Enhancing Social Service Referrals in a Rural Community Health Center: A Pilot Project Using Cross-sector Collaboration Software

Literature shows that non-medical factors, such as social determinants of health (SDOH), may be more significant in promoting health than medical factors. Using standardized technology platforms presents a promising avenue for enhancing care coordination between health and social service organizations, thereby better addressing SDOH. Local Problem: Rural Americans, particularly in states like Colorado with predominantly rural regions, face pronounced health disparities compared to their urban counterparts. In Southwest Colorado, residents identify SDOH as a primary contributor to poor health outcomes, signaling a critical need for targeted interventions to address these social factors in rural populations. Methods: A pre-intervention survey was utilized to determine participant satisfaction, familiarity with community organizations, and confidence in the referral process. Additionally, the pre- survey evaluated participants' perceived barriers and facilitators to making referrals to community organizations and the perceived feasibility and usability of the referral platform. The post-survey assessed feasibility, usability, and satisfaction related to the intervention. Interventions: Phase one involved establishing a partnership between a federally qualified health center (FQHC) and a leading cross-collaboration software company, Unite Us, and creating a pre-intervention survey. Phase two focused on training participants to use the Unite Us platform effectively. Post-survey data was analyzed in phase three to evaluate feasibility, usability, and satisfaction. Results: Participants in the study demonstrated varied engagement with the Unite Us platform, with some primarily using it to explore available organizations and share resources rather than for direct referrals. Participants generally expressed satisfaction with the platform and found it easy to navigate. Barriers to platform usage included a lack of pertinent resources in the geographical area and difficulty in making referrals. Despite these challenges, participants viewed the platform positively and were open to its continued use and improvement. Conclusion: While the Unite Us platform holds promise for addressing SDOH and improving care coordination, its effectiveness may be influenced by regional disparities in resource availability. Further research is necessary to enhance platform utilization, especially in rural areas.