SDOH Clinical Care
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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 https://github.com/HL7/fhir-sdoh-clinicalcare/ and changes regularly. See the Directory of published versions

Artifacts Index

Page standards status: Informative

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

Capability Statements

SDOHCC Coordination Platform Capability Statement

This resource describes the required and desired behavior of systems acting as SDOH clinical care ‘coordination platforms’ (CPs).

SDOHCC Referral Recipient - Light Capability Statement

This resource describes the required and desired behavior of systems acting as ‘light-weight’ SDOH clinical care ‘referral recipients’.

SDOHCC Referral Recipient Capability Statement

This resource describes the required and desired behavior of systems acting as SDOH clinical care ‘referral recipients’.

SDOHCC Referral Source Capability Statement

This resource describes the required and desired behavior of systems acting as SDOH clinical care ‘referral sources’.

SDOHCC Patient Application

This resource describes the required and desired behavior of systems acting as apps for patients and care-givers who need to monitor progress on SDOH referrals and may need to take actions such as filling out forms, booking appointments, etc.

Profiles

SDOHCC Condition

Profile for Social Determinants of Health (SDOH) conditions.

SDOHCC Consent

Profile for consent related to the release of Social Determinants of Health (SDOH) information to non-HIPAA covered organizations.

SDOHCC Goal

Profile for goals that address Social Determinants of Health (SDOH).

SDOHCC Group

Profile for identifying groups of patients who have a Social Determinants of Health (SDOH) condition and are members of a specific payer organization.

SDOHCC Healthcare Service

Profile that describes the means by which a healthcare service can be contacted.

SDOHCC Location

Profile that describes address information for a healthcare service.

SDOHCC Observation Assessment

Profile for Social Determinants of Health (SDOH) observations that involve assessment (e.g., by a provider, payer, etc.) as opposed to being derived only from screening surveys (as is the case for the SDOHCC Screening Response Observation).

SDOHCC Observation Screening Response

Profile for observations that represent question and answer pairs from Social Determinants of Health (SDOH) screening instruments.

SDOHCC Procedure

Profile for interventions that address Social Determinants of Health.

SDOHCC ServiceRequest

Profile for service requests that address Social Determinants of Health.

SDOHCC Task For Patient

Profile for SDOH-related tasks to be carried out by the patient or someone acting on their behalf.

SDOHCC Task For Referral Management

Profile for tasks requesting fulfillment of an SDOHCC ServiceRequest (i.e. referral for service) and subsequently tracking and managing the fulfillment of that referral.

Value Sets

SDOHCC ValueSet LOINC SNOMEDCT

This value set contains all of LOINC and SNOMED CT.

SDOHCC ValueSet Observation Status

Codes for the status of a screening response observation.

SDOHCC ValueSet SDOH Category

Codes that represent Social Determinants of Health (SDOH) domains.

SDOHCC ValueSet SDOH Questionnaire Category

Codes that represent categories of Social Determinants of Health (SDOH) questionnaires.

SDOHCC ValueSet Referral Task Status

Codes for the status of a referral task.

SDOHCC ValueSet Task Code

Codes for the general action a task involves.

SDOHCC ValueSet Task Priority

Codes for the priority of a task for a patient.

SDOHCC ValueSet Task Status

Codes for the status of a task for a patient.

Code Systems

SDOHCC CodeSystem Temporary Codes

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

Extensions

SDOHCC Extension HealthcareService Telecom Appointment

Extension for flagging a HealthcareService.telecom as one the patient can use to make an appointment.

Search Parameters

ServiceRequestSupportingInfo

Allows searching by the ‘supportingInfo’ references on a ServiceRequest. Primarily used to support _include of the supportingInfo resources when retrieving a ServiceRequest.

TaskOutputReference

Allows searching by the ‘output’ values of a Task with a type of Reference. Primarily used to support _include of the outputs when retrieving a Task.

Examples

Patient Colin Abbas Example

An example of a patient. This example is used as the referenced patient in other examples in this IG.

SDOHCC Condition Unemployed Example

An example of a Condition (a health concern) that is based on an Observation related to employment status that is derived from a QuestionnaireResponse to PRAPARE (represented in LOINC).

