SDOH Clinical Care
3.0.0 - STU 3

SDOH Clinical Care, published by HL7 International / Patient Care. This guide is not an authorized publication; it is the continuous build for version 3.0.0 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

## CapabilityStatement: SDOHCC Patient Application

Official URL: http://hl7.org/fhir/us/sdoh-clinicalcare/CapabilityStatement/SDOHCC-PatientApp | Version: 3.0.0
Standards status: Trial-use | Maturity Level: 2 | Computable Name: SDOHCC_PatientApp

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.

These systems will not expose their own FHIR interfaces, but will monitor information available from other FHIR servers - be it referral sources, coordination platforms or referral recipients. They will primarily monitor and update Task resources as well as the resources referenced by those Tasks.

Raw OpenAPI-Swagger Definition file | Download

## SDOHCC Patient Application

- Implementation Guide Version: 3.0.0
- FHIR Version: 4.0.1
- Supported Formats: `xml`, `json`
- Published on: 2021-06
- Published by: HL7 International / Patient Care

> Note 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.

## FHIR RESTful Capabilities

### Mode: `client`

Patient apps query for data relevant to the current patient, post updates as appropriate and occasionally create new resources, such as QuestionnaireResponses

Security
Enable CORS: no
Security services supported: `SMART-on-FHIR`

> Implementations must meet the general privacy & security requirements documented in this implementation guide.

Summary of System-wide Interactions

- SHOULD support the `batch`interaction described as follows:

  Allows polling for changes to multiple resource types simultaneously

### Capabilities by Resource/Profile

#### Summary

The summary table lists the resources that are part of this configuration, and for each resource it lists:

- The relevant profiles (if any)
- The interactions supported by each resource (Read, Search, Update, and Create, are always shown, while VRead, Patch, Delete, History on Instance, or History on Type are only present if at least one of the resources has support for them.
- The required, recommended, and some optional search parameters (if any).
- The linked resources enabled for `_include`
- The other resources enabled for `_revinclude`
- The operations on the resource (if any)

Resource Type | Profile | R | S | U | C | Searches | `_include` | `_revinclude` | Operations
--- | --- | --- | --- | --- | --- | --- | --- | --- | ---
CareTeam | Supported Profiles US Core CareTeam Profileversion: null7.0.0) | y? | y? |  |  | _id, _lastUpdated |  |  |
Condition | Supported Profiles SDOHCC Condition | Y | Y |  |  | _id, _lastUpdated, category, clinical-status, code, patient, verification-status |  |  |
Observation | Supported Profiles SDOHCC Observation Assessment SDOHCC Observation Screening Response | Y | Y |  |  | _id, _lastUpdated, category, code, patient |  |  |
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 Profileversion: null7.0.0) | Y | Y | 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 |  |  |
Practitioner | Supported Profiles US Core Practitioner Profileversion: null7.0.0) | Y | Y |  |  | _id, _lastUpdated |  |  |
PractitionerRole | Supported Profiles SDOHCC PractitionerRole | Y | Y |  |  | _id, _lastUpdated, organization, practitioner | `PractitionerRole:organization`, `PractitionerRole:practitioner` |  |
Questionnaire | Supported Profiles Extractable Questionnaire - StructureMap |  | Y |  |  | 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 |  |  | _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` |  |
Task | Supported Profiles SDOHCC Task For Patient SDOHCC Task For Referral Management | y? | Y | Y |  | _id, _lastUpdated, code, owner, patient, requester, status, focus, output | `Task:output` |  |

#### Resource Conformance: SHALL CareTeam

Core FHIR Resource
CareTeam
Reference Policy
`literal`
Interaction summary

- MAY support
  `read`

  Allows the system to retrieve a CareTeam that is the intended performer of a ServiceRequest.

  `search-type`

  Allows the monitoring of previously-retrieved CareTeams that are the intended performer of ServiceRequests.

Supported Profiles

US Core CareTeam Profileversion: null7.0.0)

Documentation

> 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

Search Parameters

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

#### Resource Conformance: SHALL Condition

Core FHIR Resource
Condition
Reference Policy
`literal`
Interaction summary

- SHOULD support
  `read`

  Allows the system to retrieve a Condition that is the requester or performer of a ServiceRequest.

