SDOH Clinical Care
2.2.0 - STU 2.2 United States of America flag

SDOH Clinical Care, published by HL7 International / Patient Care. This guide is not an authorized publication; it is the continuous build for version 2.2.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-sdoh-clinicalcare/ and changes regularly. See the Directory of published versions

CapabilityStatement: SDOHCC Referral Recipient Capability Statement

Official URL: http://hl7.org/fhir/us/sdoh-clinicalcare/CapabilityStatement/SDOHCC-ReferralRecipient Version: 2.2.0
Standards status: Trial-use Computable Name: SDOHCC_ReferralRecipient

This resource describes the required and desired behavior of systems acting as SDOH clinical care ‘referral recipients’. These are typically community-based organizations that can provide services such as food bank access, housing remediation, etc.

In some cases, a referral recipient might actually further refer the patient to a downstream service provider through non-FHIR means. In such cases, the system is still treated as a ‘referral recipient’ rather than a Coordination Platform because, from a FHIR interface perspective, the referral process ‘stops’ with that system. Referral recipients must be able to receive or monitor for Tasks issued by Referral Sources and Coordination Platforms. They must also be able to respond to access the ServiceRequest representing the referral pointed to by the Task and any relevant information referenced by the referral, update the Task with their acceptance or rejection of the referral, and finally provide information about what interventions were actually performed using the Procedure resource.\n\n There are actually two types of referral recipients defined in this implementation guide. This CapabilityStatement describes the expected behavior of more sophisticated service delivery systems that are capable of exposing a FHIR service and persisting Tasks and Procedures in their own environment. A separate set of interface expectations is defined for ‘Light’ Referral Recipients that are not capable of exposing an endpoint and where the Task and any resulting Procedures must be stored in the requesting system’s database.

Raw OpenAPI-Swagger Definition file | Download

Generated Narrative: CapabilityStatement SDOHCC-ReferralRecipient

SDOHCC Referral Recipient

  • Implementation Guide Version: 2.2.0
  • FHIR Version: 4.0.1
  • Supported Formats: xml, json
  • Supported Patch Formats:
  • Published on: 2021-06
  • Published by: HL7 International / Patient Care

Note to Implementers: FHIR Capabilities

Any FHIR capability may be 'allowed' by the system unless explicitly marked as 'SHALL NOT'. A few items are marked as MAY in the Implementation Guide to highlight their potential relevance to the use case.

FHIR RESTful Capabilities

REST Configuration: 1

Mode: client

The clinical care referral recipient needs to access information from and update information in SDOH clinical care referral sources and/or coordination platforms that have solicited the filling of SDOH-related referrals by this system

Security
Enable CORS: no
Security services supported: SMART-on-FHIR

Implementations must meet the general privacy & security requirements documented in this implementation guide.

Summary of System-wide Interactions
  • SHOULDSupports the batchinteraction described as follows:

    Allows polling for changes to multiple resource types simultaneously

Capabilities by Resource/Profile

Summary

The summary table lists the resources that are part of this configuration, and for each resource it lists:

