How a relationship-first interview captures far more than the 40% national average.
The healthcare industry agrees on a hard truth: social determinants of health — housing, relationships, purpose, lifestyle, history — drive the majority of health outcomes. The industry also agrees it is bad at capturing them. Nationally, organizations document only about 40% of SDOH measures.
The reason isn’t a lack of effort. It’s a flaw in the method.
Why the form fails
Most SDOH data is collected through screening — a checklist administered during an intake or a clinical visit. The setting is transactional, the questions are clinical, and the resident has little reason to volunteer more than the form asks for. People don’t disclose the texture of their lives to a clipboard. They round their answers down, skip what feels too personal, and move on.
The result is thin, brittle data: a few boxes checked, the richest context missing. You learn that someone lives alone. You don’t learn that they were a high school music teacher for thirty years, that their closest friend is two doors down, or that they’ve stopped going to the dining room since their spouse passed. The form captures status. It misses the person.
The conversation approach
TSOLife takes the opposite path. Instead of a screening, residents take part in a structured, relationship-first interview — a real conversation, conducted in around 30 minutes, designed to build rapport rather than extract data.
Because the process is conversational and resident-centered, people open up. They tell stories. They mention the things a checklist never asks about. And those stories are dense with exactly the information SDOH screening is trying to find.
A single structured interview generates more than 150 data points — covering social determinants of health, lifestyle factors, and personal interests. In one encounter-data assessment, a single ~60-minute interview produced an average of about 310 social data points per resident; one resident’s interview yielded 331 insights in a day, compared with 23 drawn from five to seven months of passive operational records.
The outcome: TSOLife captures 90% of SDOH measures — more than double the 40% national average.
Why the difference matters
Higher capture isn’t a vanity metric. It’s the difference between data you can act on and data you can’t.
Operational systems are good at recording what residents do — which events they attended, when, where. Clinical systems record diagnoses and care plans. But neither captures who the resident is — the preferences, the relationships, the emotional and social context that explain the behavior and predict the outcomes. That’s the gap conversation fills.
With it, a community can personalize engagement to who someone actually is, surface unmet social needs before they become clinical events, and speak to payors and families in the validated language of population health. Without it, even the most robust calendar and the most complete chart are working half-blind.
“Capture SDOH through a form, and you get 40% and a transaction. Capture it through conversation, and you get 90% and a connection.
Relationship as infrastructure
There’s a quieter benefit, too. The interview isn’t only a data-collection method — it’s the first meaningful relationship a resident builds in the community. The act of being asked, listened to, and remembered is itself an engagement event, and it sets the tone for everything that follows.
That’s the design principle: the richest data and the strongest relationships come from the same source. Capture SDOH through a form, and you get 40% and a transaction. Capture it through conversation, and you get 90% and a connection.