SDOH Clinical Care
0.0.4C3 - CI Build

SDOH Clinical Care, published by HL7 International - Patient Care WG. This is not an authorized publication; it is the continuous build for version 0.0.4C3). This version is based on the current content of https://github.com/HL7/sdoh-cc/ and changes regularly. See the Directory of published versions

Artifacts Summary

This page provides a list of the FHIR artifacts defined as part of this implementation guide.

Behavior: Capability Statements

The following artifacts define the specific capabilities that different types of systems are expected to have in order to comply with this implementation guide. Systems complying with the implementation guide are expected to declare conformance to one or more of the following capability statements.

SDOHCC_PMEHR_Actor_Capability_Statement The system that initiates the task to request a list of patients to be screened using a certain screening questionnaire. The PMEHR actor is assumed to either be grouped with an SDC Form Designer actor or to have access to Questionnaire Resources produced by other systems that are compliant with the SDC Form Designer and SDC Form Manager actors. The PMEHR uses the capability of a Form Designer technical actor to create a Questionnaire Resource that expresses a screening instrument. See the LHC Form Builder for an example: [https://lhcforms.nlm.nih.gov/](https://lhcforms.nlm.nih.gov/). For screening instruments included in the Gravity Project Master List, use temporary codes included in the Master List where permanent codes are not yet available.Link to Section of the IG about the Master List and Temporary Codes.

Structures: Resource Profiles

These define constraints on FHIR resources that need to be complied with by conformant implementations

SDOHCC_Goal_FoodInsecurity_1 This profile supports Gravity Project data elements that focus on the Food Insecurity domain. The profile constrains Goals related to: Food Security.
SDOHCC_Condition_FoodInsecurity_1 This profile supports Gravity Project data elements that focus on the Food Insecurity domain. The profile constrains Conditions related to: Food insecurity, Mild food insecurity, Moderate food insecurity, or Severe food insecurity.
SDOHCC_Observation_FoodInsecurity_1 This profile supports Gravity Project data elements that focus on the Food Insecurity domain. The profile constrains Observations related to: Food Insecurity. It allows the creation of Observations of: Food insecurity unknown, Food insecurity absent (aka Food security present), Food insecurity present, Mild food insecurity present, Moderate food insecurity present, and Severe food insecurity present.
SDOHCC_Procedure_FoodInsecurity_1 This profile supports Gravity Project data elements that focus on the Food Insecurity domain. The profile constrains Procedures related to: Food Insecurity.
SDOHCC_Consent_FoodInsecurity_1 This profile constrains the base FHIR Consent Resource for Food Insecurity.
SDOHCC_List_FoodInsecurity 1 This profile constrains the List Resource for representing a patient or list of patients to be screened.
SDOHCC_ServiceRequest_FoodInsecurity_1 This profile supports Gravity Project data elements that focus on the Food Insecurity domain. The profile constrains Service Requests related to: Food Insecurity.
SDOHCC_Task_Screening_1 This profile constrains the Task Resource for representing a patient screening task.
SDOHCC_List_Screening_1 This profile constrains the List Resource for representing a patient or list of patients to be screened.

Terminology: Value Sets

These define sets of codes used by systems conforming with this implementation guide

SDOHCC_ValueSet_Task_1 Clinical Focus: Concepts in this Value Set are used to indicate the type of task to be performed. Data Element Scope is Task.code It is defined extensionally to include the concept of "patient screening task".
SDOHCC_ValueSet_CommunicationCategory_1 Clinical Focus: Concepts in this Value Set are used to categorize types of information communicated between systems. Data Element Scope is Communication.category. It is defined extensionally to include the concept of "patient screening information.
SDOHCC_ValueSet_MessageHeader_1 Clinical Focus: Concepts in this Value Set are used to document various types of messages used within a Patient Screening Task. (simple assertion). Data Element Scope is MessageHeader.event. It is defined extensionally to include the concepts of "screening task request", "screening response", "screening task update".
SDOHCC_ValueSet_FoodInsecurity_1 Clinical Focus: Concepts in this Value Set are used to document food insecurity as a clinical finding (simple assertion) or condition. Data Element Scope is Observation.code or Condition.code. It is defined extensionally to include the concepts of "Food insecurity" and the more specific concepts of "Mild food insecurity", "Moderate food insecurity", and "Severe food insecurity".
SDOHCC_ValueSet_FoodInsecurity_2 Clinical Focus: Concepts in this Value Set are used to document food insecurity conditions for the purpose of billing using ICD-10. Data Element Scope is Condition.code. It is defined extensionally to include the concepts of "Lack of adequate food and safe drinking water", "Food insecurity" and "Lack of adequate food".
SDOHCC_ValueSet_ContextValue_2 Clinical Focus: Concepts in this Value Set are used to document the reason that Observation.value for food insecurity as a clinical finding (simple assertion) has not been populated. Data Element Scope is Observation.dataAbsentReason. It is defined extensionally to include the concepts of "Unknown", "Asked But Unknown", and "Asked But Declined".
SDOHCC_ValueSet_ContextValue_1 Clinical Focus: Concepts in this Value Set are used to document the presence or absence of food insecurity as a clinical finding (simple assertion). Data Element Scope is Observation.value. It is defined extensionally to include the concepts of "Known present" or "Known absent".
SDOHCC_ValueSet_FoodInsecurityIntervention_1 Clinical Focus: Concepts in this Value Set are used to document activities that might be performed to address food insecurity conditions/observations. Data Element Scope is Procedure.code and ServiceRequest.code. It is defined extensionally to include procedure concepts that address food insecurity conditions/observations.
SDOHCC_ValueSet_SocialServiceProgram_1 Clinical Focus: Concepts in this Value Set are used to document programs that might address food insecurity. Data Element Scope is ServiceRequest.orderDetail. It is defined extensionally to include concepts that represent social service programs.
SDOHCC_ValueSet_IntentValue_1 Clinical Focus: Concepts in this Value Set are used to document the intent of service requests related to food insecurity. Data Element Scope is ServiceRequest.intent. It is defined extensionally to include the concepts of "Plan" and "Order".

