food insecurity,
housing insecurity,
income insecurity,
unemployment,
unhealthy living or working conditions,
discrimination,
workplace harassment,
intimate partner violence,
childhood trauma,
and more.

If a patient answers any of the SDH survey items affirmatively, the patient record will be flagged, and FQHC staff notified. Staff then has the option to refer the patient through the platform's intranet to either internal staff counselors for follow-on intervention, or to third party community resource providers.

Third party resource providers include:

food banks,
homeless shelters,
women's shelters,
job training centers,
addiction treatment facilities,
and more

The platform contains a feedback application to enable the internal counselor or third party resource provider to provide feedback thru the patient record as to the status of referral, as well as the patient's progress going forward. This feedback mechanism facilitates referral accountability and prevents patients from “falling through the cracks”.

Here is the list of the SDH platform's applications/features:

16 item Social Determinants of Health Survey
Our Direct Connect application allows for electronic referral of SDH-identified patients to either internal BH staff, or community resource providers (food banks, homeless shelters, addiction treatment facilities, etc) via our internal intranet
Referral feedback app prevents referred patients from falling through the cracks
Unlimited onboarding of third party resource providers (providers are not required to license the platform)
Both staff-facilitated and patient self-administered SDH screening options are available
Patient self-administered screenings can be conducted in the waiting room via a tablet or smartphone, or remotely prompted in advance of patient's next in-office visit
Remote prompting of patient self-administered screenings is done via email, text and voice messaging, including a multiple prompt feature to ensure patient compliance
Email notifications are sent to staff when patient screening data is received
Health coaching tools included (see below)
Embedding of custom screening tools possible (e.g. PRAPARE survey)
Screening analytics across entire patient population, filterable by date range and facility location
Data export to CSV
Aligns with NCQA PCMH Standard 4/Element A/Factor 4
Minimal training required
Minimal staff time needed to administer
Integratable with most EMRs
Payable with existing grant funds possible
Includes training and ongoing technical support

Click to see additional features

EHR integration- The platform can be integrated with most EHR software for seamless operation (call for details)
Workflow integration- The platform is designed for seamless integration into time-critical medical practice environments (call for details)
Patient self-screening- Patients who do not have language or literacy challenges can self-administer all screenings and surveys, either in the waiting room or in-home via a tablet computer or smart phone; or via a remote prompt (sent via email, text message and/or voice message reminder) from the privacy of their own homes in advance of their next -in-office visit. NOTE: patient self-administered screenings yield more reliable data than staff facilitated screenings, and take burden off of staff.
Facilitated screening- For those patients with language or literacy challenges, all screenings and surveys may be “facilitated” by a staff member
Email alerts- Email alerts are sent to staff each time a patient completes a screening (this prompts staff to log in and retrieve the screening data), and to follow up with the patient as needed
Custom screeners and assessments- Additional screening surveys and assessments can be embedded into platform, including those for pediatric and adolescent populations
Filing Cabinet- All patient screening responses are stored in the patient’s “filing cabinet” on the patient portal which can be accessed by the patient 24/7
Reimbursement- Many of the screenings conducted on the platform may be eligible for insurance reimbursement (call for details)
Secure intranet email- Staff can communicate with patients via the platform’s secure intranet email application
Secure video conferencing- Staff can conduct video conferencing sessions, facilitated screenings, and interviews with patient’s via the platform’s secure video conferencing application
Analytics- The platform’s database tracks all patient data to enable staff to easily view actionable screening analytics across the entire patient population. This data can be filtered by date-range, and by facility locations.
Data Export/Reporting- The platform contains an easy-to-use data export feature that enables export of all patient screening data to CSV for HRSA, UDS, HEDIS, NCQA, Joint Commission and grant agency reporting
Branding- Branding of the platform with your logo, contact info, etc. is included.
Training and Technical Support- Licensing of the platform includes online training conducted via GoTo Meeting, and technical support via phone and email Mon-Fri 8:30 am to 5:30 pm PST. Note: minimal staff time is needed to administer and manage the platform
Grant eligibility- The platform may be eligible for a wide variety of grant opportunities, including health technology grants, and grants focused on behavioral health integration, social determinants of health, SBIRT implementation, substance use screening, depression screening, MAT, PCMH, service area competition, and more (Call for details)
Privacy/Compliance- The platform is HIPAA and 42 CFR Part 2 compliant
Business Associate Agreement- Licensing of the platform includes execution of a Business Associate and Qualified Service Organization Agreement

Health Coaching Tools (available Q2 2017)

The tools listed below are intended for use by clinics, medical group practices, public health agencies and health plans that wish to implement a one-on-one health coaching program to proactively help patients achieve meaningful behavior change.

NOTE: Proactive health coaching is one of the elements included in PCMH recognition, and its use may count toward valuable PCMH recognition points, as well as fulfill certain meaningful use requirements (Call for details)

Change Agent (Details)
ChangeAgent is our proprietary interactive goal setting tool that uses Motivational Interviewing to help patients identify motivations, strengths, and barriers for achieving behavior change. All goals can be shared with the Health Coach for follow-on discussion (Call for details)
Task Tracker (Details)
The Task Tracker tool allows patients to specify the steps needed to achieve the behavior change goals they set using the ChangeAgent tool. All Task Tracker steps can be shared with the Health Coach for follow-on discussion (Call for details)
Vision Board (Details)
Vision Board allows patients to upload photographs and images that help them visualize the steps needed to achieve the behavior change goals they set using the ChangeAgent and Task Tracker tools. All Vision Board content can be shared with the Health Coach for follow-on discussion (Call for details)
CBT Reframer (Details)
Our proprietary CBT Re-framing Tool employs Cognitive Behavioral Therapy principles to enable patients to take their unhelpful thoughts and feelings and re-frame them into neutral or positive ones. Re-framing results can be shared with the health coach for follow on discussion. This is an essential tool for teaching patients the basics of cognitive re-framing (Call for details)
Life Satisfaction Survey (Details)
The Life Satisfaction Survey is a 10 item survey that measures life satisfaction and general wellbeing across 10 life-dimensions. Responses to the survey questions can alert staff to the need for follow-up or intervention, which may help to mitigate unnecessary office and ER visits or hospital readmissions (Call for details)
Lifestyle Behaviors Survey (Details)
The Lifestyle Behaviors Survey enables the patient to identify critical behaviors that directly impact health and wellbeing, and to further identify which behaviors the patient wishes to change or improve. Responses to the survey questions can alert staff to the need for follow-up or intervention, which may help to mitigate unnecessary office and ER visits or hospital readmissions. (Call for details)
Medical Care Inventory (Details)
The Medical Care Inventory enables the patient and coach to identify areas where the patient needs to improve medical care self-management (Call for details)
Resilience Checkup (Details)
The Resilience Checkup allows both the patient and health coach to assess the patient’s level of resilience, and to identify areas where resilience-building may be needed (Call for details)
Mindspa (Details)
MindSpa is an audio relaxation sanctuary offering hypnotherapy, guided imagery, ambient sound, and self-soothing exercises to calm the mind and revitalize the spirit (Call for details)

The Social Determinants of Health platform is designed for use by community clinics, hospitals, and public health agencies

How It Works

Health Coaching Tools (available Q2 2017)

For more information, or to arrange a live demo of the Social Determinants of Health platform via GoTo Meeting, call:

800-717-0955