SDOHCC Consent Information Disclosure Example

An example of a Consent for information disclosure related to SDOH information. A PDF is attached to this consent.

SDOHCC Goal Food Security Example

An example of a food security Goal that addresses a food insecurity Condition.

SDOHCC Group SDOH Patients For Payer Example

An example of Group for patients that have any SDOH condition and are members of a specific payer organization.

SDOHCC HealthcareService Telecom Appointment Example

An example of a HealthcareService with telecom(s) that can be used to make an appointment flagged. This example is used as the referenced healthcare service in other IG examples.

SDOHCC Location Example

An example of a Location for a HealthcareService that the patient might want to schedule an appointment at. This example is used as the referenced location in other IG examples.

SDOHCC Observation Assessment Social Isolation Example

An example of a social isolation Observation that is not necessarily derived only from a screening survey. This observation involves additional assessment (e.g., by a provider, payer, etc.). This example also includes an Observation.category (i.e., Social Connection) that, at the time the example was added to the IG, was not yet in the “SDOHCC ValueSet SDOH Category”. The example illustrates that categorization is possible using category codes that may not yet be included in the SDOHCC ValueSet SDOH Category (which will continue to be expanded as the Gravity Project continues to develop SDOH terminology content).

SDOHCC Observation Assessment Inadequate Food Intake Example

An example of an inadequate food intake Observation that is not necessarily derived only from a screening survey. This observation involves additional assessment (e.g., by a provider, payer, etc.).

SDOHCC Observation Assessment Transport Too Expensive Example

An example of a transportation Observation that is not necessarily derived only from a screening survey. This observation involves additional assessment (e.g., by a provider, payer, etc.). This example also includes an Observation.category (i.e., Transportation Insecurity) that is included in the “SDOHCC ValueSet SDOH Category”. Additionally, a subcategory of Transportation Insecurity (i.e., Transportation Insecurity Financial) is included to illustrate that it is possible to further subcategorize a “SDOHCC ValueSet SDOH Category” code with a code that is not in the ValueSet.

SDOHCC Organization Clinic Example

An example of a clinic Organization. This example is used as the referenced organization in other IG examples.

SDOHCC Organization Coordination Platform Example

An example of a coordination platform Organization. This example is used as the referenced organization in other IG examples.

SDOHCC Organization Payer Example

An example of a payer organization. This example is used as the referenced organization in other SDOHCC examples.

SDOHCC Practitioner Dr Jan Water Example

An example of a Practitioner. This example is used as the referenced practitioner in other IG examples.

SDOHCC Practitioner Role Dr Jan Water Example

An example of a family medicine physician PractitionerRole. This example is used as the referenced practitioner role in other IG examples.

SDOHCC Procedure Food Pantry Application Assistance Example

An example of a completed Procedure for assistance with applying to a food pantry that is based on a ServiceRequest and references as its reason a food insecurity Condition.

SDOHCC Procedure Provision Of Food Example

An example of a completed Procedure for provision of food.

SDOHCC Procedure Summer Food Program Application Assistance Example

An example of a completed Procedure for assistance with applying to a summer food program that is based on a ServiceRequest and references as its reason a food insecurity Condition.

SDOHCC ServiceRequest Active Food Pantry Application Assist Example

An example of an active ServiceRequest for assistance with applying to a food pantry that references as its reason a food insecurity Condition.

SDOHCC ServiceRequest Subreferral Garden Program Example

An example of a completed, original-order ServiceRequest (i.e., SDOHCC Service Request Active Food Pantry Application Assist Example) that is based on a Service Request to an intermediary organization (e.g., a Coordination Platform) that then created this Service Request (i.e., Assistance with application for garden program) to be fulfilled by a Community Based Organization.

SDOHCC ServiceRequest Subreferral Summer Food Program Example

An example of a completed, original-order ServiceRequest (i.e., SDOHCC Service Request Active Food Pantry Application Assist Example) that is based on a Service Request to an intermediary organization (e.g., a Coordination Platform) that then created this Service Request (i.e., Assistance with application for Summer Food Service Program) to be fulfilled by a Community Based Organization.

