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Announcements

  1. END TO END HOUSING DATA ELEMENTS READY FOR REVIEW! The Housing Instability and Homelessness Master List is now available here for end-to-end review and comments.  Please email your end-to-end review comments to gravityproject@emiadvisors.net by no later than the close of business on Thursday, August 6th, 2020.

  2. NEW Food Insecurity Coding Submissions

    1. The Gravity Project recently completed submissions for new food insecurity codes to LOINC, ICD-10, and SNOMED-CT based on the coding gaps identified in the final food insecurity master list.  View the latest coding submissions here.

  3. ONC USCDI Submissions

    1. ONC announced the United State Core for Data Interoperability (USCDI) is now open for submissions through October 9, 2020.
    2. The Gravity Project invites the Gravity Community to submit the Gravity identified LOINC codes and proposed SNOMED CT and ICD-10 codes to the  ONC New Data Element and Class (ONDEC) submission system here.
    3. The Gravity Project team will draft a formal letter on behalf of the Gravity Project. If you want to be added to this letter, please send your interest to: gravityproject@emiadvisors.net.
  4. The HL7® FHIR Virtual Connectathon will occur from September 9th to 11th

    1. The Gravity team is leading the Gravity Project SDOH-CC Connectathon Track (testing Gravity Use Case 1) 
    2. The Gravity track will collaborate with the Care Coordination Connectathon Track: Testing use of FHIR across the care continuum-generating an sending a multiple chronic conditions care plan, SDOH screening, eReferral, and functional assessment.        
    3. Sign up to be a participant here.
  5. SEND US YOUR DATA ELEMENTS for Inadequate Housing and Transportation

    1. Please continue to send us your data element concepts for Inadequate Housing and Transportation. Click here to submit your data element concepts.

  6. JOIN OUR NEXT Gravity Project Community Collaborative Meeting

    1. Please join us for the bi-weekly Gravity Project Community Meeting Thursday, August 6th from 4:00 - 5:30 pm ET (1:00 - 2:30 pm PT).  The web meeting URL and dial-in information are available here.  If you are unable to attend the meeting, materials and recordings are posted hereFor further information, please visit the Gravity Project Meeting Schedule.

  7. The Gravity Project is HIRING! 

    1. The Gravity Project is looking for a new Senior Project Manager to manage all the Gravity workstreams and coordinate across our three Governance Committees. Please see job posting here. Qualified candidates can send their resumes to hello@emiadvisors.net.

  8. May FHIR IG Connectathon Reports Available

    1. View Lessons Learned slides from the MIHIN Interopathon here.

    2. View Lessons Learned slides from HL7 May FHIR Connectathon here

COVID-19 and SDOH

We have stood up a public collaboration space where everyone can share ideas and resources around COVID-19 and SDOH efforts.  Please visit and contribute to the new Gravity Project SDOH COVID-19 Response page, where you'll find a blog and other resources.  Anyone can view the blog, but a Confluence login is required for those who wish to post blog content.  Click here for instructions on how to request a Confluence login.  Email webmaster@hl7.org for login and technical support. 

Gravity Events and Newsletter

Participate in ACL’s Social Care Referrals Challenge Competition Webinar on Tuesday, July 28th 2020. This challenge grant is currently open for submissions.

Please view event details here.

Gravity Project will be participating WEDI Forum virtually on Tuesday, August 2020. Please view event details here.

Gravity Social Media

The Gravity Project is now official on social media! We invite you to follow us on LinkedIn and Twitter. We will be using the social media platforms for relevant project and SDOH data integration related communications. Help us spread the word!

Gravity Project Sponsors

We are grateful for the all the contributions of our Gravity Community. We can no do this without you. Click the button below to view our current sponsors and inquire about your organization becoming a Gravity Project sponsor. 

Gravity Project Sponsors

Join the Gravity Project! The success of the Gravity Project depends on the contribution of volunteers who are eager to make rapid progress on the standardization of social determinants of health data.  We need experts to contribute to and validate definitions for SDH related data elements and value sets.Participants are asked to join the project at any time either as a Committed Member or Other Interested Party as part of the HL7 Consensus Process.  To join the project, sign up here.  
  • To check your project membership status, click here.  If you wish to change your membership from Other Interested Party to Committed Member, please send an email request to GravityProject@emiadvisors.net .
  • NOTE:  Both member types can submit comments on project documentation.  However, only Committed Members may vote on final documentation.  If you would like to have voting rights, please change your membership status or join the project as a Committed Member.

Overview


The Social Interventions Research and Evaluation Network (SIREN), with funding from the Robert Wood Johnson Foundation and in partnership with EMI Advisors, LLC, is pleased to invite you to join the Gravity Project. Driven by the growing interest in capturing social risk and protective factor data in health care settings, the Gravity Project brings industry leaders together to identify and harmonize social risk and protective factor data for interoperable electronic health information exchange.The Gravity Project will convene a public collaborative process in 2019 and 2020 to accomplish the following goals for the social domains of food security, housing stability and quality, and transportation access:
  • Develop use cases to support documentation of specific social domains across screening, diagnosis, goal setting, and intervention activities within EHR and related systems;
  • Identify common data elements and their associated value sets to support the use cases;
  • Develop a consensus-based set of recommendations on how best to capture and group these data elements for interoperable electronic exchange and aggregation; and
  • Initiate development of an HL7® Fast Health Interoperability Resource (FHIR®) Implementation Guide based on the defined use cases and associated data sets that will be finalized in the next phase of work.


Project objectives will be accomplished through bi-weekly one-hour virtual meetings and collaborative project product development through the HL7 project confluence page.