  • The relevant profiles (if any)
  • The interactions supported by each resource (Read, Search, Update, and Create, are always shown, while VRead, Patch, Delete, History on Instance, or History on Type are only present if at least one of the resources has support for them.
  • The required, recommended, and some optional search parameters (if any).
  • The linked resources enabled for _include
  • The other resources enabled for _revinclude
  • The operations on the resource (if any)
Resource TypeProfileRSUCSearches_include_revincludeOperations
CareTeamSupported Profiles
  US Core CareTeam Profile
yy_id, _lastUpdated
ConditionSupported Profiles
  SDOHCC Condition
yy_id, _lastUpdated, category, clinical-status, code, patient, verification-status
ConsentSupported Profiles
  SDOHCC Consent
yy_id, _lastUpdated, source-referenceConsent:source-reference:DocumentReference
DeviceSupported Profiles
  Device
yy_id, _lastUpdated
DocumentReferenceSupported Profiles
  US Core DocumentReference Profile
yy_id, _lastUpdated
GoalSupported Profiles
  SDOHCC Goal
yy_id, _lastUpdated, achievement-status, category, lifecycle-status, patient, target-date
HealthcareServiceSupported Profiles
  SDOHCC Healthcare Service
yy_id, _lastUpdated, location
LocationSupported Profiles
  SDOHCC Location
yy_id, _lastUpdated
ObservationSupported Profiles
  SDOHCC Observation Assessment
  SDOHCC Observation Screening Response
  SDOHCC Observation Ethnicity OMB
  SDOHCC Observation Race OMB
  SDOHCC Observation Gender Identity
  SDOHCC Observation Personal Characteristic
  SDOHCC Observation Personal Pronouns
  SDOHCC Observation Recorded Sex Gender
  SDOHCC Observation Sexual Orientation
yy_id, _lastUpdated, category, code, code-value-concept, date, derived-from, patient, status
OrganizationSupported Profiles
  US Core Organization Profile
yy_id, _lastUpdated
PatientSupported Profiles
  US Core Patient Profile
yy_id, _lastUpdated
PractitionerSupported Profiles
  US Core Practitioner Profile
yy_id, _lastUpdated
PractitionerRoleSupported Profiles
  US Core PractitionerRole Profile
yy_id, _lastUpdated, organization, practitionerPractitionerRole:organization, PractitionerRole:practitioner
ProcedureSupported Profiles
  SDOHCC Procedure
yyyy_id, _lastUpdated, based-on, category, code, date, patient, performer, status
RelatedPersonSupported Profiles
  RelatedPerson
yy_id, _lastUpdated
ServiceRequestSupported Profiles
  SDOHCC ServiceRequest
yy_id, _lastUpdated, category, code, intent, occurrence, patient, performer, requester, status, supporting-infoHealthCareService:location, ServiceRequest:supporting-info, ServiceRequest:pertains-to-goal, ServiceRequest:patient, ServiceRequest:requester, ServiceRequest:performer, PractitionerRole:practitioner, PractitionerRole:organization
SubscriptionSupported Profiles
  Backported R5 Subscription
yy$status, $topic-list

Resource Conformance: SHALL CareTeam
Core FHIR Resource
CareTeam
Reference Policy
literal
Interaction summary
  • MAYsupport read, search-type.

Documentation

For referral sources that receive referrals from upstream systems, used to access information about the intended performer of a ServiceRequest when the performer is a specific team of people. Note: Conformance expectations for this resource are lower because CareTeam performers are expected to be uncommon in most SDOH uses

Search Parameters
ConformanceParameterTypeDocumentation
SHALL_idtoken

Allows retrieving known CareTeam records - and more specifically, retrieving more than one in a single call to poll for updates

SHOULD_lastUpdateddate

Allows filtering for only records that have changed since last query

 
Resource Conformance: SHALL Condition
Core FHIR Resource
Condition
Reference Policy
literal
Interaction summary
  • SHALLsupport read.
  • SHOULDsupport search-type.

Documentation

For referral sources that receive referrals from upstream systems, used to access information about a patient's SDOH-related conditions, particularly those that are the reason for a referral

Search Parameters
ConformanceParameterTypeDocumentation
SHALL_idtoken

Allows retrieving known Condition records - and more specifically, retrieving more than one in a single call to poll for updates

SHALLcategorytoken

Allows filtering to only SDOH-related conditions

SHALLpatientreference

Allows filtering to only conditions associated with a specific patient. Some systems will require that searches be patient-specific

SHOULD_lastUpdateddate

Allows filtering for only records that have changed since last query

SHOULDclinical-statustoken

Allows filtering to only active conditions

SHOULDcodetoken

Allows filtering to only specific SDOH conditions or sets of conditions

SHOULDverification-statustoken

Allows filtering to exclude refuted or entered-in-error conditions

 
Resource Conformance: SHALL Consent
Core FHIR Resource
Consent
Reference Policy
literal
Interaction summary
  • SHALLsupport read.
  • SHOULDsupport search-type.