SDOHCC Task Patient Review Information Completed Example

An example of a completed Task For Patient where the task was to review material.

SDOHCC Task Patient Information Request Completed Example

An example of a completed Task For Patient where the task was a request for information.

SDOHCC Task Referral Management Order Fulfillment Accepted Example

An example of an accepted Task For Referral Management that has as the Task.focus a ServiceRequest for assistance with applying to a food pantry.

SDOHCC Task Referral Management Order Fulfillment Completed Example

An example of a completed Task For Referral Management that has a ServiceRequest for assistance with applying to a food pantry as the Task.focus and a Procedure for assistance with applying to a food pantry as the Task.output.

SDOHCC Task Referral Management Order Subtask Accepted Example

An example of an accepted Task For Referral Management that delegates responsibility to fulfill a referral from an intermediary organization to another organization (e.g., when a Coordination Platform receives a Task from a referral source and passes it on to a Community Based Organization).

SDOHCC Task Referral Management Order Subtask Completed Example

An example of a completed Task For Referral Management that delegates responsibility to fulfill a referral from an intermediary organization to another organization (e.g., when a Coordination Platform receives a Task from a referral source and passes it on to a Community Based Organization).

SDOHCC Task Patient Make Appointment Completed Example

An example of a completed Task For Patient where the task was to make an appointment.

SDOHCC Task Patient Risk Questionnaire Completed Example

An example of a completed Task For Patient where the task was to complete a Hunger Vital Signs questionnaire (a questionnaire of the category ‘risk questionnaire’).

SDOHCC DocumentReference Diabetes Handout Example

Document Reference for a Diabetes Handout. An example of a DocumentReference for a diabetes handout. This example is used as the referenced document in other IG examples.

PRAPARE Examples

For the PRAPARE assessment instrument, these are examples of a Questionnaire, a QuestionnaireResponse, and a StructureMap, as well as of Observations and a Condition derived from the QuestionnaireResponse using the StructureMap.

SDOHCC Questionnaire PRAPARE

A Questionnaire instance that represents the questions and answers from the PRAPARE questionnaire represented in LOINC (code 93025-5).

SDOHCC QuestionnaireResponse PRAPARE Example

An example of an SDC QuestionnaireResponse that represents questions and selected answers from the PRAPARE questionnaire represented in LOINC (code 93025-5). The example is generated using the LHC-Forms SDC Questionnaire App.

SDOHCC StructureMap PRAPARE

A StructureMap instance that represents the resource that transforms specific questions and answers from the PRAPARE questionnaire represented in LOINC (code 93025-5) into their corresponding Observations and derived Conditions (health concerns).

SDOHCC Observation Response PRAPARE Child Care Need Example

An example of a screening response Observation that represents a question and answer related to unmet child care needs from the PRAPARE questionnaire represented in LOINC.

SDOHCC Observation Response PRAPARE Clothing Need Example

An example of a screening response Observation that represents a question and answer related to unmet clothing needs from the PRAPARE questionnaire represented in LOINC.

SDOHCC Observation Response PRAPARE Employment Status Example

An example of a screening response Observation that represents a question and answer related to employment status from the PRAPARE questionnaire represented in LOINC.

SDOHCC Observation Response PRAPARE Housing Status Example

An example of a screening response Observation that represents a question and answer related to housing status from the PRAPARE questionnaire represented in LOINC.

SDOHCC Condition Homeless Example

An example of a homelessness Condition (a health concern) that is based on an Observation related to housing status that is derived from a QuestionnaireResponse to PRAPARE (represented in LOINC).

Hunger Vital Sign Examples

For the Hunger Vital Sign assessment instrument, these are examples of a Questionnaire, a QuestionnaireResponse, and a StructureMap, as well as of an Observation and Condition derived from the QuestionnaireResponse using the StructureMap.

SDOHCC Questionnaire Hunger Vital Sign

A Questionnaire instance that represents the questions and answers from the LOINC Hunger Vital Sign [HVS] questionnaire (LOINC code 88121-9).

