| Gravity Project | 360x SDOH | Comments/Difference |
|---|
SDOHCC Goal (http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-Goal) | 360x does not provide related goal information as part of the referral. | Out of Scope for 360x because 360x focuses on only referral process. |
SDOHCC Task for Referral Management
| 360x uses HL7v2 Messages to update the status of the referral. The ORC segment is the part of the HL7v2 message most similar the FHIR Task. ORC uses two fields to update the state: Status, Business Status (which is use case specific) and Reason. | FHIR & Gravity Project uses Task for workflow Management with unique value sets for Task Status and ServiceRequest Status. The "Focus," of the Task, what the Task is acting on is the ServiceRequest. Whereas the status of the ServiceRequest is controlled by the initiator of that ServiceRequest, the status of the Task is controlled by the "Owner," of the task, the person responsible for carrying it out. |
SDOHCC ServiceRequest (http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ServiceRequest) ServiceRequest.Category:SDOH - Referrals are categorized by SDOH Category Domain Request.status - draft | active | on-hold | revoked | completed | entered-in-error | unknown ServiceRequest.intent - proposal | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option ServiceRequest.priority - routine | urgent | asap | stat | The OBR Code in the HL7v2 message most closely relates to FHIR ServiceRequest. Initially 360x will limit: a) Requester to Practitioner and Practitioner Role. b) Performer limited to Organization or HealthcareService References. | FHIR ServiceRequests can be made of a much wider variety of "Performers": Reference(HealthcareService | Device | RelatedPerson | US Core Patient Profile | US Core Practitioner Profile | US Core PractitionerRole Profile | US Core Organization Profile | US Core CareTeam Profile) |
SDOHCC Task for Patient (https://build.fhir.org/ig/HL7/fhir-sdoh-clinicalcare/StructureDefinition-SDOHCC-TaskForPatient.html) - Task for Patient provides workflow management data for patient communication and specifies codes describing the type of task: Make Contact, Review Material, General Information, Complete Questionnaire. | Patient communications is out of scope for 360x. | A 360x referral can specify the requirement that a patient task needs to be completed. This could take the form of Gravity Project's Task for Patient Codes, or as part of the V2 message the questions and answers can be specified as "order specific questions." The referral recipient can document the outcome of any patient specific task with: (1) Gravity Project's Task for Patient Codes–Make Contact, Review Material, General Information, Complete Questionnaire, or (2) documented responses to the Order Specific Questions. |
US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient) | Primary Language - Supported PID-15 - HL7v2 Message | Gravity Project uses FHIR US Core language - The language which can be used to communicate with the patient about his or her health. |
SDOHCC Procedure ( http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-Procedure)
Procedure.status - preparation | in-progress | not-done | on-hold
| stopped | completed | entered-in-error | unknown
| The OBR Code in the HL7v2 message most closely relates to the FHIR Procedure. This can include the very same SNOMED CT Procedure Codes that are used in the Gravity Project. | Both standards use the same SNOMEDCT codes. Gravity uses the FHIR Procedure resource, whereas 360x uses the HL7v2 message to update the status of the referral with the requisite codes. |
US Core Location Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-location) | Organization of the referral initiator provided in HL7v2 message. Referral Recipient Location fetched from relationship between organization and location from Direct Directory. Direct Addresses can be location specific. There is a "System" and "Facility" in a message header. | managingOrganization - Organization responsible for provisioning and upkeep |
US Core PractitionerRole Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole) | The closest equivalent to PractitionerRole in 360x is the ability of a direct address to be associated with a Practitioner. However PractitionerRole is not required in 360x. | Gravity's FHIR standard supports a more flexible definition of PractitionerRoles. It could also enable referrals to Practitioner/Organization referral recipients using PractitionerRole.endpoint where a FHIR or Direct address may be represented. |
US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner) - basic demographics and other administrative information about an individual practitioner. | The Direct Address and the NPI provide equivalent of Practitioner and PractitionerRole for sender. Referral recipient corresponds to Organization, ParctitionerRole not required. | 360x does not support Practitioner. |
US Core Organization Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization) | 360x Referrals are made to organizations. Direct Address serves as identifier for the organization. Organizations have ORG_SPEC and Individuals with Direct Addresses have PROV_SPEC_CODE (NUCC Codes) that describe these services. | Both standards need a standard for Organization Matching. For example, Employer ID Number and address of the organization/location. |
SDOHCC HealthcareService (https://build.fhir.org/ig/HL7/fhir-sdoh-clinicalcare/StructureDefinition-SDOHCC-HealthcareService.html) | 360x requires a Direct Address and doesn't specify whether the referral is going to a HealthcareService, Organization or PractitionerRole. Often Direct is implemented by using one address for scheduling all services and others have departmental Direct Addresses. Others have Direct Addresses on the facility level. Multiple facilities may even use the same Direct Address. | FHIR HealthcareService provides the ability to represent much more diverse set of data, which is not available in the Direct Directory: Language, Coverage Area, Eligibility and Characteristic to name a few. |
US Core CareTeam Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-careteam) | The primary care physician is the point of contact for the patient's care and it is out of scope for how the Care Team is updated about the referrals. | Gravity requires CareTeam and 360x does not support it. |
SDOHCC Condition (http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-Condition) Conditions are Categorized by SDOH Domain | Use Health Concern/Diagnosis ICD-10 as reason for referral with the option of SNOMED-CT Codes as the Service | Both standards use the same Health Concern/Diagnosis codes. |
SDOHCC Observation Screening Response (http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ObservationScreeningResponse) | SDOHCC Observation Screening Response (http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ObservationScreeningResponse) | Out of Scope for 360x because 360x focuses on only referral process. |
SDOHCC Observation Assessment (http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ObservationAssessment) | SDOHCC Observation Assessment (http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-ObservationAssessment) | Out of Scope for 360x because 360x focuses on only referral process. |
| SDOHCC Consent (http://hl7.org/fhir/us/sdoh-clinicalcare/StructureDefinition/SDOHCC-Consent) | Out of Scope for 360x because 360x focuses on only referral process. Sharing referral data falls under HIPAA Treatment Payment and Operations. | 360x is providing minimal necessary data on patients. Gravity's FHIR specification requires consent to be shared under the "Coordination Platform Capability Statement." |