Documentation

Used to access the consent that authorizes disclosure of ServiceRequest information to non-HIPAA-covered entities

Search Parameters
ConformanceParameterTypeDocumentation
SHALL_idtoken

Allows retrieving known consent records - and more specifically, retrieving more than one in a single call to poll for updates

SHALLsource-referencereference

Allows including the document that contains the PDF or similar representation of a paper consent

SHOULD_lastUpdateddate

Allows filtering for only records that have changed since last query

 
Resource Conformance: SHALL Device
Core FHIR Resource
Device
Reference Policy
literal
Interaction summary
  • SHOULDsupport read, search-type.

Documentation

Used to retrieve the requester or intended performer of an SDOH ServiceRequest. Note: Conformance expectations for this resource are lower because Device requesters and performers are expected to be uncommon in most SDOH uses

Search Parameters
ConformanceParameterTypeDocumentation
SHALL_idtoken

Allows retrieving known Device records - and more specifically, retrieving more than one in a single call to poll for updates

SHOULD_lastUpdateddate

Allows filtering for only records that have changed since last query

 
Resource Conformance: SHALL DocumentReference
Core FHIR Resource
DocumentReference
Reference Policy
literal
Interaction summary
  • SHALLsupport read.
  • SHOULDsupport search-type.

Documentation

Used to retrieve a scanned or other form of document representing the text of a consent. Also used for PDF forms.

Search Parameters
ConformanceParameterTypeDocumentation
SHALL_idtoken

Allows retrieving known DocumentReference records - and more specifically, retrieving more than one in a single call to poll for updates

SHOULD_lastUpdateddate

Allows filtering for only records that have changed since last query

 
Resource Conformance: SHALL Goal
Core FHIR Resource
Goal
Reference Policy
literal
Interaction summary
  • SHALLsupport read.
  • SHOULDsupport search-type.

Documentation

Used to access goals related to an SDOH referral

Search Parameters
ConformanceParameterTypeDocumentation
SHALL_idtoken

Allows retrieving known Goal records - and more specifically, retrieving more than one in a single call to poll for updates

SHALLcategorytoken

Allows filtering to only include SDOH-related goals

SHALLpatientreference

Allows filtering to only include goals for a particular patient. Some systems will require searches to be patient-specific

SHOULD_lastUpdateddate

Allows filtering for only records that have changed since last query

SHOULDachievement-statustoken

Allows filtering to only include unmet goals

SHOULDlifecycle-statustoken

Allows filtering to only include active goals

SHOULDtarget-datedate

Allows filtering based on when a particular goal is desired to be achieved

 
Resource Conformance: SHALL HealthcareService
Core FHIR Resource
HealthcareService
Reference Policy
literal
Interaction summary
  • SHOULDsupport read, search-type.

Documentation

For referral sources that receive referrals from upstream systems, used to access information about the intended performer of a ServiceRequest when the performer is a specific service within a larger facility. Also used to indicate who a patient or caregiver should contact about a particular service.

Search Parameters
ConformanceParameterTypeDocumentation
SHALL_idtoken

Allows retrieving known HealthcareService records - and more specifically, retrieving more than one in a single call to poll for updates

SHALLlocationreference

Allows retrieval of the phyical site(s) associated with a HealthService

SHOULD_lastUpdateddate

Allows filtering for only records that have changed since last query

 
Resource Conformance: SHALL Location
Core FHIR Resource
Location
Reference Policy
literal
Interaction summary
  • SHOULDsupport read.
  • MAYsupport search-type.

Documentation

Used to access information about the potential sites at which a requested service might be performed. Allows a patient to evaluate the suitability of a proposed activity or service.

Search Parameters
ConformanceParameterTypeDocumentation
SHALL_idtoken

Allows retrieving known Location records - and more specifically, retrieving more than one in a single call to poll for updates

SHOULD_lastUpdateddate

Allows filtering for only records that have changed since last query

 
Resource Conformance: SHALL Observation
Core FHIR Resource
Observation
Reference Policy
literal
Interaction summary
  • SHALLsupport read.
  • SHOULDsupport search-type.

