FOOD ACCESS SUPPORT TECHNOLOGY (FAST): A CENTRALIZED CITY-WIDE PLATFORM TO COORDINATE FOOD DELIVERY

ABSTRACT

BACKGROUND: Food delivery has emerged as a major need during the COVID-19 pandemic due to exacerbated socioeconomic insecurity and quarantine precautions. Efficient coordination, however, is often hampered by fragmentation and varying resource availability among health and food services in a city. The purpose of this study was to describe the rapid-cycle development and early implementation of Food Access Support Technology (FAST), a centralized digital platform that pairs health systems with community-based food and delivery partners to facilitate food access. METHODS: Using FAST, providers and staff can post requests for food delivery on patients' behalf, which are reviewed and claimed by eligible CBOs that can meet dietary criteria (e.g., low-sodium). Depending on CBO capacity, the delivery arm of the request may be completed by the same CBO or a different delivery partner, also matched via FAST. The design process engaged key stakeholders city-wide, including health systems, CBOs, and the Philadelphia Department of Public Health. Iterative, rapid-cycle innovation underpinned the development and scaling of FAST, with focus groups, user interviews, and weekly teamassessments driving programmatic changes.As of December 2021, FAST has onboarded 2 health systems and 10 CBOs. The platform tracked process measures, including request status and time between changes in request status. RESULTS: Between March and December 2021, 149 requests for food delivery were posted to FAST, representing 117 unique patients in 37 distinct postal codes. Of these requests, 117 (79%) were completed by 10 different food and delivery partners. The remaining were either in the process of completion (10%), cancelled (8%), or unfulfilled because patients were unreachable (3%). About 34% of requests were initiated from a health system, with the rest initiated directly from a food CBO for delivery only. Most requests (53%) were for one week's worth of food, though requests were completed for as much as 8 weeks' worth of food. The median time from post to delivery was 1 (IQR 0-4) day. Specifically, posted requests were usually claimed by a food and/or delivery partner in less than a day (IQR 0-0), and a median of 1 (IQR 0-4) day elapsed from claim by a delivery partner to actual delivery. Requests for prepared meals took longer to complete (7 days, IQR 0- 34) than requests for unprepared food (4 days, IQR 1-12). CONCLUSIONS: The early implementation of FAST suggests that centralized platforms for food delivery can benefit both patients and organizations by streamlining partnerships between health systems and CBOs - as well as facilitating the real-time coordination and sharing of resources among CBOs - to efficiently and effectively meet the food needs of patients. As calls mount for health systems to address the social determinants of health, FAST offers a rapid-cycle, community-engagedmodel for efficient resource coordination that may be increasingly crucial to respond to social needs and promote patient health.