UCSF

Introduction In 2016, UCSF implemented an electronic health record (EHR) based tool, the Supportive Care Needs Survey (SCNS), to systematically identify psychosocial concerns and connect patients with appropriate resources. The American College of Surgeons Commission on Cancer Standard 5.2 mandates direct outreach to patients endorsing moderate distress, substantially increasing social work workload. UCSF partnered with Patient Support Corps (PSC) students to conduct outreach and streamline referrals to social work. PSC is a four-year co-op internship in which pre-health college students earn academic credit while working as healthcare navigators. For this evaluation, we reviewed data collected in 2025 to report on program reach. Design At the start of each of their weekly half-day shifts, students review an EHR report showing all patients who have upcoming appointments in 14 participating cancer clinics. Each student messages up to 40 of these patients per shift via the patient portal with an attached SCNS questionnaire. If the patient completes the questionnaire, the EHR calculates their scores for distress, anxiety, and depression. Students call patients with moderate scores, assess specific needs, and refer them to relevant resources. To evaluate program reach, we conducted a structured audit of the EHR and REDCap tracking database to extract program outcomes. Findings Between January and December 2025, 10 students distributed 7,771 SCNS questionnaires. Of these, 2,712 (35%) patients responded. Among respondents, 1,682 (62%) reported mild, 686 (25%) moderate, and 334 (12%) severe distress. Out of 686 moderately distressed patients, interns followed up with telephone calls to 617 (90%). Students spoke with and provided individualized resource letters for 350 (57%) of these patients. When students failed to reach 267 (43%) of targeted patients after 2 calls, they sent a general resource letter via the patient portal. Implications This stepped care model expands workforce capacity and reduces social work burden while aligning intervention intensity with patient reported severity. Integrating student interns into triage optimizes resource allocation and maintains compliance with Commission on Cancer standards. The model is scalable to other supportive care programs. Future directions include testing this model in other institutions and evaluating patient impact.