SDOHCC QuestionnaireResponse Hunger Vital Sign Example

An example of an SDC QuestionnaireResponse that represents questions and selected answers from the LOINC Hunger Vital Sign [HVS] questionnaire (LOINC code 88121-9). The example is generated using the LHC-Forms SDC Questionnaire App.

SDOHCC StructureMap HungerVitalSign

A StructureMap instance that represents the resource that transforms a specific question and answer from the LOINC Hunger Vital Sign [HVS] questionnaire (LOINC code 88121-9) into a corresponding Observation (SDOHCC Observation response Hunger Vital Sign Q3 Example) and derived Condition (SDOHCC Condition Food Insecurity Example).

SDOHCC Observation Response Hunger Vital Sign Question 3 Example

An example of a screening response Observation that represents Food insecurity risk [HVS] (LOINC code 88124-3) from the Hunger Vital Sign [HVS] questionnaire (LOINC code 88121-9). This Observation is derived from the first two questions in the Hunger Vital Sign [HVS] questionnaire. This Observation does not have an Observation.performer because Food insecurity risk [HVS] is derived as opposed to answered directly on the questionnaire.

SDOHCC Condition Food Insecurity Example

An example of a food insecurity Condition (a health concern) that references, as evidence, Observations derived from the LOINC Hunger Vital Sign [HVS] questionnaire (88121-9).

SDOHCC Device Software Example

An example of a software device. This example is used as the referenced device in other SDOHCC examples.

SDOHCC Condition Asserter Device Example

An example of a food insecurity Condition that references, as evidence, Observations derived from the LOINC Hunger Vital Sign [HVS] questionnaire (88121-9) and uses an extension on Condition.asserter to reference the software device that uses the answers to HVS questions 1 and 2 to derive the answer to HVS question 3 (at risk for food insecurity).

Social Connection and Isolation Panel (NHANES) Examples

For the NHANES assessment instrument, these are examples of Observations that were not created from a QuestionnaireResponse and, therefore, do not reference QuestionnaireResponse (via derivedFrom). Instead, the Observation grouping (via hasMember) links the NHANES assessment instrument to the Observations that resulted from it.

SDOHCC Observation Response NHANES Grouping Example

An example of an Observation grouping that uses hasMember to group 6 Observations from the LOINC Social connection and isolation panel (LOINC code 76506-5) because QuestionnaireResponse is not referenced by the 6 individual Observations created from the panel. In the absence of the references to QuestionnaireResponse, this example illustrates how the 6 Observations from the panel can be linked in an Observation grouping.

SDOHCC Observation Response NHANES Question 1 Example

An example of a screening response Observation that represents the first question from the NHANES assessment instrument represented in LOINC.

SDOHCC Observation Response NHANES Question 2 Example

An example of a screening response Observation that represents the second question from the NHANES assessment instrument represented in LOINC.

SDOHCC Observation Response NHANES Question 3 Example

An example of a screening response Observation that represents the third question from the NHANES assessment instrument represented in LOINC.

SDOHCC Observation Response NHANES Question 4 Example

An example of a screening response Observation that represents the fourth question from the NHANES assessment instrument represented in LOINC.

SDOHCC Observation Response NHANES Question 5 Example

An example of a screening response Observation that represents the fifth question from the NHANES assessment instrument represented in LOINC.

SDOHCC Observation Response NHANES Question 6 Example

An example of a screening response Observation that represents the score from the NHANES assessment instrument represented in LOINC. This result is derived from the results of the 5 questions.

Draft Artifacts for Personal Characteristic Observations

SDOHCC Observation Ethnicity OMB

Profile for ethnicity observations that use Office of Management and Budget (OMB) ethnicity category codes and CDC ethnicity codes. This profile is intended for draft use only. For further details on this profile see Draft Specifications for Personal Characteristics.

SDOHCC Observation Gender Identity

Profile for gender identity observations which are based on a person’s inner sense of being a girl/woman/female/feminine, boy/man/male/masculine, nonbinary, something else, or having no gender. This profile is intended for draft use only. For further details on this profile see Draft Specifications for Personal Characteristics.

