The Gravity Project creates and maintains a consensus-building community to expand available Core Social Determinant of Health (SDOH) Data for Interoperability and accelerate standards-based information exchange by using HL7 FHIR. Gravity Project is part of the HL7 FHIR Accelerator Program.

Many of the recent innovations at scale in this area begin with the strategic collection of SDOH data. As examples, the Centers for Medicare & Medicaid Services Innovation Center (CMS Innovation Center) Comprehensive Primary Care Plus Model requires providers to assess patients’ social risks; and the CMS Innovation Center’s Accountable Health Communities Model developed a social risk assessment tool to help identify and address social risks across clinical and community-based settings. However, presently there is no consensus on the coding and standards-based modeling to facilitate the data uses envisioned for SDOH information. The Gravity Project is addressing the question of how to record and document SDOH information in the clinical care setting, across the four primary activities of care (screening, assessment/diagnosis, care planning, and treatment). 

The FHIR IG work for Gravity will include several iterative builds of the SDOH-CC IG, multiple rounds of Connectathon testing, and periodic updates to summarize this work for the Community. General education about FHIR IG development and HL7 ballot participation will be provided to build awareness and develop skills relevant for participation in standards development at the Community level.

The Gravity Project will incrementally develop one (1) FHIR IG covering the capture and exchange of multiple SDOH domains across the four clinical activities of screening, diagnosis (health concerns), goals, and interventions. 

• Phase I Domains (2019-2020)
  • Food Insecurity
  • Housing Instability, Homelessness, and Inadequate Housing
  • Transportation Insecurity
  • Financial Insecurity
  • Demographics (educational attainment, employment, veteran status)
• Phase II Domains (2021)
  • Material Hardship
  • Social Connection
  • Stress
  • Elder Abuse
  • Intimate Partner Violence

The Gravity Project will incrementally develop one (1) FHIR IG covering the capture and exchange of multiple SDOH domains across the four clinical activities of screening, diagnosis (health concerns), goals, and interventions.