SDOH Clinical Care
2.2.0 - STU 2.2
SDOH Clinical Care
2.2.0 - STU 2.2
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
| Official URL: http://hl7.org/fhir/us/sdoh-clinicalcare/CapabilityStatement/SDOHCC-ReferralSource | Version: 2.2.0 | |||
| Standards status: Trial-use | Computable Name: SDOHCC_ReferralSource | |||
This resource describes the required and desired behavior of systems acting as SDOH clinical care 'referral sources'. These are typically EHR or Payer systems that initiate the process of identifying patients with SDOH needs and requesting appropriate services.
Because systems that originate requests for service may sometimes also be recipients of requests for service, the requirements include 'SHOULD' expectations to also accept and process requests from other systems. The referral source may either interact directly with a Referral Recipient or will interact through an intermediary Coordination Platform. Responsibilities of Referral Sources include capturing information from a patient in the form of QuestionnaireResponses, Observations, Conditions and Goals as well as creating the ServiceRequest instances that refer patients for needed services and the Tasks that initiate fulfillment of those referrals.
Raw OpenAPI-Swagger Definition file | Download
Generated Narrative: CapabilityStatement SDOHCC-ReferralSource
xml, jsonNote 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.
clientThe referral source needs to receive information about procedures done in response to referrals. They SHOULD also be able to receive information from upstream systems in cases where they are referred to themselves.
SMART-on-FHIRImplementations must meet the general privacy & security requirements documented in this implementation guide.
batchinteraction described as follows:Allows polling for changes to multiple resource types simultaneously
The summary table lists the resources that are part of this configuration, and for each resource it lists:
_include_revinclude| Resource Type | Profile | R | S | U | C | Searches | _include | _revinclude | Operations |
|---|---|---|---|---|---|---|---|---|---|
| CareTeam | Supported Profiles US Core CareTeam Profile | y | y | _id, _lastUpdated | |||||
| Condition | Supported Profiles SDOHCC Condition | y | y | _id, _lastUpdated, category, clinical-status, code, patient, verification-status | |||||
| Consent | Supported Profiles SDOHCC Consent | y | y | _id, _lastUpdated, source-reference | Consent:source-reference:DocumentReference | ||||
| Device | Supported Profiles Device | y | y | _id, _lastUpdated | |||||
| DocumentReference | Supported Profiles US Core DocumentReference Profile | y | y | _id, _lastUpdated | |||||
| Goal | Supported Profiles SDOHCC Goal | y | y | _id, _lastUpdated, achievement-status, category, lifecycle-status, patient, target-date | |||||
| HealthcareService | Supported Profiles SDOHCC Healthcare Service | y | y | _id, _lastUpdated, location | |||||
| Location | Supported Profiles SDOHCC Location | y | y | _id, _lastUpdated | |||||
| Observation | Supported 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 | y | y | _id, _lastUpdated, category, code, code-value-concept, date, derived-from, patient, status | |||||
| Organization | Supported Profiles US Core Organization Profile | y | y | _id, _lastUpdated | |||||
| Patient | Supported Profiles US Core Patient Profile | y | y | _id, _lastUpdated | |||||
| Practitioner | Supported Profiles US Core Practitioner Profile | y | y | _id, _lastUpdated | |||||
| PractitionerRole | Supported Profiles US Core PractitionerRole Profile | y | y | _id, _lastUpdated, organization, practitioner | PractitionerRole:organization, PractitionerRole:practitioner | ||||
| Procedure | Supported Profiles SDOHCC Procedure | y | y | _id, _lastUpdated, based-on, category, code, date, patient, performer, status | |||||
| Questionnaire | Supported Profiles Extractable Questionnaire - StructureMap | y | code, context-type-value, identifier, publisher, status, subject-type, title, url, version | $populate | |||||
| QuestionnaireResponse | Supported Profiles SDC Questionnaire Response | y | y | _id, _lastUpdated, author, authored, patient, questionnaire, status | |||||
| RelatedPerson | Supported Profiles RelatedPerson | y | y | _id, _lastUpdated | |||||
| ServiceRequest | Supported Profiles SDOHCC ServiceRequest | y | y | _id, _lastUpdated, category, code, intent, occurrence, patient, performer, requester, status, supporting-info | HealthCareService:location, ServiceRequest:supporting-info, ServiceRequest:pertains-to-goal, ServiceRequest:patient, ServiceRequest:requester, ServiceRequest:performer, PractitionerRole:practitioner, PractitionerRole:organization | ||||
| Subscription | Supported Profiles R4/B Topic-Based Subscription | y | y | $status | |||||
| Task | Supported Profiles SDOHCC Task For Patient SDOHCC Task For Referral Management | y | y | y | y | _id, _lastUpdated, code, owner, patient, requester, status, focus, output | Task:focus, Task:output, HealthCareService:location, ServiceRequest:supporting-info, ServiceRequest:pertains-to-goal, ServiceRequest:patient, ServiceRequest:requester, ServiceRequest:performer, PractitionerRole:practitioner, PractitionerRole:organization |
literalreadAllows the system to retrieve a CareTeam that is the intended performer of a ServiceRequest.
search-typeAllows the monitoring of previously-retrieved CareTeams that are the intended performer of ServiceRequests.