Terminology: Code Systems

These define new code systems used by systems conforming with this implementation guide

SDOHCC_CodeSystem_TemporaryCodes A local code system defined within the context of the SDOH-CC IG.
SDOHCC_IdentifierSystem_TemporaryIdentifiers A local identifier system defined within the context of the SDOH-CC IG.

Example: Example Instances

These are example instances that show what data produced and consumed by systems conforming with this implementation guide might look like

SDOHCC_List_HungerVitalSignPatient_1_Example_1 Example of a List resource used to document a list of patients to be screened. This IG uses the base List resource. Further constraints are not profiled at this time.
SDOHCC_Consent_ScreeningInfo_1_Example_1 Example of a Consent resource use to document a patient's consent to share requested information. This IG uses the base Consent resource. Further constraints are not profiled at this time.
SDOHCC_Condition_FoodInsecurity_1_Example_1 Example of an Condition resource used to document a condition on a patient's problem list. The Condition include an onset date which records the point in time considered to be the time when the person began experiencing the condition. The Condition may include an abatement date to indicate the time when the person stopped experiencing the condition because the condition was no longer present. Onset and abatement dates can be precise to a moment in time, or generalized to a day, month, or year. The precision of the time should match the specificity of the available evidence. The Condition.asserter names the person responsible for asserting the patient's condition and the organization the asserter represented. The Condition.recorder names the person responsible for documenting the condition in the patient's record and that person's represented organization. PractitionerRole is always used to represent the practitioner and his or her associated organization. The Condition resource is conformant to the SDOHCC_Condition_FoodInsecurity_1 profile which is adapted from the US Core Condition profile. 7/18/2019: Patient is assisted by the nurse to complete a food insecurity questionnaire and is assessed at that time to have had food insecurity over the past 3 months. The nurse notices the patient is coming in for a checkup on 7/30/2019 and adds to the physician's task list to assess and address the food insecurity issue. 7/30/2019: Patient sees PCP and, during that visit, is enrolled by the PCP in a program to address food insecurity. A care plan is created with a goal to resolve this problem by 11/30/2019 (within 4 months). 10/27/2019: Patient has a phone interview assessment by the nurse (using same questionnaire) and is no longer food insecure today. The goal is updated to achieved with a status date of 10/27/2019 and the condition is updated to be abated as of 10/27/2019.
SDOHCC_Task_Example_1 TBD
SDOHCC_Observation_FoodInsecurity_1_Example_2 Example of an Observation resource used to document a clinical finding (simple assertion) that food insecurity was observed to be present for an indicated time period. The Observation indicates the point in time it was made and the performer of the observation names the person responsible for making the assertion and the organization the performer represented. PractitionerRole is always used to represent the practitioner and his or her associated organization. The Observation resource is conformant to the SDOHCC_Observation_FoodInsecurity_1 profile which is adapted from the US Core Observation profile. 7/18/2019: Patient is assisted by the nurse to complete a food insecurity questionnaire and is assessed at that time to have had food insecurity over the past 3 months. The nurse notices the patient is coming in for a checkup on 7/30/2019 and adds to the physician's task list to assess and address the food insecurity issue. 7/30/2019: Patient sees PCP and, during that visit, is enrolled by the PCP in a program to address food insecurity. A care plan is created with a goal to resolve this problem by 11/30/2019 (within 4 months). 10/27/2019: Patient has a phone interview assessment by the nurse (using same questionnaire) and is no longer food insecure today. The goal is updated to achieved with a status date of 10/27/2019 and the condition is updated to be abated as of 10/27/2019.