  `search-type`

  Allows the monitoring of previously-retrieved Conditions that are referenced by ServiceRequests.

Supported Profiles

SDOHCC Condition

Documentation

> 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

Search Parameters

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

#### Resource Conformance: SHALL Observation

Core FHIR Resource
Observation
Reference Policy
`literal`
Interaction summary

- SHALL support
  `read`

  Allows the system to retrieve an Observation referenced by a ServiceRequest or other resource.

  `search-type`

  Allows the retrieval of Observations recorded about a patient and/or monitoring of previously-retrieved Observations (though typically, they won't change once recorded).

Supported Profiles

SDOHCC Observation Assessment
SDOHCC Observation Screening Response

Documentation

> Allows patients and caregivers to see observations recorded by their care providers, including those referenced by other resources

Search Parameters

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 to only SDOH-related observations
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 been created or changed since last query
SHOULD | code | `token` | Allows filtering to only specific SDOH observation types

#### Resource Conformance: SHALL Consent

Core FHIR Resource
Consent
Reference Policy
`literal`
Interaction summary

- SHOULD support
  `read`

  Allows the system to retrieve a Consent referenced as a 'supportingInformation' item of a ServiceRequest.

  `search-type`

  Allows the monitoring of previously-retrieved Consents related to ServiceRequests of interest.

Supported Profiles

SDOHCC Consent

Documentation

> Used to access the consent that authorizes disclosure of ServiceRequest information to non-HIPAA-covered entities

Search Parameters

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

#### Resource Conformance: SHALL Device

Core FHIR Resource
Device
Reference Policy
`literal`
Interaction summary

- SHOULD support
  `read`

  Allows the system to retrieve a Device that is the requester or intended performer of a ServiceRequest.

  `search-type`

  Allows the monitoring of previously-retrieved Devices that are the requester or intended performer of ServiceRequests.

Supported Profiles

Device

Documentation

> 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

Search Parameters

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

#### Resource Conformance: SHALL DocumentReference

Core FHIR Resource
DocumentReference
Reference Policy
`literal`
Interaction summary

- SHALL support
  `create`

  Allows the app to record a new PDF (e.g. a completed form)

  `read`

  Allows the system to retrieve a PDF or similar content referenced by a Consent or Task.

- SHOULD support
  `update`

  Allows the system to revise a previously stored PDF

  `search-type`

  Allows the monitoring of previously-retrieved DocumentReferences in the event the image/document is amended/corrected/updated.

Supported Profiles

US Core DocumentReference Profileversion: null7.0.0)

Documentation

> Used to retrieve a scanned or other form of document representing the text of a consent. Also used for PDF forms.

Search Parameters

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

#### Resource Conformance: SHALL Goal

Core FHIR Resource
Goal
Reference Policy
`literal`
Interaction summary

- SHOULD support
  `read`

  Allows the system to retrieve a goal referenced by a ServiceRequest.

  `search-type`

  Allows the monitoring of previously-retrieved Goals in the event they are updated.

Supported Profiles

SDOHCC Goal

Documentation

> Used to access goals related to an SDOH referral

Search Parameters

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

#### Resource Conformance: SHALL HealthcareService

Core FHIR Resource
HealthcareService
Reference Policy
`literal`
Interaction summary

- SHALL support
  `read`

  Allows the system to retrieve a HealthcareService referenced by a Task.

- MAY support
  `search-type`

  Allows the monitoring of previously-retrieved HealthcareServices.

Supported Profiles

SDOHCC Healthcare Service

Documentation

> Allows patient apps to retrieve information about who should be contacted (to book an appointment or for other reasons)

Search Parameters

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

#### Resource Conformance: SHALL Location

Core FHIR Resource
Location
Reference Policy
`literal`
Interaction summary

- SHOULD support
  `read`

  Allows the system to retrieve a Location that is an available location for a service.

- MAY support
  `search-type`

  Allows the monitoring of previously-retrieved Locations that are the intended locations for services.

Supported Profiles

SDOHCC Location

Documentation

> 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.

Search Parameters

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

#### Resource Conformance: SHALL Practitioner

Core FHIR Resource
Practitioner
Reference Policy
`literal`
Interaction summary

- SHOULD support
  `read`

  Allows the system to retrieve a Practitioner that is the requester or intended performer of a ServiceRequest.

