Stream: implementers
Topic: Social Determinants of Health
Grahame Grieve (Feb 21 2019 at 04:59):
There was quite some interest at HIMSS about Social Determinants of Health, and what these look like in FHIR. Lots of people asked me about this. I wrongly thought we had some work in train... but we don't.
Grahame Grieve (Feb 21 2019 at 05:00):
There is work happening through ONC (?I think) led by @Evelyn Gallego to capture this but Evelyn (or someone else - it's amazing how many interactions I had at HIMSS) told me that this interest is fairly narrow, focused on Payor interests - which is not the same set of data s other interest groups
Grahame Grieve (Feb 21 2019 at 05:01):
it overlaps with ODH (https://build.fhir.org/ig/HL7/us-odh/), or relates to it (@Rob Hausam led that)
Grahame Grieve (Feb 21 2019 at 05:01):
Who would own this in HL7 (which WG?)
Grahame Grieve (Feb 21 2019 at 05:02):
Is there enough interest in this to drive a community? A Zulip stream? An HL7 project. Evelyn, can you describe what the project your are involved with is doing? - thanks
Nick Hatt (Feb 21 2019 at 15:42):
@Grahame Grieve We work some of the marquee SDOH-specific software vendors. I'm happy to intro you, or outline their high level EHR-integration needs.
Eric Haas (Feb 21 2019 at 18:12):
SDOH is closely tied to all the Questionnaire work in Argo, SDC and PRO
Grahame Grieve (Feb 21 2019 at 21:17):
@Nick Hatt I'm happy to be introduced, but introducing them the community doing the work is more relevant.
Grahame Grieve (Feb 21 2019 at 21:17):
I've asked Evelyn to detail how to get involved
Mark Kramer (Mar 18 2019 at 22:48):
MITRE would like to be involved. We have plenty of clinical talent in this area. We need to build a group of like-minded diverse interests. FHIR Fast Track???
David Pyke (Mar 18 2019 at 22:49):
THis could be work that CBCP could focus on. Social Determinants are a big part of Community Based Care
Inderpal Singh (Sep 09 2021 at 19:05):
Hi All,
I'm looking to capture various social determinants of health for a project that I'm currently working on and was hoping to get some guidance from the community on the best approach. From the Gravity project, it appears they are using the Observation resource to capture this type of information. Have other followed a similar approach? Has anyone used a resource other than Observation?
Thanks
Lloyd McKenzie (Sep 09 2021 at 20:27):
Actually, Gravity uses a mixture of 3 resources - QuestionnaireResponse for raw data capture; Observation for specific data points, scores, etc.; and Condition for long-term tracking and management of patient state/problems
What other resources were you evaluating?
Inderpal Singh (Sep 09 2021 at 21:04):
QuestionnaireResponse is what I was originally evaluating and thought would be the best fit for the data I was trying to capture. I looked into Observation as well but I have not considered Condition. I'll take another look at the Gravity IG and review those resources.
Thank you!
Lloyd McKenzie (Sep 10 2021 at 14:37):
Be aware that while QuestionnaireResponse is useful for capture, it's pretty useless for query.
Brendan Keeler (Sep 10 2021 at 22:56):
How do these link together? Or just different states in the workflow?
Lloyd McKenzie (Sep 10 2021 at 23:18):
An Observation can have a derivedFrom link to QuestionnaireResponse and Condition can have 'evidence.detail' that points to either Observation or QuestionnaireResponse.
Josh Mandel (Sep 11 2021 at 04:38):
I think QuestionnaireResponses are just fine for many kinds of queries :-)
Brendan Keeler (Sep 11 2021 at 14:04):
Okay so I'm imagining an observation being automatically generated by a questionnaireresponse and then created as a condition after clinician review
Lloyd McKenzie (Sep 11 2021 at 15:59):
You can query QuestionnaireResponses by patient, by Questionnaire type and by date. But you can't query QuestionnaireResponses by the data they contain. So if you're looking for particular diagnoses, allergies, medications, etc., QuestionnaireResponse isn't going to cut it and you'll need to extract the information into Conditions, AllergyIntolerances, MedicationStatements in order for it to be searchable.
In Gravity, they auto-generate the Condition as 'unconfirmed' with a 'Device' author, inferred from a QuestionnaireResponse. A human can then update it to confirm it and become the author after human review.
Last updated: Apr 12 2022 at 19:14 UTC
