ONC launches SDOH interoperability pilot

This new group can use various Fast Health Interoperability Resources resources as they pilot how to best adopt the SDOH Clinical Care FHIR Implementation Guide (SDOH CC IG) in screening, diagnosis, goal setting and interventions.


The pilot, funded under a cooperative agreement by the Office of the National Coordinator for Health IT (ONC) and Health Level Seven International (HL7), focuses on applying FHIR Gravity social risk terminology – to exchange information.

“Our combined efforts are expected to demonstrate how best to advance our nation’s technical infrastructure to enable SDOH interoperability as supported by ONC’s United States Core Data for Interoperability (USCDI) Version 2,” ONC authors Ryan Argentieri, Samantha Meklir and Jawanna Henry wrote in ONC’s HealthITbuzz blog. 

The USCDI standard consists of a core set of data classes and elements for health information exchanges to capture information about conditions outside of medical practice that put a person’s health and well-being at risk – chiefly food, housing and transportation access. 

“The ability to use and build from established standards in real-time and as part of screening practices that help identify specific needs related to insecurity is an important step in enabling more coordinated care and timely assistance or interventions needed to improve health outcomes,” according to Argentieri, Meklir and Henry.

Community-based organizations can participate in the pilot alongside clinical partners to help advance SDOH interoperability by improving access, exchange and use of standards with real-world experiences.

They’re not limited to using the SDOH standards in ONC’s guide in their work, according to the post.


Through the secure collection, documentation, reporting, access and use of data across provider types, ONC aims to address health inequities that have their root causes in poverty and racism.

With the Centers for Medicare & Medicaid Services mandating hospitals be ready to report on SDOH screening quality in 2024, a multi-stakeholder effort to advance an FHIR-based approach is needed to help providers meet CMS requirements, according to HL7 CEO Dr. Charles Jaffe.

Jaffe said in the HL7 blog last month that while much work has been done to standardize data exchange in order to enhance SDOH interoperability, “there remains a gap when screening is administered in different [electronic health records] and/or in third-party applications outside of a certified electronic health record.”

Since HL7 pledged to share the standards free of charge under licensing terms, many partnerships and collaborations with both public and private healthcare entities have bloomed. More recently, this includes a collaboration with the American Medical Informatics Association announced in May and the CodeX project, which focuses on improving data standardization and interoperability for prior authorizations in oncology.


“ONC helped fund this work through a cooperative agreement with HL7 in support of HHS’s Strategic Approach to Addressing Social Determinants of Health to Advance Health Equity, a three-pronged strategy to support robust and interconnected data infrastructure, improve access to health and social services and adopt a whole of government approach for enhancing population health and well-being,” wrote Argentieri, Meklir and Henry.

Andrea Fox is senior editor of Healthcare IT News.
Email: [email protected]

Healthcare IT News is a HIMSS publication.

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