ArticleMedical care2025
The Impact of a Bidirectional Clinic to Community Social Care Referral Program.
Article in Medical care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Digital social prescribing: a concept analysis.Frontiers in public health · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
19 authors.
Funding
Abstract
backgroundPractical knowledge of how to address patients' social needs could have a large health impact.
objectiveDescribe a scalable electronic health record (EHR)-facilitated, clinic-to-community linkage (CCL) program that addresses social needs at 6 clinics in 4 health systems. RESEARCH
designPrimary care teams referred eligible patients to United Way 211 (UW 211) via a point-of-care EHR referral between 2018 and 2023. Patients were eligible if they were adults with uncontrolled blood pressure or blood sugar or 2-17 years old with overweight/obesity or asthma. UW 211 referred patients to assess and connect them with community resources and provided electronic feedback to the EHR. We conducted descriptive analyses of process measures (eg, patients referred, needs identified, need resolution). We then conducted pre-post analyses of selected health outcomes (ie, blood pressure, weight, and asthma exacerbations) versus comparison clinics.
resultsReferral ranges varied by clinic from 3% to 43%, with 1224 total patients referred and 38% (n=461) reached by UW 211. All 461 had at least one need, and 87% (n=400) had one need resolved or a resolution in progress. Reached patients had an average of 2.9 (SD 1.3) needs and an average of 10.1 resource referrals provided (SD 6.1). Top needs included food, physical activity, housing and utilities. No differences were found pre to post within the intervention clinics except for improvements in blood pressure control. However, comparison clinics had greater improvements in blood pressure control during the same time frame.
conclusionsAn EHR-facilitated, closed-loop CCL program to address patients' social needs is feasible. Further research on the comparative effectiveness and sustainability of models to address social needs will be critical in advancing health equity.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.