SDOHCC_Procedure_FoodInsecurity_1_Example_1 Example of a Procedure resource used to document that an activity was performed to [fill in action] to address a person's observed food insecurity. The Procedure resource also is conformant to the US Core Procedure profile.7/18/2019: Patient is assisted by the nurse to complete a food insecurity questionnaire and is assessed at that time to have had food insecurity over the past 3 months. The nurse notices the patient is coming in for a checkup on 7/30/2019 and adds to the physician's task list to assess and address the food insecurity issue. 7/30/2019: Patient sees PCP and, during that visit, is enrolled by the PCP in a program to address food insecurity. A care plan is created with a goal to resolve this problem by 11/30/2019 (within 4 months). 10/27/2019: Patient has a phone interview assessment by the nurse (using same questionnaire) and is no longer food insecure today. The goal is updated to achieved with a status date of 10/27/2019 and the condition is updated to be abated as of 10/27/2019.
SDOHCC_Encounter_Enc1_Example_1 This example is included to support the observation, condition, procedure and goal examples provided in this IG. This example itself is not focal to the SDOH examples.
SDOHCC_Observation_FoodInsecurity_1_Example_1 Example of an Observation resource used to document a clinical finding (simple assertion) that food insecurity was observed to be absent for an indicated time period. The Observation indicates the point in time it was made and the performer of the observation names the person responsible for making the assertion and the organization the performer represented. PractitionerRole is always used to represent the practitioner and his or her associated organization. The Observation resource is conformant to the SDOHCC_Observation_FoodInsecurity_1 profile which is adapted from the US Core Observation profile. 7/18/2019: Patient is assisted by the nurse to complete a food insecurity questionnaire and is assessed at that time to have had food insecurity over the past 3 months. The nurse notices the patient is coming in for a checkup on 7/30/2019 and adds to the physician's task list to assess and address the food insecurity issue. 7/30/2019: Patient sees PCP and, during that visit, is enrolled by the PCP in a program to address food insecurity. A care plan is created with a goal to resolve this problem by 11/30/2019 (within 4 months). 10/27/2019: Patient has a phone interview assessment by the nurse (using same questionnaire) and is no longer food insecure today. The goal is updated to achieved with a status date of 10/27/2019 and the condition is updated to be abated as of 10/27/2019.
SDOHCC_Practitioner_f005_Example_1 This example is included to support the observation, condition, procedure and goal examples provided in this IG. This example itself is not focal to the SDOH examples.
SDOHCC_Practitioner_f007_Example_1 This example is included to support the observation, condition, procedure and goal examples provided in this IG. This example itself is not focal to the SDOH examples.
SDOHCC_Patient_pat1_Example_1 This example is included to support the observation, condition, procedure and goal examples provided in this IG. This example itself is not focal to the SDOH examples.
SDOHCC_Encounter_f201_Example_1 This example is included to support the observation, condition, procedure and goal examples provided in this IG. This example itself is not focal to the SDOH examples.
SDOHCC_Encounter_f203_Example_1 This example is included to support the observation, condition, procedure and goal examples provided in this IG. This example itself is not focal to the SDOH examples.
SDOHCC_Goal_FoodInsecurity_1_Example_1 Example of a Goal resource used to document a goal of food security as measured by an observation (clinical finding) that asserts food insecurity absent. The Goal resource also is conformant to the US Core Goal profile.7/18/2019: Patient is assisted by the nurse to complete a food insecurity questionnaire and is assessed at that time to have had food insecurity over the past 3 months. The nurse notices the patient is coming in for a checkup on 7/30/2019 and adds to the physician's task list to assess and address the food insecurity issue. 7/30/2019: Patient sees PCP and, during that visit, is enrolled by the PCP in a program to address food insecurity. A care plan is created with a goal to resolve this problem by 11/30/2019 (within 4 months). 10/27/2019: Patient has a phone interview assessment by the nurse (using same questionnaire) and is no longer food insecure today. The goal is updated to achieved with a status date of 10/27/2019 and the condition is updated to be abated as of 10/27/2019.
SDOHCC_Questionnaire_HungerVitalSign_1_Example_1 This example represents the Hunger Vital Sign food insecurity screening instrument using a Questionnaire resource that complies to the SDC Questionnaire profile.
SDOHCC_QuestionnaireResponse_HungerVitalSign_1_Example_1