JMIR Publications

ABSTRACT

Background:

Assessing Circumstances and Offering Resources for Needs (ACORN) is a Veterans Administration (VA) clinical intervention designed to identify and address social needs to improve health and well-being among all Veterans. We co-designed the ACORN Dashboard to facilitate access to real-time social needs and intervention data for VA clinical care teams and leadership.

Objective:

To (1) describe the iterative development of the ACORN Dashboard, (2) assess end-user feedback and Dashboard utilization, and (3) discuss the role of social needs dashboards in facilitating continuous quality improvement in healthcare settings.

Methods:

An interprofessional team of subject matter experts and end-user feedback contributed to the design. Phase 1 included more than 7 months of weekly working meetings. We initially constructed a wireframe in PowerPoint, then translated it into a prototype in Power BI, a data visualization software. Using Power BI, we built data visualizations to communicate population-level sociodemographic and ACORN screening data. Through feedback sessions, staff from 8 VA medical centers (VAMCs) reviewed the prototype and recommended improvements regarding the Dashboard’s purpose, content, and usability. Phase 2 involved 6 weeks of weekly working meetings where we developed and iteratively refined 5 written drafts of clinically relevant variables for potential inclusion in the Patient-Level Data Page. This list informed a Power BI prototype. We also developed the ACORN Implementation Map page in Power BI to display implementation locations and settings. We again used feedback sessions with 8 VAMCs to review and refine the newly added pages and discuss improvements. To assess utilization, we obtained metadata from a VA-specific Power BI report and user experience data from an ACORN VAMC survey.

Results:

The ACORN Dashboard displays national data that is updated daily, reflecting 83,546 screens administered across 82 VA facilities between July 1, 2021-April 30, 2025. The Dashboard was viewed 18,192 times by 2,251 unique users, and on average, 263 unique users viewed the Dashboard every month between October 1, 2023-April 30, 2025. Dashboard variables include the number of screens completed, sociodemographic characteristics of Veterans screened, prevalence of social needs, and interventions provided to address needs. Phase 1 feedback interviews included recommendations for a page with patient-level data to supplement the population-level pages, incorporation of additional filters to select specific data, and development of a user guide. In Phase 2, key insights included enhancement of end-users’ ability to search by Veteran or staff name, guidance about screening frequency, changing the display order of variables, and the inclusion of variable definitions.

Conclusions:

Using co-design to develop, maintain, and continually refine data dashboards enhances implementation of social screening and interventions in healthcare settings. In addition to supporting individual-level patient care, population-level dashboard data informs continuous quality improvement, promotes health equity, and identifies gaps in services to address identified needs.