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
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known CareTeam records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
literalreadAllows the system to retrieve a Condition that is the reason for a ServiceRequest.
search-typeAllows the monitoring of previously-retrieved Conditions that are referenced by ServiceRequests.
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
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known Condition records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHALL | category | token | Allows filtering to only SDOH-related conditions |
| SHALL | patient | reference | Allows filtering to only conditions associated with a specific patient. Some systems will require that searches be patient-specific |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
| SHOULD | clinical-status | token | Allows filtering to only active conditions |
| SHOULD | code | token | Allows filtering to only specific SDOH conditions or sets of conditions |
| SHOULD | verification-status | token | Allows filtering to exclude refuted or entered-in-error conditions |
literalreadAllows the system to retrieve a Consent referenced as a 'supportingInformation' item of a ServiceRequest.
search-typeAllows the monitoring of previously-retrieved Consents related to ServiceRequests of interest.
Used to access the consent that authorizes disclosure of ServiceRequest information to non-HIPAA-covered entities
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known consent records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
| SHOULD | source-reference | reference | Allows including the document that contains the PDF or similar representation of a paper consent |
literalreadAllows the system to retrieve a Device that is the requester or intended performer of a ServiceRequest.
search-typeAllows the monitoring of previously-retrieved Devices that are the requester or intended performer of ServiceRequests.
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
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known Device records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
literalreadAllows the system to retrieve a PDF or similar content referenced by a Consent or Task.
search-typeAllows the monitoring of previously-retrieved DocumentReferences in the event the image/document is amended/corrected/updated.
Used to retrieve a scanned or other form of document representing the text of a consent. Also used for PDF forms.
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known DocumentReference records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
literalreadAllows the system to retrieve a goal referenced by a ServiceRequest.
search-typeAllows the monitoring of previously-retrieved Goals in the event they are updated.
Used to access goals related to an SDOH referral
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known Goal records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHALL | category | token | Allows filtering to only include SDOH-related goals |
| SHALL | patient | reference | Allows filtering to only include goals for a particular patient. Some systems will require searches to be patient-specific |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
| SHOULD | achievement-status | token | Allows filtering to only include unmet goals |
| SHOULD | lifecycle-status | token | Allows filtering to only include active goals |
| SHOULD | target-date | date | Allows filtering based on when a particular goal is desired to be achieved |
literalreadAllows the system to retrieve a HealthcareService that is the intended performer of a ServiceRequest.
search-typeAllows the monitoring of previously-retrieved HealthcareServices that are the intended performer of ServiceRequests.
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.
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known HealthcareService records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHALL | location | reference | Allows retrieval of the phyical site(s) associated with a HealthService |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
literalreadAllows the system to retrieve a Location that is an available location for a service.
search-typeAllows the monitoring of previously-retrieved Locations that are the intended locations for services.
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.
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known Location records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
literalreadAllows the system to retrieve an Observation referenced by a ServiceRequest.
search-typeAllows the monitoring of previously-retrieved Observations for updates/corrections.
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
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. Also used to share certain SDOH-relevant demographic information.
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known Observation records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHALL | category | token | Allows filtering for only SDOH-related observations |
| SHALL | patient | reference | Allows filtering for observations specific to a particular patient. Some systems will require that all queries be patient-specific |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
| SHOULD | code | token | Allows filtering for specific types of observations |
| SHOULD | date | date | Allows filtering for observations that held in a particular time period |
| SHOULD | derived-from | reference | Allows filtering for observations derived from a particular QuestionnaireResponse |
| SHOULD | status | token | Allows filtering for observations that are completed or revised (i.e. not in-progress or entered-in-error) |
| MAY | code-value-concept | composite | Allows filtering for observations that have a specific coded value answer for a specified observation type |
literalreadAllows the system to retrieve an Organization that is the requester or intended performer of a ServiceRequest.
search-typeAllows the monitoring of previously-retrieved Organizations that are the requester or intended performer of ServiceRequests.
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
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known Organization records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
literalreadAllows the system to retrieve the Patient that is the subject of a ServiceRequest.
search-typeAllows the monitoring of previously-retrieved Patients.
