Volume 4, Issue 4

Special: SONNET Director Update

California

SONNET at Five Years:
Where Have We Been? Where Are We Going?


A message from: John F. Steiner, MD, MPH

Colleagues:

Five years ago, I began discussions with Loel Solomon (then vice president, Community Health and now professor of Health Systems Science in the Bernard J. Tyson School of Medicine), Jim Bellows (managing director, Evaluation and Analytics at Kaiser Permanente, Care Management Institute), and Karen Emmons (who then was vice president for research and director of the Kaiser Foundation Research Institute) about developing a learning community to synthesize knowledge about measurement and screening for social risk factors, their impact on clinical care, and the effectiveness of interventions to mitigate those risk factors for Kaiser Permanente (KP) members and our communities. The Social Needs Network for Evaluation and Translation (SONNET) network grew out of those discussions and began in 2017 with funding from KP National Community Health.

In 2017-18, SONNET reached out to over 30 programs that launched small-scale interventions within individual clinics or departments across KP markets. We summarized our learnings in a Scoping Review. In this review, we advocated for a more concerted planning and coordination of programs and increased standardization of measurement. We also championed the need for rigorous evaluation to address the “outcomes wheel” of program impacts. Many of these early learnings were summarized in a supplement to the Permanente Journal.

Addressing social risk factors was one of Bernard Tyson’s (former chairman and chief executive officer) grand visions. We have taken significant steps to achieve that vision under the leadership of Bechara Choucair (senior vice president and chief community health officer, Loel Solomon, Anand Shah (vice president, Social Health) and their colleagues in Community Health. With the collaboration of leaders across the Kaiser Foundation Health Plan and Permanente Medical Groups, KP has entered the era of large-scale interventions, among them:

  • The Thrive Local initiative is rolling out across KP markets under the leadership of Sarita Mohanty (vice president, Care Coordination, Medicaid and Vulnerable Populations, National Medicaid) and Jenn Frost (director, Social Services Resource Locator). The intervention provides access to information about community resources, standardizing measurement of social risk factors, establishing community networks, and enhancing bidirectional communication between KP and its community partners.
  • Under the Food for Life initiative, Pam Schwartz (senior director of Community Impact and Learning), Bev Davis (executive director, National Delivery System Strategy and Design), and others have developed programs to increase SNAP enrollment, provide medically tailored meals at hospital discharge, and provide incentives to purchase healthy food.
  • Cara Lewis, associate investigator, Bianca DiJulio, senior manager of Survey Research, and their team from the KP Washington Health Research Institute, just completed a survey of over 10,000 KP members across all KP markets to define the prevalence of social risk factors among our members. Because COVID-19 erupted while the survey was in the field, we will also document pandemic’s effects on these risk factors.

Where has SONNET been in all this? All of these initiatives include rigorous evaluations, led by SONNET researchers and others from KP’s research departments. These evaluations have been funded by KP to provide essential information to the leaders who launched these initiatives and to share KP-generated evidence to other health care systems and the scientific community. To date, KP has invested over $10 million in evaluations and other SONNET activities. Regional leaders have also made substantial investments in this work. Rachel Gold, senior investigator from the Center for Health Research, KP Northwest, represented KP on the select panel convened by the National Academy of Medicine which has helped set the agenda for social interventions into the future (Integrating Social Needs Care into the Delivery of Health Care to Improve the Nation's Health).

At this five-year mark, KP has so much to be proud of in its sustained commitment to addressing social risk factors. We of SONNET are proud of our role in advocating for the evaluation of this work. I’m so grateful to have been a part of it all and to have established relationships with committed leaders, front-line practitioners, and researchers who believe so passionately in the importance of social health.

Where will SONNET go next? 2021 and beyond should see a cascade of reports and papers from the evaluations of these large KP initiatives and related research from SONNET scientists and other KP researchers. These reports will help operational leaders identify the factors that enhance or impede the success of KP initiatives and facilitate their dissemination, implementation and sustainability. Inevitably, this first generation of interventions will lead to a host of new questions about the best way to assess and improve social health. Overall, the COVID-19 pandemic reminds us every day that physical and social health cannot be separated. Strategies to recover from the pandemic’s devastating impact on the bodies, minds, social and economic welfare of our members and communities will also require rapid and rigorous evaluation.

In December, I will be stepping down as SONNET director, in anticipation of my retirement early in 2021. An internal search for my successor is well underway, and we expect the new director to be in place with sufficient time for a coordinated transfer of responsibilities. I am proud of what we’ve accomplished in the early years of SONNET, but even more proud of KP’s vision and commitment to address the most fundamental human needs of the members and community we serve.

Thanks,

John F. Steiner, MD, MPH
Senior Investigator and SONNET Director
The Institute for Health Research
PO BOX 378066 | Denver, CO 80237-8066
John.F.Steiner@kp.org

Share this post