Documentation

For referral sources that receive referrals from upstream systems, used to access information about SDOH-related observations for a patient - particularly those that are reasons for a referral as well as certain SDOH-relevant demographic information

Search Parameters
ConformanceParameterTypeDocumentation
SHALL_idtoken

Allows retrieving known Observation records - and more specifically, retrieving more than one in a single call to poll for updates

SHALLcategorytoken

Allows filtering for only SDOH-related observations

SHALLpatientreference

Allows filtering for observations specific to a particular patient. Some systems will require that all queries be patient-specific

SHALLstatustoken

Allows filtering for observations that are completed or revised (i.e. not in-progress or entered-in-error)

SHOULD_lastUpdateddate

Allows filtering for only records that have changed since last query

SHOULDcodetoken

Allows filtering for specific types of observations

SHOULDdatedate

Allows filtering for observations that held in a particular time period

SHOULDderived-fromreference

Allows filtering for observations derived from a particular QuestionnaireResponse

MAYcode-value-conceptcomposite

Allows filtering for observations that have a specific coded value answer for a specified observation type

 
Resource Conformance: SHALL Organization
Core FHIR Resource
Organization
Reference Policy
literal
Interaction summary
  • SHALLsupport read.
  • SHOULDsupport search-type.

Documentation

For referral sources that receive referrals from upstream systems, used to access information about an Organization that is the requester or intended performer of a ServiceRequest

Search Parameters
ConformanceParameterTypeDocumentation
SHALL_idtoken

Allows retrieving known Organization records - and more specifically, retrieving more than one in a single call to poll for updates

SHOULD_lastUpdateddate

Allows filtering for only records that have changed since last query

 
Resource Conformance: SHALL Patient
Core FHIR Resource
Patient
Reference Policy
literal
Interaction summary
  • SHALLsupport read.
  • SHOULDsupport search-type.

Documentation

For referral sources that receive referrals from upstream systems, used to access information about the Patient that is the subject a ServiceRequest

Search Parameters
ConformanceParameterTypeDocumentation
SHALL_idtoken

Allows retrieving known Patient records - and more specifically, retrieving more than one in a single call to poll for updates

SHOULD_lastUpdateddate

Allows filtering for only records that have changed since last query

 
Resource Conformance: SHALL Practitioner
Core FHIR Resource
Practitioner
Reference Policy
literal
Interaction summary
  • SHALLsupport read.
  • SHOULDsupport search-type.

Documentation

For referral sources that receive referrals from upstream systems, used to access information about an Practitioner that is the requester or intended performer of a ServiceRequest

Search Parameters
ConformanceParameterTypeDocumentation
SHALL_idtoken

Allows retrieving known Practitioner records - and more specifically, retrieving more than one in a single call to poll for updates

SHOULD_lastUpdateddate

Allows filtering for only records that have changed since last query

 
Resource Conformance: SHALL PractitionerRole
Core FHIR Resource
PractitionerRole
Reference Policy
literal
Interaction summary
  • SHALLsupport read.
  • SHOULDsupport search-type.

Documentation

For referral sources that receive referrals from upstream systems, used to access information about an PractitionerRole that is the requester or intended performer of a ServiceRequest

Search Parameters
ConformanceParameterTypeDocumentation
SHALL_idtoken

Allows retrieving known PractitionerRole records - and more specifically, retrieving more than one in a single call to poll for updates

SHOULD_lastUpdateddate

Allows filtering for only records that have changed since last query

SHOULDorganizationreference

Allows doing an _include on Organization when retrieving the PractitionerRole

SHOULDpractitionerreference

Allows doing an _include on Practitioner when retrieving the PractitionerRole

 
Resource Conformance: SHALL Procedure
Core FHIR Resource
Procedure
Reference Policy
literal
Interaction summary
  • SHALLsupport create, update, read.
  • SHOULDsupport search-type.

