Enhancing FHIR for Social Services
0.1.0 - ci-build United States of America flag

Enhancing FHIR for Social Services, published by HL7 Human and Social Services Work Group (HSSWG) (Human and Social Services). This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/efss/ and changes regularly. See the Directory of published versions

Enhancing FHIR for Social Services

Official URL: http://hl7.org/fhir/us/efss/ImplementationGuide/hl7.fhir.efss Version: 0.1.0
Draft as of 2024-04-03 Computable Name: EFSSIG

HHS Data Strategy

From the HHS Data Strategy document, “Data is available, accessible, timely, equitable, meaningfully usable, and protected – and being actively used by HHS, our partners, and the public to realize HHS’ mission.”

  • Cultivate Data Talent
  • Foster Data Sharing
  • Integrate Administrative Data into Program Operations
  • Enable Whole-Person Care Delivery by Connecting Human Services Data
  • Responsibly Leverage Artificial Intelligence

HHS Data Vision

Enhancing FHIR


Also from the HHS Data Strategy document (1):

“Human services lags health care in the availability, interoperability, and electronic exchange of data, particularly at the point of care. There is a need for more comprehensive data standards; freely available, standard taxonomies for human services provider information; better tools to manage consent, map household relationships, and perform matching and linkage; expanded provider onboarding; and aligned incentives and requirements to stimulate data flows. Interoperability improvements would significantly enhance case management, coordinated care and service delivery, closed loop screening and referral with “warm handoffs” between providers, expedited enrollment into benefits and service programs, and enable more efficient and equitable program design and delivery. Collectively, these advances would improve participants’ experience and access to services. The 2009 HITECH Act and CMS’s Meaningful Use program invested tens of billions of dollars in interoperable health data exchange; in the absence of commensurate investment in human services data exchange, progress can nonetheless be made. In light of the extensive health and public health common data standards development in recent decades and the need for cross-sector data sharing to deliver integrated services, human services data must become interoperable with health data, building from common data standards such as the U.S. Core Data for Interoperability (USCDI).”


“Real-time, relevant data and data-driven insights are available to human services practitioners, health care providers, facilities/programs, and state, Tribal, local, and territorial governments to establish a whole-person and whole-family view of wellness and needs; seamlessly connect people with needed support services; proactively predict future needs and better address them at an individual and system level; effectively manage programs and facilities; evaluate the effectiveness and value of service provision at a local and macro level; and more equitably and efficiently plan and allocate resources.” (1)

Develop Data Standards

“Ensure full human services representation in HHS and external standards-development bodies. Identify and prioritize gaps in standards, use cases, infrastructure (i.e., cloud systems, retention), and policy/governance (i.e., consent management, household relationship mapping) based on HHS, ecosystem, and end-user priorities. (1)

“Partner with standards setting organizations to strategically develop human services standards, use cases, and tools that address the most critical gaps, including creating USCDI+ data set standards to support human services programs.

“Coordinate with federal partners to ensure human services standards and taxonomies are open and accessible to implementers.”

FHIR and Social Services

As part of our initial investigations, we identified several gaps and difficulties implementers and users were encountering applying FHIR Standards in Social Service environments. Within this guide - we have highlighted gaps and proposed approaches to resolving these gaps.


  1. From the HHS Data Strategy document