The Social Interventions Research and Evaluation Network (SIREN) has launched the Gravity Project, a national collaborative to improve and harmonize documentation around social determinants of health (SDOH) data in EHR systems.
According to its website, SIREN’s mission is to catalyze and disseminate high-quality research that advances efforts to address social determinants of health (SDOH) in healthcare settings. One challenge the network has identified is related to the capacity of existing medical terminology standards to effectively capture the necessary data.
With funding from the Robert Wood Johnson Foundation and in partnership with EMI Advisors LLC, SIREN said the Gravity Project will:
- Develop use cases related to documenting social risk and protective factors data on screening, diagnosis, treatment, and population health management activities;
- Identify common data elements and their associated value sets to support the uses cases;
- Develop a consensus-based set of code recommendations for capturing and grouping these data elements for interoperable electronic exchange and aggregation; and
- Initiate an HL7 Fast Health Interoperability Resource (FHIR) Implementation Guide based on the defined use cases and associated data sets.
The project will focus on food security; housing stability and quality; and transportation access. It will examine and augment coding standards in each domain that can be used to capture three core healthcare activities:
• Screening: This refers to activities where SDOH data from individual patients are initially captured, either through a self-administered, provider-administered, or health plan-administered questionnaire.
• Assessment/Diagnosis: These include activities where providers and health plans analyze the data obtained through screening to determine a patient’s social risks and needs.
• Treatment/Interventions: These refer to actions undertaken by providers and health plans to help address identified social needs. These activities include referrals, case management, care planning, counseling and education, and provision of services and orders.
This project will not focus on evaluating, testing or harmonizing existing social risk screening tools
The Gravity Project timeline calls for work to begin in the third week of April 2019, with terminology and coding harmonization recommendations completed sometime between October and December. Phase 2 of the Gravity Project will be carried out in 2020 with further development and balloting of the HL7 FHIR SDOH Implementation Guide as part of the HL7 balloting process.
The project is being guided by the following steering committee members:
- Lisa Bari, Centers for Medicare and Medicaid Services (CMS) Innovation Center
- Keri Christensen, National Committee for Quality Assurance (NCQA)
- Chris Dymek, Agency for Healthcare Research and Quality (AHRQ)
- Margo Edmunds, Academy Health / National Interoperability Collaborative (NIC)
- Cara James, CMS Office of Minority Health
- Nafisa Jiwani, CMS Innovation Center (detail), Centers for Disease Control and Prevention (CDC)
- David Kendrick, MyHealth Network
- Jessica Khan, McKinsey & Company
- Lisa Lehmann, Department of Veterans Affairs (VA)
- Brenna Long, VA
- Sam Meklir, Office of the National Coordinator (ONC)
- Nancy Myers, American Hospital Association Center for Health Innovation
- Tom Novak, ONC
- Pam Owens, AHRQ
- Michelle Proser, National Association of Community Health Centers (NACHC)
- Walter Suarez, Kaiser Permanente
- Al Taylor, ONC
- Bill Winfrey, CMS Innovation Center
- Carlos Villarreal, Blue Cross Blue Shield Association
Participation in the Gravity Project is open to all interested organizations and individuals. Project participants will meet virtually for one hour once a week.