For referral sources that receive referrals from upstream systems, used to access information about the Patient that is the subject a ServiceRequest
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known Patient records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
literalreadAllows the system to retrieve a Practitioner that is the requester or intended performer of a ServiceRequest.
search-typeAllows the monitoring of previously-retrieved Practitioners that are the requester or intended performer of ServiceRequests.
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
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known Practitioner records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
literalreadAllows the system to retrieve a PractitionerRole that is the requester or intended performer of a ServiceRequest.
search-typeAllows the monitoring of previously-retrieved PractitionerRoles that are the requester or intended performer of ServiceRequests.
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
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known PractitionerRole records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
| SHOULD | organization | reference | Allows doing an _include on Organization when retrieving the PractitionerRole |
| SHOULD | practitioner | reference | Allows doing an _include on Practitioner when retrieving the PractitionerRole |
literalreadAllows the referral source to retrieve procedures referenced by Tasks from more sophisticated 'delivery' systems that store their data on their own system rather than using the referral source as a persistence layer.
search-typeAllows the referral source to check for updates on Procedures after they've already been received or to look for procedures that haven't yet been linked as outputs to the Tasks that initiated the work.
Used to access information from downstream systems about actions that have been performed as a result of a referral
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known Procedure records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHALL | based-on | reference | Allows filtering for procedures resulting from a particular service request |
| SHALL | category | token | Allows filtering for procedures that are SDOH-related |
| SHALL | patient | reference | Allows filtering for procedures based on who they were delivered to. Some systems may require that all searches be patient-specific. |
| SHALL | performer | reference | Allows filtering for procedures based on who delivered the procedure. |
| SHALL | status | token | Allows filtering for procedures that are complete or in progress |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
| SHOULD | code | token | Allows filtering for procedures based on the specific service delivered |
| SHOULD | date | date | Allows filtering for procedures based on when they were delivered |
literalsearch-typeAllows the referral source to search for questionnaires relevant to a patient context.
Used to retrieve SDOH-related Questionnaires to be filled out by a patient or representative. Also allows retrieving Questionnaires associated with existing QuestionnaireResponses for editing by SMART-on-FHIR apps.
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | url | uri | Allows retrieving Questionnaires based on its canonical URL |
| SHALL | version | token | Allows retrieving a specific version of a Questionnaire |
| SHOULD | code | token | Allows filtering for questionnaires associated with particular LOINC or similar codes |
| SHOULD | context-type-value | composite | Allows filtering for procedures that are SDOH-related |
| SHOULD | identifier | token | Allows retrieving Questionnaires with a known identifier |
| SHOULD | publisher | string | Allows retrieving Questionnaires based on who is responsible for them |
| SHOULD | status | token | Allows retrieving Questionnaires that are active (and not draft or required) |
| SHOULD | subject-type | token | Allows retrieving Questionnaires that are intended to be completed about patients - as opposed to practitioner, organizations, etc. |
| SHOULD | title | string | Allows retrieving Questionnaires based on the name of the form |
| Conformance | Operation | Documentation |
|---|---|---|
| MAY | $populate | Allows SMART on FHIR or other systems to pre-populate a questionnaire response with existing information either available locally or queried from elsewhere |
literalreadAllows the retrieval of QuestionnaireResponses pointed to as supporting information by a ServiceRequest or as output of a Task.
search-typeAllows checking for updates in previously retrieved QuestionnaireResponses.
Used to allow QuestionnaireResponses referenced by a ServiceRequest or Task
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known QuestionnaireResponse records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHALL | author | reference | Allows filtering QuestionnaireResponses previously created/edited by a particular individual |
| SHALL | patient | reference | Allows retrieving QuestionnaireResponses associated with a particular patient. Some systems may only permit searches that are patient-specific |
| SHALL | questionnaire | reference | Allows retrieving QuestionnaireResponses that have been completed against a specified form |
| SHALL | status | token | Allows retrieving QuestionnaireResponses that are complete (or incomplete) |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
| SHOULD | authored | date | Allows filtering for QuestionnaireResponses by when they were created/last edited |
literalreadAllows the system to retrieve a RelatedPerson that is the requester or intended performer of a ServiceRequest.
search-typeAllows the monitoring of previously-retrieved RelatedPersons that are the requester or intended performer of ServiceRequests.
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
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known RelatedPerson records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
literalreadAllows client systems to retrieve the ServiceRequest pointed to by a Task.
search-typeAllows client systems to monitor multiple ServiceRequests for change simultaneously via polling.