Documentation

Used to record information about actions that have been performed as a result of a referral

Search Parameters
ConformanceParameterTypeDocumentation
SHALL_idtoken

Allows retrieving known Procedure records - and more specifically, retrieving more than one in a single call to poll for updates

SHALLbased-onreference

Allows filtering for procedures resulting from a particular service request

SHALLcategorytoken

Allows filtering for procedures that are SDOH-related

SHALLpatientreference

Allows filtering for procedures based on who they were delivered to. Some systems may require that all searches be patient-specific.

SHALLperformerreference

Allows filtering for procedures based on who delivered the procedure.

SHALLstatustoken

Allows filtering for procedures that are complete or in progress

SHOULD_lastUpdateddate

Allows filtering for only records that have changed since last query

SHOULDcodetoken

Allows filtering for procedures based on the specific service delivered

SHOULDdatedate

Allows filtering for procedures based on when they were delivered

 
Resource Conformance: SHALL RelatedPerson
Core FHIR Resource
RelatedPerson
Reference Policy
literal
Interaction summary
  • MAYsupport read, search-type.

Documentation

For referral sources that receive referrals from upstream systems, used to access information about the requester or intended performer of a ServiceRequest when they are someone with a personal relationship to the Patient. Note: Conformance expectations for this resource are lower because CareTeam performers are expected to be uncommon in most SDOH uses

Search Parameters
ConformanceParameterTypeDocumentation
SHALL_idtoken

Allows retrieving known RelatedPerson records - and more specifically, retrieving more than one in a single call to poll for updates

SHOULD_lastUpdateddate

Allows filtering for only records that have changed since last query

 
Resource Conformance: SHALL ServiceRequest
Core FHIR Resource
ServiceRequest
Reference Policy
literal
Interaction summary
  • SHALLsupport read.
  • SHOULDsupport search-type.

Documentation

For referral sources that receive referrals from upstream systems, used to retrieve an order for SDOH-related services

Search Parameters
ConformanceParameterTypeDocumentation
SHALL_idtoken

Allows retrieving known ServiceRequests records - and more specifically, retrieving more than one in a single call to poll for updates

SHALLcategorytoken

Allows filtering to only retrieve ServiceRequests that are SDOH-related

SHALLintenttoken

Allows filtering to retrieve only 'order' ServiceRequests and not plans, proposals, etc.

SHALLpatientreference

Allows filtering to retrieve only ServiceRequests associated with a particular patient. Note that some systems may mandate that searches are always patient-specific

SHALLstatustoken

Allows filtering to retrieve only active ServiceRequests

SHOULD_lastUpdateddate

Allows filtering for only records that have changed since last query

SHOULDcodetoken

Allows filtering to retrieve ServiceRequests for specific types of services

SHOULDoccurrencedate

Allows filtering to retrieve ServiceRequests based on the timeframe in which the service needs to be provided

SHOULDperformerreference

Allows filtering to retrieve only ServiceRequests that designate a specific performer

SHOULDrequesterreference

Allows filtering to retrieve only ServiceRequests created by a specific practitioner

SHOULDsupporting-inforeference

Allows _include to retrieve supporting information for a ServiceRequest - particularly Consent

 
Resource Conformance: SHOULD Subscription
Core FHIR Resource
Subscription
Reference Policy
Interaction summary
  • SHOULDsupport create.
  • MAYsupport update.

Documentation

Used to allow upstream systems to subscribe to and monitor Tasks stored on this system for change

Extended Operations
ConformanceOperationDocumentation
SHOULD$status

Necessary for systems supporting subscriptions to ensure that the subscription is functioning properly and to check for errors

MAY$topic-list

Allows discovery of what subscription topics the systems supports - needed for systems that aren't pre-configured to be aware of what topics are available for use.

REST Configuration: 2

Mode: server

The clinical care referral recipient needs to allow SDOH clinical care referral sources and coordination platforms to have solicited the filling of SDOH-related referrals by this system and also to access Procedures that describe interventions taken by the users of this system.

