A Systematic Review of Electronic Community Resource Referral Systems.

INTRODUCTION: Community Resource Referral Systems (CRRSs) delivered electronically through healthcare Information Technology (IT) systems (e.g., Electronic Medical Records (EMRs)) have become more common in efforts to address patients' unmet Health Related Social Needs (HRSNs). CRRSs connect patients with social supports such as food assistance, utility support, transportation, and housing. This systematic review identifies barriers and facilitators that influence CRRS implementation in the United States (US) by identifying and synthesizing peer-reviewed literature over a 15-year period. METHODS: This systematic review was conducted following PRISMA guidelines through a search of five scientific databases to capture literature published between January 2005 and December 2020. Data analysis occurred from August 2021 to July 2022. RESULTS: This review includes 41 articles out of 2,473 initial search results. Included literature revealed that CRRSs functioned to address a variety of HRSNs and were delivered in different ways. Integrating CRRS into clinic workflows, maintenance of community-based organization (CBO) inventories and strong clinic-CBO partnerships facilitated implementation. The sensitivity of HRSNs, technical challenges and associated costs presented as barriers. Overall, EMR-integration and automation of the referral process was reported as advantageous for stakeholders. DISCUSSION: This review provides information and guidance for healthcare administrators, clinicians, and researchers designing or implementing electronic CRRSs in the US. Future studies would benefit from stronger implementation science methodological approaches. Sustainable funding mechanisms for CBOs, clear stipulations regarding how healthcare dollars can be spent on HRSNs, and innovative governance structures that facilitate clinic-CBO collaboration are needed to promote growth and sustainability of CRRSs in the US.