Embracing Co-Design and Interprofessional Teamwork to Build an Innovative Dashboard for a National Social Needs...

Assessing Circumstances and Offering Resources for Needs (ACORN) is a US Department of Veterans Affairs (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.

This study aimed to (1) describe the iterative development of the ACORN Dashboard, (2) assess end user feedback and Dashboard usage, and (3) discuss the role of social needs dashboards in facilitating continuous quality improvement in health care settings.

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 Microsoft PowerPoint, then translated it into a prototype in Power BI, a data visualization software. Using Microsoft 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 usage, we obtained metadata from a VA-specific Power BI report and user experience data from an ACORN VAMC survey.

The ACORN Dashboard displays national data that are updated daily, reflecting 83,546 screens administered across 82 VAMCs facilities between July 1, 2021, and April 30, 2025. The Dashboard was viewed 18,192 times by 2251 unique users, and, on average, 263 (SD 91.2) unique users viewed the Dashboard every month between October 1, 2023, and 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 semistructured feedback sessions 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.

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