Security
Enable CORS: no
Security services supported: SMART-on-FHIR

Implementations must meet the general privacy & security requirements documented in this implementation guide.

Summary of System-wide Interactions
  • SHOULDSupports the batchinteraction described as follows:

    Allows other systems to poll for changes to multiple resource types simultaneously

Capabilities by Resource/Profile

Summary

The summary table lists the resources that are part of this configuration, and for each resource it lists:

  • The relevant profiles (if any)
  • The interactions supported by each resource (Read, Search, Update, and Create, are always shown, while VRead, Patch, Delete, History on Instance, or History on Type are only present if at least one of the resources has support for them.
  • The required, recommended, and some optional search parameters (if any).
  • The linked resources enabled for _include
  • The other resources enabled for _revinclude
  • The operations on the resource (if any)
Resource TypeProfileRSUCSearches_include_revincludeOperations
DocumentReferenceSupported Profiles
  US Core DocumentReference Profile
yyyy_id, _lastUpdated
SubscriptionSupported Profiles
  Backported R5 Subscription
yy$status, $topic-list
TaskSupported Profiles
  SDOHCC Task For Patient
  SDOHCC Task For Referral Management
yyyy_id, _lastUpdated, code, owner, patient, requester, status, focus, outputTask:output

Resource Conformance: SHALL DocumentReference
Core FHIR Resource
DocumentReference
Reference Policy
literal
Interaction summary
  • SHALLsupport create, read, search-type.
  • SHOULDsupport update.

Documentation

Used convey a scanned or other form of document representing the text of a consent. Also used for PDF forms.

Search Parameters
ConformanceParameterTypeDocumentation
SHALL_idtoken

Allows retrieving known DocumentReference records - and more specifically, retrieving more than one in a single call to poll for updates

SHOULD_lastUpdateddate

Allows filtering for only records that have changed since last query

 
Resource Conformance: SHOULD Subscription
Core FHIR Resource
Subscription
Reference Policy
Interaction summary
  • SHOULDsupport create.
  • MAYsupport update.

Documentation

Used to allow upstream coordination platforms and referral sources to subscribe to and monitor Tasks created on this system

Extended Operations
ConformanceOperationDocumentation
SHOULD$status

Allows upstream systems to verify their subscription is functioning properly and to check for errors

MAY$topic-list

Allows upstream systems to discover of what subscription topics this system supports - needed for systems that aren't pre-configured to be aware of what topics are available for use.

Resource Conformance: SHALL Task
Core FHIR Resource
Task
Reference Policy
literal
Interaction summary
  • SHALLsupport create, update, read, search-type.

Documentation

Used by upstream referral sources and coordination platforms to create and update Tasks seeking fufillment of ServiceRequests. Also used by downstream referral recipiencts to monitor and update Tasks stored on this system as they respond to requests to fulfill referrals and link in information about actions taken so far

Search Parameters
ConformanceParameterTypeDocumentation
SHALL_idtoken

Allows retrieving known Task records - and more specifically, retrieving more than one in a single call to poll for updates

SHALLcodetoken

Allows filtering for 'fulfill' tasks as opposed to others. Some systems may require code to be included as a filter criteria as different Task codes may correspond to different internal database tables.

SHALLpatientreference

Allows monitoring of tasks associated with a particular patient. (Some systems may require that all queries be done in the context of a single patient.)

SHALLrequesterreference

Allows retrieving all tasks that have been requested by a particular organization or individual. This will commonly be used to monitor the tasks initiated by a particular system

SHALLstatustoken

Allows filtering to only active or completed tasks

SHALLfocusreference

Allows retrieving the task(s) seeking fulfillment of a particular ServiceRequest

SHOULD_lastUpdateddate

Allows filtering for only records that have changed since last query

SHOULDownerreference

Allows filtering only for tasks that are assigned to a particular owner (or alternatively, tasks that have not yet been assigned)

SHOULDoutputreference

Allows for the 'output' of a Task to be included when retrieving a Task