For referral sources that receive referrals from upstream systems, used to retrieve an order for SDOH-related services
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known ServiceRequests records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHALL | category | token | Allows filtering to only retrieve ServiceRequests that are SDOH-related |
| SHALL | intent | token | Allows filtering to retrieve only 'order' ServiceRequests and not plans, proposals, etc. |
| SHALL | patient | reference | Allows filtering to retrieve only ServiceRequests associated with a particular patient. Note that some systems may mandate that searches are always patient-specific |
| SHALL | status | token | Allows filtering to retrieve only active ServiceRequests |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
| SHOULD | code | token | Allows filtering to retrieve ServiceRequests for specific types of services |
| SHOULD | occurrence | date | Allows filtering to retrieve ServiceRequests based on the timeframe in which the service needs to be provided |
| SHOULD | performer | reference | Allows filtering to retrieve only ServiceRequests that designate a specific performer |
| SHOULD | requester | reference | Allows filtering to retrieve only ServiceRequests created by a specific practitioner |
| SHOULD | supporting-info | reference | Allows _include to retrieve supporting information for a ServiceRequest - particularly Consent |
createNecessary if using subscriptions to monitor updates to the Task
updateNeeded to allow the requester to update a subscription - to adjust delivery target, to add additional tasks to monitor (if subscribing by id) typically to cancel a request for fulfillment
When tasks have been created on upstream systems, used to access information about updates to those Tasks
| Conformance | Operation | Documentation |
|---|---|---|
| SHOULD | $status | Necessary for systems supporting subscriptions to ensure that the subscription is functioning properly and to check for errors |
literalcreateAllows the referral source to create tasks on a delivery system (or downstream coordination system).
updateAllows the referral source to modify the status of previously created tasks - e.g. to cancel them.
readAllows the referral source to poll a single Task for changes.
search-typeAllows the referral source to poll multiple tasks simultaneously, as well as to retrieve referenced resources as part of a single query.
Used to create Tasks on downstream systems seeking fufillment of ServiceRequests on a coordinating system serving as an intermediary and to retrieve Task updates from a fulfilling system. Also used to create tasks soliciting information from patients.
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known Task records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHALL | code | token | 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. |
| SHALL | patient | reference | 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.) |
| SHALL | requester | reference | 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 |
| SHALL | status | token | Allows filtering to only active or completed tasks |
| SHALL | focus | reference | Allows retrieving the task(s) seeking fulfillment of a particular ServiceRequest |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
| SHOULD | owner | reference | Allows filtering only for tasks that are assigned to a particular owner (or alternatively, tasks that have not yet been assigned) |
| SHOULD | output | reference | Allows for the 'output' of a Task to be included when retrieving a Task |
serverReferral sources must make both the referral and all information referenced by it available to downstream coordination platforms and referral recipient systems and - depending on the capabilities of the receivers - may also need to make the Tasks themselves available for query and support writing of procedures in situations where the recipient is a 'light' referral recipient that doesn't have local persistence or FHIR server capabilities.
SMART-on-FHIRImplementations must meet the general privacy & security requirements documented in this implementation guide.
batchinteraction described as follows:Allows other systems to poll for changes to multiple resource types simultaneously
The summary table lists the resources that are part of this configuration, and for each resource it lists:
_include_revinclude| Resource Type | Profile | R | S | U | C | Searches | _include | _revinclude | Operations |
|---|---|---|---|---|---|---|---|---|---|
| CareTeam | Supported Profiles US Core CareTeam Profile | y | y | _id, _lastUpdated | |||||
| Condition | Supported Profiles SDOHCC Condition | y | y | y | y | _id, _lastUpdated, category, clinical-status, code, patient, verification-status | |||
| Consent | Supported Profiles SDOHCC Consent | y | y | y | y | _id, _lastUpdated, source-reference | Consent:source-reference:DocumentReference | ||
| Device | Supported Profiles Device | y | y | _id, _lastUpdated | |||||
| DocumentReference | Supported Profiles US Core DocumentReference Profile | y | y | y | y | _id, _lastUpdated | |||
| Goal | Supported Profiles SDOHCC Goal | y | y | y | y | _id, _lastUpdated, achievement-status, category, lifecycle-status, patient, target-date | |||
| Group | Supported Profiles SDOHCC Group | y | y | _id, _lastUpdated, characteristic-value, code, managing-entity, member | Group:member | ||||
| HealthcareService | Supported Profiles SDOHCC Healthcare Service | y | y | _id, _lastUpdated, location | |||||
| Location | Supported Profiles SDOHCC Location | y | y | _id, _lastUpdated | |||||
