Loneliness, isolation need attention from healthcare providers

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Screening for loneliness/isolation can be a first step for healthcare providers to address the issue and improve outcomes and potentially reduce costs. A year ago, Oak Street Health added an evidence-based screening tool , the UCLA Loneliness Scale, to its annual patient health risk assessment.

But just asking the question—without a recommendation or treatment that a provider can offer—can leave providers with a “now what?” quandary.

Cindy Jordan, CEO of Pyx Health, which offers a platform designed to reduce loneliness and social isolation, said many organizations haven’t ventured into handling this part of a patient’s life for a couple of reasons. Healthcare delivery is still largely using a medical model based on treatments. And there’s not an abundance of obvious treatments a hospital or primary-care group can offer.

“When you do tell your doctor you’re lonely, there’s a bit of, ‘Well, what am I supposed to do with that information?’ ” Jordan said.

She contends that loneliness should be a treatable, billable condition to entice providers to start helping their patients address it.

But Suberlak doesn’t think loneliness and isolation should be pathologized, mainly because that would just create more stigma, and the solutions are often low-cost.

“We are using low-tech interventions, which include proactive wellness calls, and then creating an individual care plan with a patient to say, ‘What are you able to do right now, what are your strengths and resources,’ and tapping into that,” Suberlak said, adding that Oak Street employs social workers or community health workers to help target these patients.

Rush University Medical Center also employs a similar risk screening, and integrated the question into its EHR system, sold by Epic Systems Corp. Eve Escalante, manager of program innovation at Rush, said the hospital started off with having physicians and other providers do the screening manually, but didn’t have great results.

“If it’s not in Epic, it’s not going to get done because it’s not integrated in the typical flow of a visit,” Escalante said, adding that the EHR system also helps calculate a risk score and provide predictive modeling on a patient-population level. When a patient scores high, they’re enrolled in the provider’s “Friendly Caller” program, which has made over 700 calls to older adults since April 2020 when it first piloted.

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