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  1. SAVE THE DATE: SDOH CC FHIR IG Public Meetings will be scheduled for October 2020.

  2. The HL7® FHIR Virtual Connectathon occurred from September 9th to 11th

    1. Thank you to all who have participated in the HL7 FHIR Virtual Connectathon from September 9th to 11th. On Thursday, September 17th 5:00 pm - 5:30 pm EST, the Gravity Project Technical Director will present a post-connectathon debrief. 

    2. View the connecathon track recordings and presentations here.

  3. Click here to view the SDOH-CC Master and Temporary Code List.


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). Initially, the project focuses on three of the many different domains that form social determinants of health: Food Insecurity, Housing Instability and Quality, and Transportation Access.

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.

Upcoming FHIR IG Meetings

DateTimeTopicWebinar Information

If you missed any FHIR IG meetings, click here for past meeting minutes.

Quick Links

Implementation GuidesSponsoring Work GroupsGovernance DocumentsConnectathon InformationPotential Connectathon ParticipantsBallot InformationReference ImplementationsTesting and Validation Tools

SDOH Clinical Care 0.0.1 - CI Build


Patient Care



Public Health

Status: Approved 2019.11.18

FHIR IG Proposal: Proposal 

Status: Approved 2019.10.30

Sydney 2020 HL7 Connectathon 23

Sydney, Australia


May 2020 HL7 Connectathon 24


May 2020 MiHIN Interopathon


Sept 2020 HL7 Connectathon 25 - Virtual 2020.09.9-11

Ballot for STU: 2021.01

Git Hub TBD

Interventions Framework

Form Creator Demonstration

If you have any questions, please contact Gravity Technical Director, Robert Dieterle at

Project Scope Statement

For details on the approved scope for the Gravity Project SDOH Data Element FHIR IG, read the HL7 PSS.

Project Insight Number: 1567

Project Deliverables

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 and Quality
    • Transportation Access
    • Financial Strain
    • Demographics (education, employment, veteran status)
  • Phase II Domains (2021)
    • Social Isolation
    • Stress
    • Environmental Safety
    • Violence

Use Cases

1) Document SDOH Data Elements in the Clinical Care Setting

Document SDOH data in conjunction with the patient encounter.

2) Track SDOH Intervention Referrals to Completion

Document and track SDOH related intervention referrals to completion.

3) Aggregate SDOH Data Elements for Secondary Use (QRPH)

Gather and aggregate SDOH data for uses beyond the point of care (e.g., quality, research, and population/public health)

Click here to download the Gravity Use Case Package

Roadmap Timelines (updated 2020.09.18)

Other IGs to be Utilized

Implementation GuideDescription and intended use (Note that many extensions are defined within these IGs)


Version (3.1.0) - FHIR R4

The US Core Implementation Guide is based on FHIR Version R4 and defines the minimum conformance requirements for accessing patient data. The Argonaut pilot implementations, ONC 2015 Edition Common Clinical Data Set (CCDS), and the latest proposed ONC U.S. Core Data for Interoperability (USCDI) provided the requirements for this guide. The prior Argonaut search and vocabulary requirements, based on FHIR DSTU2, are updated in this guide to support FHIR Version R4. These profiles are the foundation for future US Realm FHIR implementation guides. In addition to Argonaut, they are used by DAF-Research, QI-Core, and CIMI. Under the guidance of HL7 and the HL7 US Realm Steering Committee, the content will expand in future versions to meet the needs specific to the US Realm.

These requirements were originally developed, balloted, and published in FHIR DSTU2 as part of the Office of the National Coordinator for Health Information Technology (ONC) sponsored Data Access Framework (DAF) project. For more information on how DAF became US Core see the US Core change notes.

Structured Data Capture (SDC)

Version  for FHIR R4

Questionnaires and forms permeate healthcare. They are used to capture administrative data, claims data, clinical information, research information, for public health reporting - every type of data that is manipulated by healthcare systems. They provide a user-friendly mechanism for capturing data in a consistent way. In FHIR, forms are represented using the Questionnaire resource and completed forms are represented using the QuestionnaireResponse resource. The base FHIR specification defines these resources but doesn't provide much guidance around how they should be used, nor does it set minimal expectations for interoperation. This implementation guide provides a set of guidance around the use of Questionnaire and QuestionnaireResponse. Specifically, it provides answers to - and conformance expectations around - questions such as:

  • What are the minimum capabilities a system should have to properly support FHIR-based forms?
  • How do I present questions in a table?
  • I want help text to appear in red - how do I do that?
  • What's the mechanism to calculate and display a score for a completed form?
  • I don't want to expose the logic of the questionnaire to other systems, but I still want to support form completion. How do I do that using FHIR?
  • Some of the data in this form already exists in the patient's record. How can I save the time (and prevent the transcription errors) associated with re-entering it into a form?
  • Once a form's complete, I want to import the data into other FHIR resources - is there an easy way to do that?

The implementation guide is structured to allow implementers to pick and choose the capabilities they need and combine them as necessary.




This open-source app uses the LHC-Forms form rendering widget to manage FHIR Questionnaire and QuestionnaireResponse resources. It provides partial (and growing) support for the Structured Data Capture (SDC) profile. The app is designed to be launched from an EHR system using SMART on FHIR to connect to the EHR's FHIR server. When you select "Try App" below, you will first go to a patient selector, and then to the app, the idea being that in an EHR environment, the patient would already be chosen before the app is used to fill out a form for the patient.

The app supports both STU3 and R4 versions of FHIR; the "Try App" button will connect you to an R4 FHIR server.

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