Ankit Kumar Agarwal
Ankit Kumar agarwal is a Wharton Graduate and working as “Director of IT” with NewWave Telecom and Technologies Inc. Ankit is passionate about bringing impactful changes in people’s life and writes blogs to educate people and promote digital Health.
What are Social Determinants of Health
Social determinants of health are the conditions in which people are born, grow, live, work, and age. These conditions, which are shaped by the distribution of money, power, and resources at global, national, and local levels, are responsible for a significant portion of the health inequities that exist within and between countries.
Some examples of social determinants of health include:
· Income and social status: Lower income and social status are associated with a higher risk of poor health outcomes.
· Education: Higher levels of education are associated with better health outcomes.
· Housing: Access to safe, affordable, and adequate housing is important for good health.
· Employment: Unstable or unhealthy employment conditions can negatively impact health.
· Social support networks: Strong social support networks can have a positive impact on health.
· Access to healthcare: Access to quality healthcare is important for good health.
· Gender: Gender-based discrimination and violence can negatively impact health.
Understanding and addressing social determinants of health is crucial for improving the health and well-being of populations. This can involve efforts to address the underlying social, economic, and political factors that contribute to health inequities, and it can involve the development and implementation of policies and programs that aim to promote health equity.
How FHIR can impact Social Determinants of Health
HL7 FHIR (Fast Healthcare Interoperability Resources) is a set of standards for exchanging healthcare information electronically. It is designed to be flexible, modular, and easy to implement, and it is widely used for a variety of healthcare-related applications.
FHIR can potentially have a positive impact on social determinants of health by enabling the exchange of information about social determinants of health between healthcare providers and other organizations. This can help providers identify and address social determinants of health that may be contributing to poor health outcomes for their patients.
For example, FHIR can be used to exchange information about a patient’s social and economic circumstances, such as income, education level, and housing status. This information can be used by providers to identify and address social determinants of health that may be impacting a patient’s health, and it can be used to develop and implement interventions to address those determinants.
Overall, FHIR has the potential to play a role in addressing social determinants of health by facilitating the exchange of information about social determinants and enabling the development and implementation of interventions to address those determinants.
Role of Gravity in Defining FHIR Based SDOH Interoperability standards
The Gravity Project was initiated in November 2018 by SIREN with funding from the Robert Wood Johnson Foundation to convene broad stakeholder groups in identifying and harmonizing social risk factor data for interoperable electronic health information exchange. Its mission was to create and maintain a consensus-building community to expand available SDOH core data for interoperability and accelerate standards-based information exchange by using HL7® FHIR®.
The project is a direct response to recommendations and calls to action around creating national standards for representing SDH data in EHRs. Growing evidence demonstrates strong links between social risk and an individual’s health and health care utilization. This correlation has increasingly led health systems to incorporate social risk data into clinical decision making to improve health outcomes and help reduce costs.
The Gravity Project seeks to identify coded data elements and associated value sets to represent social determinants of health data documented in EHRs across four clinical activities: screening, diagnosis, planning, and interventions. The project is focused on three specific social risk domains: food insecurity, housing instability and quality, and transportation access. These domains were selected based both on existing research linking these factors with health and utilization and on active experiments related to these domains, including in federal, state, or local demonstration projects.
The scope for Phase 1 of Gravity includes the following activities and deliverables:
· Develop use cases that will serve to guide development of recommendations about documenting SDOH data in EHRs or related systems.
· Identify common data elements and associated value sets to support the use cases.
· Develop recommendations on how best to capture and group these data elements for interoperable electronic exchange and aggregation.
· Initiate development of an HL7 Fast Health Interoperability Resource (FHIR) Implementation Guide based on the defined use cases and associated data sets in order to set up the next phase in 2020.
Gravity Project Phase 2 deliverables (2020+) are:
· Collaborate with coding and terminology suppliers to address coding gaps defined in Phase 1.
· Develop and test coded SDOH data sets for use in FHIR through Connectathon events.
· Develop and ballot an HL7 FHIR SDOH Implementation Guide.
Steps to Implement SDOH using FHIR
Implementing a FHIR-based system to address social determinants of health may involve the following steps:
· Define the scope and objectives of the project: It is important to clearly define the goals and objectives of the FHIR-based system, as well as the scope of the project. This can help ensure that the implementation is focused and efficient.
· Identify stakeholders: Identifying the stakeholders who will be affected by the implementation, including healthcare providers, social service organizations, and policyholders, is important for ensuring that all relevant parties are involved in the process.
· Conduct a needs assessment: A needs assessment can help identify the specific requirements and challenges of the implementation, and it can be used to inform the design and development of the FHIR-based system.
· Develop a plan: A detailed plan should be developed to outline the steps and resources required to implement the FHIR-based system, including any technical, regulatory, or user adoption considerations.
· Implement the system: The FHIR-based system should be implemented according to the plan, including the development and deployment of any necessary technical infrastructure and processes.
· Test and evaluate the system: The FHIR-based system should be thoroughly tested and evaluated to ensure that it is functioning correctly and meeting the needs of the stakeholders.
· Monitor and maintain the system: Ongoing monitoring and maintenance of the FHIR-based system will be required to ensure that it continues to function correctly and meet the needs of the stakeholders
*This article is Peer Reviewed by the Distilinfo Editorial team prior to the publication.*