Upcoming Gravity Project Meeting


DateTimeTopicWebinar InformationHomework Documents & Links
06 August  20204:00-5:30pm ET / 1:00-2:30pm PT

Phase I Review:  End-to-End Review of Housing Instability and Homelessness Data Elements

Phase II: Inadequate Housing Data Element Concepts

Please log on before dialing in and enter the provided participant ID.

URL:  https://emiadvisors.webex.com/emiadvisors/j.php?MTID=m9ec3c58b6940b23e068ac88e8a46c4ca

Dial-In:  (415)655-0003

Meeting ID:  738 112 808

Password (for app users):  gravity

Review and submit comments: Housing Instability and Homelessness Master List

Submit: Inadequate Housing Concepts

Email sponsorship inquiries to Henry.Alphin@emiadvisors.net

Email comments and feedback to GravityProject@emiadvisors.net

CLICK HERE FOR A FULL MEETING SCHEDULE
Click here for project documentation and deliverables.

Gravity Project Governance


The Gravity Project has transitioned to a more robust governance structure to facilitate and accommodate the project's growth and success.

Project Timeline


Project Contacts


NameTitleOrganizationEmail
Evelyn GallegoProgram ManagerEMI Advisors, LLCevelyn.gallego@emiadvisors.net
Lynette ElliottProject ManagerEMI Advisors, LLClynette.elliott@emiadvisors.net
Katiya ShellProject Manager EMI Advisors, LLCkatiya.shell@emiadvisors.net
Marissa RiceCommunications AnalystEMI Advisors, LLCmarissa.rice@emiadvisors.net 
Bob DierterleTechnical DirectorEnable Care LLCrdieterle@enablecare.us
Linda HydeCoding Subject Matter ExpertEMI Advisors, LLClinda.hyde@emiadvisors.net
Caroline FichtenbergManaging DirectorSIRENcaroline.fichtenberg@ucsf.edu
Sarah DeSilveySDOH Clinical Informatics LeadSIRENsarah.desilvey@med.uvm.edu
Mark SavageSDOH Data Policy LeadSIREN/UCSFmark.savage@ucsf.edu

Comments


Comment(s)

Thank you for leading this important work. I wonder about the "out of scope" disclaimer about not getting into the actual social needs screening instruments and items. The question is can you standardize the answers without standardizing the questions? Anyway, that is the topic I'm most interested in and am actively engaged in with Epic, and would be happy to participate/contribute as appropriate.
Greetings! Great start on the work related SDOH that is on the Confluence page. The following should be considered to be added:

Medicaid Information Technology Architecture (MITA)
https://www.medicaid.gov/medicaid/data-and-systems/mita/mita-30/index.html

Homeless Management Information System (HMIS)
https://www.hudexchange.info/resource/3824/hmis-data-dictionary/

Open Referral - I can introduce you to their Executive Director Greg Bloom
https://openreferral.org/

Among the uses for standardized SDOH data, regulatory reporting was not mentioned. Obviously there are limited regulatory reporting requirements (in part due to the limited standardization of data). It could be beneficial to develop the standard in a way that makes the data easy to be consumed by future regulators with minimal/zero click reporting involvement by provider staff. We can take inspiration from the approach to the XBRL data standard used by Australia and the Netherlands to automate corporate reporting.

https://www.xbrl.org/the-standard/how/getting-started-for-regulators/

Hope this helps!
Matt
Excited to be a part of the collaborative! From a community mobilization and engagement perspective, the materials offered on The Gravity Project Website (charter, glossary and standards/initiatives) provide a clear grounding of the project for members, define the parameters of the project and set the stage for next steps.
In addition to the use cases described in step 1 of the Scope Statement, it would be helpful to keep the six uses described the NAM 2014 Phase 2 report in mind to ensure that the data will meet multiple cases.
Institute of Medicine (2014) Capturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2. National Academies Press, Washington DC.
About 1,095 SDH codes have been highlighted via the SIREN Social Risk Codes review (relating to 20 social risk domains). This is a very comprehensive amount, but may be somewhat confusing. It will be interesting to see how we will narrow down such a vast amount of codes. Will we focus on ICD-10, LOINC, SNOMED, and CPT all together, or start with just one of these code types initially?
I recommend adding the Homeless Management Information System (HMIS) to the "Relevant Work in Social Determinants of Health" resource page.
https://www.hudexchange.info/programs/hmis/

Think that it is helpful to keep in mind HUD's definitions of homelessness and housing instability when developing SDoH housing instability data element definitions
https://www.hudexchange.info/trainings/courses/recording-and-documenting-homeless-status/
Minor comment on charter - in the first paragraph of 5.2.19 V 1.4 of charter - I think you mean National Quality FORUM (not National Quality Framework) ADMIN NOTE: Updated in Charter v1.5
suggested additions to list of materials -
(1) Another standard SDH code set is contained in the International Classification of Primary Care, 2nd edition, in its Chapter Z. ICPC-2 is the primary medical care coding and classification standard for several countries, is mapped to ICD-10 (11), and to a defined subset of SNOMED CT, the SNOMED GP-FP Reference Set.
(2) Can add to list of vendors with SDH capabilities RiverStar Software, which offers a Community Care Hub product that combines SDH screening with community service agency referral support and tracking. Can see at: https://www.riverstar.com/community-care/
Relative Standards and Initiatives -
HL7 CDA® R2 Implementation Guide: C-CDA R2.1 Supplemental Templates for Nutrition, Release 1
This Implementation Guide is clinical inpatient oriented however the care plan component is worth evaluating as a pattern and part of a use case where at risk patient needs.


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  1. Addressing Social Determinants to Improve Patient Care and Promote Health Equity: An American College of Physicians Position Paper 

    https://annals.org/aim/fullarticle/2678505/addressing-social-determinants-improve-patient-care-promote-health-equity-american