| Observation | Supported Profiles SDOHCC Observation Assessment SDOHCC Observation Screening Response | y | y | y | y | _id, _lastUpdated, category, code, code-value-concept, date, derived-from, patient, status | |||
| Organization | Supported Profiles US Core Organization Profile | y | y | _id, _lastUpdated | |||||
| Patient | Supported Profiles US Core Patient Profile | y | y | _id, _lastUpdated | |||||
| Practitioner | Supported Profiles US Core Practitioner Profile | y | y | _id, _lastUpdated | |||||
| PractitionerRole | Supported Profiles US Core PractitionerRole Profile | y | y | _id, _lastUpdated, organization, practitioner | PractitionerRole:organization, PractitionerRole:practitioner | ||||
| Procedure | Supported Profiles SDOHCC Procedure | y | y | y | y | _id, _lastUpdated, based-on, category, code, date, patient, performer, status | |||
| Questionnaire | Supported Profiles Extractable Questionnaire - StructureMap | y | code, context-type-value, identifier, publisher, status, subject-type, title, url, version | $populate | |||||
| QuestionnaireResponse | Supported Profiles SDC Questionnaire Response | y | y | y | y | _id, _lastUpdated, author, authored, patient, questionnaire, status | |||
| RelatedPerson | Supported Profiles RelatedPerson | y | y | _id, _lastUpdated | |||||
| ServiceRequest | Supported Profiles SDOHCC ServiceRequest | y | y | y | y | _id, _lastUpdated, category, code, intent, occurrence, patient, performer, requester, status, supporting-info | HealthCareService:location, ServiceRequest:supporting-info, ServiceRequest:pertains-to-goal, ServiceRequest:patient, ServiceRequest:requester, ServiceRequest:performer, PractitionerRole:practitioner, PractitionerRole:organization | ||
| Subscription | Supported Profiles R4/B Topic-Based Subscription | y | y | $status | |||||
| Task | Supported Profiles SDOHCC Task For Patient SDOHCC Task For Referral Management | y | y | y | y | _id, _lastUpdated, code, owner, patient, requester, status, focus, output | Task:focus, Task:output, HealthCareService:location, ServiceRequest:supporting-info, ServiceRequest:pertains-to-goal, ServiceRequest:patient, ServiceRequest:requester, ServiceRequest:performer, PractitionerRole:practitioner, PractitionerRole:organization |
literalreadAllows downstream coordination platforms or referral recipients to retrieve a CareTeam that is the intended performer of a ServiceRequest.
search-typeAllows downstream coordination platforms or referral recipients to monitor previously-retrieved CareTeams that are the intended performer of ServiceRequests.
Used to allow downstream systems to access to information about the intended performer of a ServiceRequest when the performer is a specific team of people
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known CareTeam records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
literalreadAllows downstream coordination platforms or referral recipients to retrieve a Condition that is the requester or performer of a ServiceRequest.
search-typeAllows downstream coordination platforms or referral recipients to monitor previously-retrieved Conditions that are referenced by ServiceRequests.
createAllows records to be authored by a SMART app if the manager system does not have the capability itself - or finds it better to use a third-party interface.
updateAllows records to be edited by a SMART app if the manager system does not have the capability itself - or finds it better to use a third-party interface.
Used to allow downstream systems to access to information about a patient's SDOH-related conditions, particularly those that are the reason for a referral
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known Condition records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHALL | category | token | Allows filtering to only SDOH-related conditions |
| SHALL | patient | reference | Allows filtering to only conditions associated with a specific patient. Some systems will require that searches be patient-specific |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
| SHOULD | clinical-status | token | Allows filtering to only active conditions |
| SHOULD | code | token | Allows filtering to only specific SDOH conditions or sets of conditions |
| SHOULD | verification-status | token | Allows filtering to exclude refuted or entered-in-error conditions |
literalreadAllows downstream coordination platforms or referral recipients to retrieve a Consent referenced as a 'supportingInformation' item of a ServiceRequest.
search-typeAllows downstream coordination platforms or referral recipients to monitor previously-retrieved Consents related to ServiceRequests of interest.
createAllows records to be authored by a SMART app if the manager system does not have the capability itself - or finds it better to use a third-party interface.
updateAllows records to be edited by a SMART app if the manager system does not have the capability itself - or finds it better to use a third-party interface.
Used to allow access to the consent that authorizes disclosure of ServiceRequest information to non-HIPAA-covered entities
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known consent records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHALL | source-reference | reference | Allows including the document that contains the PDF or similar representation of a paper consent |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
literalreadAllows downstream coordination platforms or referral recipients to retrieve a Device that is the requester or intended performer of a ServiceRequest.
search-typeAllows downstream coordination platforms or referral recipients to monitor previously-retrieved Devices that are the requester or intended performer of ServiceRequests.
