SDOH Clinical Care
2.1.0 - STU 2.1 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 2.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of and changes regularly. See the Directory of published versions

STU2 Publication Changes

Page standards status: Informative

Jira Tickets – all applied – see changes below


  • FHIR-35753 Home page should have compelling sale of problem and solution spec solves/offers
    • Provided link to gravity project on the home page

General Changes


  • FHIR-38082 Beef up the mapping instructions page
  • FHIR-38081 Mapping page should not have the mapping language content
    • updated mapping instructions

Task Instructions

  • FHIR-37480 Add Task.output slice to allow patient to indicate their “chosen-contact”
  • FHIR-35750 Suggest more robust requirements around using Task for patient Communications
  • FHIR-35634 Clarify SDOH Task distinction
  • FHIR-35746 Be clear on what the patient can change in Task
  • FHIR-35740 Tighter specification around the updating of Task fields by Patient.
  • FHIR-35751 Link to this in the relevant context
  • FHIR-35739 Examples should show historical progression with statuses

Personal Characteristics

  • FHIR-34876 Need specificity in requirements, e.g., state statutes.
  • FHIR-34863 References from Race Profile to Spec Requirements
  • FHIR-34862 References from Ethnicity Profile to Spec Requirements
  • FHIR-34860 State Requirements Unclear
  • FHIR-34858 Race and Ethnicity Text
  • FHIR-35679 Illustrate that laws vary around sharing of race and ethnicity data
  • FHIR-35685 Observation Subject Extension - use in Observation Profiles for Race and Ethnicity
  • FHIR-35338 Concern over race and ethnicity data of “related person” and “practitioner”
  • FHIR-35329 Concern over patient race and ethnicity data being shared for non-treatment purposes
  • FHIR-35022 Use a single Observation Resource to include both Race and Ethnicity Observations
  • FHIR-34999 Adding R/E Observations to the Structured Definitions without indicating they are draft will cause implementation confusion
  • FHIR-35691 “Unknown” is not appropriate as an observation method
  • FHIR-34878 Need to consider Provenance when R/E Extensions and Observation Resource is used for R/E
  • FHIR-35327 For Observation.method value set, add guidance related to use of “observed”
  • FHIR-35325 For Observation.method value set, clarify the definition of “reported-by-related-person” and add guidance related to use of “self-reported” and “reported-by-related-person”
  • FHIR-35206 Patient Application Client CapabilityStatement does not include Observation therefore patients will not be able to Read nor search for R/E Observation Profiles
  • FHIR-35715 Unclear what adhoc and adhocresponse are - please clarify
  • FHIR-35370 For Observation.method value set, add guidance related to use of “observed”.
  • FHIR-35375 Add a challenge related to the sensitivity of SDOH data

Value set changes

  • FHIR-36591 Add on-hold to the value set for .status to support patient inability to perform task for a period of time

Functional Use Cases

  • FHIR-35718 Restructure and add diagrams to make functional requirements of spec clear
  • FHIR-35639 The patient should be given an opportunity to weigh in on whether the referral was successful and goals have been accomplished (or progress made)
  • FHIR-35633 Clarifications related to Closing the Loop
  • FHIR-35623 Clarify: what happens when the CP shares that info with the CBO or other agency assisting with the Food Insecurity?
  • FHIR-35621 What is the CP doing on behalf of the provider organization that renders it a business associate?
  • FHIR-35377 Additional info about what a CP is might be helpful here
  • FHIR-34881 Referral workflow steps need to be aligned
    • Applied the above ticket dispositions to the Functional Use Cases page

Structure Definitions

  • FHIR-34891 Please relax Goal.Achievement cardinality to 0..1 to align with goals that are proposed or planned
    • changed goal.achievement cardinality to 0..1
  • FHIR-35369 Streamline representation of SDOH screening instruments
    • based on US Core decision, change grouping observation to have individual observations for multiple selection questions

Exchange Workflow

  • FHIR-35733 Patient interaction diagrams need more clarity
  • FHIR-35721 Recommend better definition and consistence with diagram and rest of 9
  • FHIR-35717 Move this section up so that it is easier to find
  • FHIR-35637 Workflow and Managing Consent diagram should be expanded to include API Resources
    • Applied the above ticket dispositions to the Exchange Workflow page

Capability Statements

  • FHIR-36045 Procedure _id search parameter Definition & Chaining makes reference to PractitionerRole records
  • FHIR-35960 Subscription in the capability statements has SDOHCC-Procedure as the supported Profile
  • FHIR-35076 Capability Statements - Please provide specific conformance assertions with respect to the various supported profiles

Privacy and Security

  • FHIR-35676 Add language to clarify that not all legal requests are up to org policy - HIPAA has specific procedures that must be followed regarding these types of disclosures