Partnering with practices to understand health barriers in Michigan cancer care and build fair, patient-focused solutions.

265 Background: Cancer rates in Michigan often exceed national averages, highlighting the need for improved patient-centered care. The Michigan Oncology Quality Consortium (MOQC), its Patient and Caregiver Oncology Quality Council (POQC), and the Patient Advocate Foundation (PAF) collaborated to develop a blueprint for patient-driven and practice-informed social drivers of health (SDOH) screening in cancer care settings. While SDOH significantly impact outcomes, current screening processes lack patient and caregiver input and standardization. This project engaged patients and stakeholders to understand how SDOH screenings affect oncology workflows and experiences, identify reporting and care delivery challenges, and explore improvements that support patient needs while reducing burdens on practices. Methods: Three small oncology practices in rural Michigan serving low-income and under-resourced populations in outpatient settings were chosen to examine their SDOH screening processes. A thorough literature review was conducted and clinical documents were reviewed to inform tailored interview guides, with POQC and PAF contributing patient-centered insights. A team from MOQC/POQC conducted 42 interviews with a range of staff, including clinicians, navigators, and administrators, focusing on SDOH screening use, workflow impacts, patient support resources, follow-up practices, and opportunities for improvement. Results: All three practices conducted a SDOH or social needs screening, but with inconsistent implementation. Thematic analysis identified three key social needs- transportation, housing, and financial hardship. Common barriers included patient stigma, staff discomfort with sensitive topics, limited resources (especially in rural areas), and lack of staff training. Practices reported no formal follow-up process to track whether patients accessed referred resources. While challenges persist, some practices are beginning to adapt in anticipation of the upcoming Centers for Medicare and Medicaid Services’ requirements to collect health-related social needs data in outpatient settings. Conclusions: This collaborative effort to understand how SDOH screenings function in Michigan oncology practices reveals critical gaps in consistency, follow-up, and support for patient needs. These findings provide the foundation for co-designing an equitable, patient-centered screening and response framework that can better address social needs while being practical for lower-resourced settings. Grounded in the experiences of both clinicians and patients, this work will inform a scalable model to improve outcomes and reduce disparities in oncology care.