HealthyLink-Integrating Food Is Medicine (FIM) Into Inpatient Discharge Process.

Background: Hospitalized food-insecure patients face a critical 72-hour gap in food support post-discharge, impacting recovery. HealthyLink aimed to design and pilot-test a contextually attuned model for patients in need.

Methods: The HealthyLink model leveraged the infrastructure of a research-health care system-regional grocery partnership. The project has 3 phases: co-design, implementation, and evaluation. During co-design, participatory processes assessed the needs of patients, community partners, and frontline workers. The pilot, guided by the Plan-Do-Study-Act method, tested iterative changes. Post-delivery surveys gathered feedback, and evaluation compared cost-related medication underuse, self-reported health, and program satisfaction. Intervention costs were tracked.

Results: A strategic partnership among Washington University, BJC HealthCare, and Schnucks (grocery chain) was fostered. HealthyLink was integrated into the hospital social worker referral platform, streamlining patient identification, enrollment, and food delivery. A heart-healthy list was curated with fresh, frozen, and shelf-stable nutrient-dense foods. Home delivery was chosen to overcome infrastructure constraints and transportation issues. Implementation lasted for 6 months with 90 patients/families receiving food delivery. Fifty-nine patients responded to the post-delivery survey, with satisfaction ratings ranging from 86.4% to 98.3%, and healing assistance ratings ranging from 88.1% to 98.3%. The self-reported physical and mental health improved, with fewer individuals reporting fair or poor health (69.5%-42.2%, 47.5%-25.4%). The average food cost per delivery was $108. The combined service fee, delivery fee, and tip amounted to $17.

Conclusion: Incorporating co-design principles into the Food is Medicine program helps identify barriers and obstacles that may not be immediately apparent. While delivery offers a valuable solution for reaching hard-to-access populations, associated costs must be considered to ensure scalability and sustainability.