The WellRx screening questionnaire, developed by a team of clinicians and researchers at the University of New Mexico and piloted in Albuquerque, has become a nationally recognized model for integrating social determinants of health screening into a clinical care setting.
Healthcare providers struggle to provide adequate care for patients who face socioeconomic challenges. Addressing social determinants of health (SDOH) is essential as they directly influence health outcomes, quality of life, and health care costs. Despite high health care spending, the U.S. still has the poorest health outcomes among other high-income nations.
The WellRx questionnaire offers a practical solution by helping providers identify key social drivers that affect a patient’s ability to achieve and maintain good health. The tool covers topics such as education, employment, food insecurity, housing, and safety. These areas are essential for understanding a patient’s full health and tailoring their care accordingly.
In 2014, the WellRx pilot was implemented in three family medicine clinics serving low-income populations and used an 11-item questionnaire to assess patients for nonmedical social needs such as housing instability, food access, and employment barriers. The results were striking, nearly half of the 3,000+ patients screened had at least one unmet social need that would have not otherwise been discussed during a medical visit.
By leveraging medical assistants to administer the screening of patients as part of routine vitals and community health workers to help connect patients to resources, WellRx showed that systematic social determinants of health screening was feasible to implement in a clinical setting and incredibly valuable for patients.
The success of WellRx began locally in New Mexico, prompting the University of New Mexico Hospital (UNMH) to hire community health workers in 2016 and adopt the tool across various settings, including the pediatric emergency department and Family Medicine Inpatient Service. By 2023, WellRx screening was integrated into the UNMH patient portal for all adult patients.
Nationally, WellRx gained recognition in 2017 when adopted by the Centers for Medicare & Medicaid Services for its Accountable Health Communities Screening Tool and featured by the National Academy of Sciences. It has since informed work by institutions such as Kaiser Permanente, Stanford’s Bill Lane Center, and the Agency for Healthcare Research and Quality.
From 2019 to 2024, it was integrated into UNM’s Cerner EMR and adopted by Oracle Health/Cerner, Cigna, and United Healthcare. It was featured in PCORI’s SIREN review, became part of COVID-19 screening protocols, and in 2024, was recommended by SAMHSA for behavioral health integration. The American Medical Association also adopted it in 2023 to support equitable healthcare.
What began as a small initiative in three New Mexico clinics has evolved into a nationally recognized model for addressing the social determinants of health (SDOH). WellRx not only demonstrated the feasibility of SDOH screening but shows a compelling example that equitable and sustainable healthcare starts with understanding of the whole patient.