Used to allow retrieval of the requester or intended performer of an SDOH ServiceRequest
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known Device records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
literalcreateAllows the app to record a new PDF (e.g. a completed form)
readAllows downstream coordination platforms or referral recipients to retrieve a PDF or similar content referenced by a Consent or Task.
search-typeAllows downstream coordination platforms or referral recipients to monitor previously-retrieved DocumentReferences in the event the image/document is amended/corrected/updated.
updateAllows the system to revise a previously stored PDF
Used convey a scanned or other form of document representing the text of a consent. Also used for PDF forms.
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known DocumentReference records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
literalreadAllows downstream coordination platforms or referral recipients to retrieve a goal referenced by a ServiceRequest.
search-typeAllows downstream coordination platforms or referral recipients to monitor previously-retrieved Goals in the event they are updated.
createAllows records to be authored by a SMART app if the manager system does not have the capability itself - or finds it better to use a third-party interface.
updateAllows records to be edited by a SMART app if the manager system does not have the capability itself - or finds it better to use a third-party interface.
Used to allow access to goals related to an SDOH referral
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known Goal records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHALL | category | token | Allows filtering to only include SDOH-related goals |
| SHALL | patient | reference | Allows filtering to only include goals for a particular patient. Some systems will require searches to be patient-specific |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
| SHOULD | achievement-status | token | Allows filtering to only include unmet goals |
| SHOULD | lifecycle-status | token | Allows filtering to only include active goals |
| SHOULD | target-date | date | Allows filtering based on when a particular goal is desired to be achieved |
literalreadAllows a payer or other oversight agency to a Group whose identity is already known (e.g. for polling).
search-typeAllows a payer or oversight agency to search for groups of interest to allow monitoring of what patients are under care/management for SDOH issues.
Exposes information about which patients associated with a particular payor coverage type currently have SDOH concerns under management
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known Group records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHALL | code | token | Allows filtering based on the type of group |
| SHALL | member | reference | Allows performing an _include to retrieve the members of the group |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
| SHOULD | characteristic-value | composite | Allows filtering based on the insurer or plan associated with the group |
| SHOULD | managing-entity | reference | Allows filtering based on who is maintaining the group |
literalreadAllows downstream coordination platforms or referral recipients to retrieve a HealthcareService that is the intended performer of a ServiceRequest.
search-typeAllows downstream coordination platforms or referral recipients to monitor previously-retrieved HealthcareServices that are the intended performer of ServiceRequests.
Used to allow downstream systems to access to 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.
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known HealthcareService records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHALL | location | reference | Allows retrieval of the phyical site(s) associated with a HealthService |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
literalreadAllows other systems to retrieve a Location that is an available location for a service.
search-typeAllows the monitoring of previously-retrieved Locations that are the intended locations for services.
Used to expose 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.
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known Location records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
literalreadAllows downstream coordination platforms or referral recipients to retrieve an Observation referenced by a ServiceRequest.
search-typeAllows downstream coordination platforms or referral recipients to monitor previously-retrieved Observations for updates/corrections.
createAllows records to be authored by a SMART app if the manager system does not have the capability itself - or finds it better to use a third-party interface.
updateAllows records to be edited by a SMART app if the manager system does not have the capability itself - or finds it better to use a third-party interface.
SDOHCC Observation Assessment
SDOHCC Observation Screening Response
Used to allow downstream systems to access to information about SDOH-related observations for a patient - particularly those that are reasons for a referral
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known Observation records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHALL | category | token | Allows filtering for only SDOH-related observations |
| SHALL | patient | reference | Allows filtering for observations specific to a particular patient. Some systems will require that all queries be patient-specific |
| SHALL | status | token | Allows filtering for observations that are completed or revised (i.e. not in-progress or entered-in-error) |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
| SHOULD | code | token | Allows filtering for specific types of observations |
| SHOULD | date | date | Allows filtering for observations that held in a particular time period |
| SHOULD | derived-from | reference | Allows filtering for observations derived from a particular QuestionnaireResponse |
| MAY | code-value-concept | composite | Allows filtering for observations that have a specific coded value answer for a specified observation type |
literalreadAllows downstream coordination platforms or referral recipients to retrieve an Organization that is the requester or intended performer of a ServiceRequest.
search-typeAllows downstream coordination platforms or referral recipients to monitor previously-retrieved Organizations that are the requester or intended performer of ServiceRequests.
Used to allow downstream systems to access to information about an Organization that is the requester or intended performer of a ServiceRequest
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known Organization records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
literalreadAllows downstream coordination platforms or referral recipients to retrieve the Patient that is the subject of a ServiceRequest.
search-typeAllows downstream coordination platforms or referral recipients to monitor previously-retrieved Patients.