  `search-type`

  Allows the monitoring of previously-retrieved Practitioners that are the requester or intended performer of ServiceRequests.

Supported Profiles

US Core Practitioner Profileversion: null7.0.0)

Documentation

> Used to access information about an Practitioner that is the requester or intended performer of a ServiceRequest

Search Parameters

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

#### Resource Conformance: SHALL PractitionerRole

Core FHIR Resource
PractitionerRole
Reference Policy
`literal`
Interaction summary

- SHOULD support
  `read`

  Allows the system to retrieve a PractitionerRole that is the requester or intended performer of a ServiceRequest.

  `search-type`

  Allows the monitoring of previously-retrieved PractitionerRoles that are the requester or intended performer of ServiceRequests.

Supported Profiles

SDOHCC PractitionerRole

Documentation

> Used to access information about an PractitionerRole that is the requester or intended performer of a ServiceRequest

Search Parameters

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

#### Resource Conformance: SHALL Questionnaire

Core FHIR Resource
Questionnaire
Reference Policy
`literal`
Interaction summary

- SHALL support
  `search-type`

  Allows the referral source to search for questionnaires relevant to a patient context.

Supported Profiles

Extractable Questionnaire - StructureMap

Documentation

> 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.

Search Parameters

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

Extended Operations

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

#### Resource Conformance: SHALL QuestionnaireResponse

Core FHIR Resource
QuestionnaireResponse
Reference Policy
`literal`
Interaction summary

- SHALL support
  `create`

  Allows the creation of QuestionnaireResponses in response to Tasks.

  `read`

  Allows the retrieval of QuestionnaireResponses linked to a pointed to as supporting information by a ServiceRequest or as outputs of a Task.

- SHOULD support
  `update`

  Allows the revision of 'in progress' QuestionnaireResponses.

  `search-type`

  Allows checking for updates in previously retrieved QuestionnaireResponses.

Supported Profiles

SDC Questionnaire Response

Documentation

> Used to allow QuestionnaireResponses to be created and updated by a patient or caregiver and work-in-progress responses to be retrieved

Search Parameters

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

#### Resource Conformance: SHALL RelatedPerson

Core FHIR Resource
RelatedPerson
Reference Policy
`literal`
Interaction summary

- MAY support
  `read`

  Allows the system to retrieve a RelatedPerson that is the requester or intended performer of a ServiceRequest.

  `search-type`

  Allows the monitoring of previously-retrieved RelatedPersons that are the requester or intended performer of ServiceRequests.

Supported Profiles

RelatedPerson

Documentation

> Used to access information about the requester or intended performer of a ServiceRequest or Task 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

Search Parameters

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

#### Resource Conformance: SHALL ServiceRequest

Core FHIR Resource
ServiceRequest
Reference Policy
`literal`
Interaction summary

- SHOULD support
  `read`

  Allows client systems to retrieve the ServiceRequest pointed to by a Task.

  `search-type`

  Allows client systems to monitor multiple ServiceRequests for change simultaneously via polling.

Supported Profiles

SDOHCC ServiceRequest

Documentation

> For referral sources that receive referrals from upstream systems, used to retrieve an order for SDOH-related services

Search Parameters

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

#### Resource Conformance: SHALL Task

Core FHIR Resource
Task
Reference Policy
`literal`
Interaction summary

- SHALL support
  `update`

  Allows modification of an assigned patient existing Task (e.g. to cancel it) or modificiation of a Task assigned to the referral recipient (to accept or reject it or add output links to performed procedures). Systems SHALL ensure that only changes to Task.status, Task.statusReason, and Task.outputs are possible, and then only for Tasks where the owner is the patient.

  `search-type`

  Allows the other systems to poll multiple tasks simultaneously, as well as to retrieve referenced resources as part of a single query.

- MAY support
  `read`

  Allows retrieval of a Task that was previously accessed.

Supported Profiles

SDOHCC Task For Patient
SDOHCC Task For Referral Management

Documentation

> Allows the patient or caregiver to monitor and update for Task assigned by referral sources or coordination platforms. Also allows the update and monitoring of tasks assigned to patients and caregivers.

Search Parameters

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