SDOHCC Observation Personal Characteristic

Defines constraints that represent the minimum requirement for personal characteristic observations which are observations that are usually self-attested but may be attested to on behalf of the subject and are generally only verifiable by the source of attestation (e.g., race, ethnicity, sexual orientation, gender identity and personal pronouns), but may sometimes be verifiable by someone other than the source of attestation (e.g., recorded sex). This profile is intended for draft use only. For further details on this profile see Draft Specifications for Personal Characteristics.

SDOHCC Observation Personal Pronouns

Profile for observations about the pronouns and possessive adjectives a person wishes to be addressed by. This profile is intended for draft use only. For further details on this profile see Draft Specifications for Personal Characteristics.

SDOHCC Observation Race OMB

Profile for race observations that use Office of Management and Budget (OMB) race category codes and CDC race codes. This profile is intended for draft use only. For further details on this profile see Draft Specifications for Personal Characteristics.

SDOHCC Observation Recorded Sex Gender

Profile for observations about “recorded sex and gender” which, in the past, were often used interchangeably. In this context, sex is a biological construct and pertains to a person’s genetics, hormones, and anatomy. This profile is intended for draft use only. For further details on this profile see Draft Specifications for Personal Characteristics.

SDOHCC Observation Sexual Orientation

Profile for observations about the sexual orientation of an individual. This profile is intended for draft use only. For further details on this profile see Draft Specifications for Personal Characteristics.

SDOHCC Extension Condition Asserter

Extension for allowing the asserter of a condition to be Device (that was used to perform an operation to arrive at the condition).

SDOHCC ValueSet Observation DataAbsentReason

Codes for the reason an observation does not have a value.

SDOHCC ValueSet Observation DerivedFrom IdType

Codes for identifiers of target resources from which recorded sex or gender information can be derived.

SDOHCC ValueSet Observation Method

Codes that represent methods by which an individual’s race or ethnicity information can be elicited.

SDOHCC ValueSet OMB Ethnicity Categories

Codes for the ethnicity categories - ‘Hispanic or Latino’ and ‘Not Hispanic or Latino’ - as defined by the OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997. This value set was created (as opposed to using the US Core OMB Ethnicity Categories value set) to deliberately prevent inclusion of null flavors.

SDOHCC ValueSet OMB Race Categories

Codes for the five race categories - ‘American Indian’ or ‘Alaska Native’,’Asian’, ‘Black or African American’, ‘Native Hawaiian or Other Pacific Islander’, and ‘White’ - as defined by the OMB Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity, Statistical Policy Directive No. 15, as revised, October 30, 1997. This value set was created (as opposed to using the US Core OMB Race Categories value set) to deliberately prevent inclusion of null flavors.

SDOHCC ValueSet Pronouns Value

Codes for the personal pronouns of an individual.

Examples of Draft Artifacts for Personal Characteristic Observations

SDOHCC Observation Ethnicity OMB Example

An example of an ethnicity Observation where the subject self-reports as Hispanic or Latino with detailed ethnicity information that highlights elements and repetitions.

SDOHCC Observation Gender Identity Example

An example of a gender identity Observation where the subject self-reports their gender identity as male.

SDOHCC Observation Personal Pronouns Example

An example of a personal pronoun Observation where the subject self-reports their pronoun preference.

SDOHCC Observation Race OMB Example

An example of a race Observation where the subject self-reports as more than one race with detailed race information that highlights elements and repetitions.

SDOHCC-Observation Race OMB Mother Example

An example of a race Observation that uses Observation.focus to make an Observation about the race of the subject’s mother (who is his caretaker).

SDOHCC Observation Race OMB Practitioner Example

An example of a race Observation that uses a FHIR extension on Observation.subject to make an Observation about the practitioner’s race.

SDOHCC Observation Recorded Sex Gender Example

An example of a recorded sex or gender Observation where a clinic has derived the designation M (male) from the subject’s driver’s license.

SDOHCC Observation Sexual Orientation Example

An example of a sexual orientation Observation where the subject self-reports as homosexual.

SDOHCC Related Person Mother Example

An example of a Related Person who is the mother of the subject/patient (Colin Abbas).

Terminology Parameters

terminology-settings

Terminology Settings