Used to allow downstream systems to access to information about the Patient that is the subject a ServiceRequest
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known Patient records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
literalreadAllows downstream coordination platforms or referral recipients to retrieve a Practitioner that is the requester or intended performer of a ServiceRequest.
search-typeAllows downstream coordination platforms or referral recipients to monitor previously-retrieved Practitioners that are the requester or intended performer of ServiceRequests.
Used to allow downstream systems to access to information about an Practitioner that is the requester or intended performer of a ServiceRequest
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known Practitioner records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
literalreadAllows downstream coordination platforms or referral recipients to retrieve a PractitionerRole that is the requester or intended performer of a ServiceRequest.
search-typeAllows downstream coordination platforms or referral recipients to monitor previously-retrieved PractitionerRoles that are the requester or intended performer of ServiceRequests.
Used to allow downstream systems to access to information about an PractitionerRole that is the requester or intended performer of a ServiceRequest
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known PractitionerRole records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
| SHOULD | organization | reference | Allows doing an _include on Organization when retrieving the PractitionerRole |
| SHOULD | practitioner | reference | Allows doing an _include on Practitioner when retrieving the PractitionerRole |
literalcreateAllows downstream coordination platforms and referral recipients to write records of procedures done in response to a referral in situations where they can't store the procedure on their own local system.
updateAllows downstream coordination platforms and referral recipients to update records of procedures done - e.g. changing status, adding notes.
readAllows upstream systems to retrieve procedures referenced by Tasks.
search-typeAllows upstream systems to check for updates on Procedures after they've already been received or to look for procedures that haven't yet been linked as outputs to the Tasks that initiated the work.
Used to allow downstream coordination platforms and referral recipients to provide information about actions that have been performed as a result of a referral as well as to allow upstream systems to access that information.
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known Procedure records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHALL | based-on | reference | Allows filtering for procedures resulting from a particular service request |
| SHALL | category | token | Allows filtering for procedures that are SDOH-related |
| SHALL | patient | reference | Allows filtering for procedures based on who they were delivered to. Some systems may require that all searches be patient-specific. |
| SHALL | performer | reference | Allows filtering for procedures based on who delivered the procedure. |
| SHALL | status | token | Allows filtering for procedures that are complete or in progress |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
| SHOULD | code | token | Allows filtering for procedures based on the specific service delivered |
| SHOULD | date | date | Allows filtering for procedures based on when they were delivered |
literalsearch-typeAllows SMART apps or downstream systems to search for questionnaires relevant to a patient context.
Used to allow retrieval of SDOH-related Questionnaires to be filled out by a patient or representative. Also allows retrieving Questionnaires associated with existing QuestionnaireResponses for editing by SMART-on-FHIR apps.
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | url | uri | Allows retrieving Questionnaires based on its canonical URL |
| SHALL | version | token | Allows retrieving a specific version of a Questionnaire |
| SHOULD | code | token | Allows filtering for questionnaires associated with particular LOINC or similar codes |
| SHOULD | context-type-value | composite | Allows filtering for procedures that are SDOH-related |
| SHOULD | identifier | token | Allows retrieving Questionnaires with a known identifier |
| SHOULD | publisher | string | Allows retrieving Questionnaires based on who is responsible for them |
| SHOULD | status | token | Allows retrieving Questionnaires that are active (and not draft or required) |
| SHOULD | subject-type | token | Allows retrieving Questionnaires that are intended to be completed about patients - as opposed to practitioner, organizations, etc. |
| SHOULD | title | string | Allows retrieving Questionnaires based on the name of the form |
| Conformance | Operation | Documentation |
|---|---|---|
| MAY | $populate | Allows SMART on FHIR or other systems to pre-populate a questionnaire response with existing information either available locally or queried from elsewhere |
literalcreateAllows questionnaire responses to be authored by a SMART app if the manager system does not have the capability itself - or finds it better to use a third-party interface.
updateAllows questionnaire responses to be edited by a SMART app if the manager system does not have the capability itself - or finds it better to use a third-party interface.
readAllows the retrieval of QuestionnaireResponses to use as a starting point for new responses or to continue editing.
search-typeAllows checking for updates in previously retrieved QuestionnaireResponses.
