Additional Considerations
Management leaders may consider different screening methods and identify those that are most feasible in the context of their clinics.
Online Patient Portal: Before Appointment or During Appointment Check-in
Benefits
- Patients can complete screenings within standard intake forms before the appointment, saving time at check-in and reducing potentially stigmatizing conversations about food access.
- Patients can complete screenings within standard intake forms during appointment check-in, providing an opportunity for language translation or addressing questions with clinical staff.
- Clinical staff can verbally administer screeners and complete forms in rooming.
- Providers can easily view screening and eligibility results and make referrals accordingly.
Challenges
- Requires upfront costs to build EHR shortcuts, coding, and referral connections.
Paper Screeners and Referrals
Benefits
- Patients with low digital literacy or uncertainty of technology security may prefer paper forms.
- No upfront technology investments.
- Clinical staff can verbally administer screeners and complete forms in rooming.
Challenges
- Increases staff time to track and manually enter screening results, especially if completed in a system outside the EHR.
- Introduces risk of clinical care deprioritization due to time constraints and outcomes not being tracked within the EHR.
Self-Referral via Online Platform
Benefits
- Patients can self-screen outside of a scheduled medical appointment, saving time in clinic and reducing potentially stigmatizing conversations about food access.
- Care managers or FIM vendors can confirm eligibility and refer or enroll patients in FIM services, thereby reducing provider and staff time in the screening and referral process.
Challenges
- Requires program enrollment tracking and capping self-referrals if program capacity is reached.
- Requires proactive follow-up by the care team to ensure program enrollment is completed by the patient.
Food and Nutrition Insecurity Screening Tools
Tool
Overview
Benefits
Challenges
- A two-item validated tool to identify household food insecurity in clinical and community settings.
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Most prevalent. Available in most EHR systems, including EPIC.
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Quick and easy to use.
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Identifies food security as a binary outcome (Yes or No).
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Patient discomfort sharing information.
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A short-form, lower-burden alternative to the U.S. Household Food Security Survey Module.
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Offers a practical substitute for surveys with limited time/resources and supports comparability with national food security statistics.
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Does not measure the most severe levels of food insecurity nor ask about conditions of children in the household.
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Patient discomfort sharing information.
- A one-item screener developed to use in conjunction with the Hunger Vital Sign.
- Validated to identify patients with “very low food security.”
- Understanding the prevalence of more severe food insecurity is useful for health systems beyond measuring food insecurity generally (low and very low combined).
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Patient discomfort sharing information.
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Burden to clinical team to collect information on an additional question beyond the two-item Hunger Vital Sign.
- A 20-item screener that helps health care organizations improve patient care by addressing SDOH.
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Standardized and actionable.
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Wider range of social needs considered.
- Part of a longer screening survey.
- May be hard to align resources with identified needs.
- Patient discomfort sharing information.
- Burden to clinical team to collect information.
- A two-item screener that helps identify barriers to healthy eating.
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Identifies specific reasons why consuming healthy foods is challenging beyond cost.
- Patient discomfort sharing information.
- May be considered by clinical teams to be too burdensome to conduct when paired with food security screening.
PDF: Additional information on each tool ▶