Used to allow SMART apps to cread, update and retrieve QuestionnaireResponses relevant to SDOH care
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known QuestionnaireResponse records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHALL | author | reference | Allows filtering QuestionnaireResponses previously created/edited by a particular individual |
| SHALL | patient | reference | Allows retrieving QuestionnaireResponses associated with a particular patient. Some systems may only permit searches that are patient-specific |
| SHALL | questionnaire | reference | Allows retrieving QuestionnaireResponses that have been completed against a specified form |
| SHALL | status | token | Allows retrieving QuestionnaireResponses that are complete (or incomplete) |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
| SHOULD | authored | date | Allows filtering for QuestionnaireResponses by when they were created/last edited |
literalreadAllows downstream coordination platforms or referral recipients to retrieve a RelatedPerson that is the requester or intended performer of a ServiceRequest.
search-typeAllows downstream coordination platforms or referral recipients to monitor previously-retrieved RelatedPersons that are the requester or intended performer of ServiceRequests.
Used to allow downstream systems to access to information about the requester or intended performer of a ServiceRequest when they are someone with a personal relationship to the Patient
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known RelatedPerson records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
literalreadAllows client systems to retrieve the ServiceRequest pointed to by a Task.
search-typeAllows client systems to monitor multiple ServiceRequests for change simultaneously via polling.
createAllows records to be authored by a SMART app if the manager system does not have the capability itself - or finds it better to use a third-party interface.
updateAllows records to be edited by a SMART app if the manager system does not have the capability itself - or finds it better to use a third-party interface.
Used to allow retrieval of an order for SDOH-related services
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known ServiceRequests records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHALL | category | token | Allows filtering to only retrieve ServiceRequests that are SDOH-related |
| SHALL | intent | token | Allows filtering to retrieve only 'order' ServiceRequests and not plans, proposals, etc. |
| SHALL | patient | reference | Allows filtering to retrieve only ServiceRequests associated with a particular patient. Note that some systems may mandate that searches are always patient-specific |
| SHALL | status | token | Allows filtering to retrieve only active ServiceRequests |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
| SHOULD | code | token | Allows filtering to retrieve ServiceRequests for specific types of services |
| SHOULD | occurrence | date | Allows filtering to retrieve ServiceRequests based on the timeframe in which the service needs to be provided |
| SHOULD | performer | reference | Allows filtering to retrieve only ServiceRequests that designate a specific performer |
| SHOULD | requester | reference | Allows filtering to retrieve only ServiceRequests created by a specific practitioner |
| SHOULD | supporting-info | reference | Allows _include to retrieve supporting information for a ServiceRequest - particularly Consent |
createAllows upstream systems to initiate a subscription to monitor updates to Tasks (and theoretically other things)
updateAllows upstream systems to revise existing subscriptions - to adjust delivery target, to add additional tasks to monitor (if subscribing by id), etc.
Used to allow downstream (and occasionally upstream) systems to subscribe to and monitor changes to Tasks stored on this system
| Conformance | Operation | Documentation |
|---|---|---|
| SHOULD | $status | Allows upstream systems to verify their subscription is functioning properly and to check for errors |
literalcreateAllows upstream coordination platforms and referral sources system to create tasks on this system seeking fulfillment of a ServiceRequest or an action to be performed by a patient or caregiver.
updateAllows modification of an existing Task by upstream systems (e.g. to cancel it) or by downstream systems (to accept or reject it or add output links to performed procedures). Servers SHALL enforce appropriate permissions on systems with respect to updates. Specifically, only authors of a Task have authority to update all aspects of the Task. (Systems MAY limit what changes can be made to tasks that have been accepted or completed.) Assigned task owners may change the status, statusReason and outputs. Users who are neither the author or owner of a Task cannot make changes to it.
readAllows retrieval of a Task that was referenced in a subscription notification or per-Task polling for change.
search-typeAllows the other systems to poll multiple tasks simultaneously, as well as to retrieve referenced resources as part of a single query.
Used by upstream referral sources and coordination platforms to create and update Tasks seeking fufillment of ServiceRequests or for actions to be performed by a patient. Also used by downstream referral recipients 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
| Conformance | Parameter | Type | Documentation |
|---|---|---|---|
| SHALL | _id | token | Allows retrieving known Task records - and more specifically, retrieving more than one in a single call to poll for updates |
| SHALL | code | token | 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. |
| SHALL | patient | reference | 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.) |
| SHALL | requester | reference | 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 |
| SHALL | status | token | Allows filtering to only active or completed tasks |
| SHALL | focus | reference | Allows retrieving the task(s) seeking fulfillment of a particular ServiceRequest |
| SHOULD | _lastUpdated | date | Allows filtering for only records that have changed since last query |
| SHOULD | owner | reference | Allows filtering only for tasks that are assigned to a particular owner (or alternatively, tasks that have not yet been assigned) |
| SHOULD | output | reference | Allows for the 'output' of a Task to be included when retrieving a Task |
IG © 2021+ HL7 International / Patient Care. Package hl7.fhir.us.sdoh-clinicalcare#2.2.0 based on FHIR 4.0.1. Generated 2024-09-06
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