SDOH Clinical Care
2.0.0 - STU 2 US

This page is part of the SDOH Clinical Care for Multiple Domains (v2.0.0: STU 2) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions

Home Page

Official URL: Version: 2.0.0
Draft as of 2022-10-25 Computable Name: Sdohclinicalcare


Social Determinants of Health (SDOH) are increasingly being recognized as essential factors that influence healthcare outcomes. This HL7 Implementation Guide (IG) defines how to exchange SDOH content defined by the Gravity Project using the HL7 FHIR standard. It defines how to represent coded content used to support the following care activities: screening, clinical assessment/diagnosis, goal setting, and the planning and performing of interventions. This IG addresses the need to gather SDOH information in multiple settings, share that information between stakeholders, and exchange referrals between organizations to address specific social risk needs, all with appropriate patient consent. In addition, the IG demonstrates how to share clinical data to support secondary purposes such as population health, quality, and research. The guide supports the following use cases:

  • Document SDOH data in conjunction with patient encounters with providers, payers, and community services
  • Document and track SDOH-related interventions to completion
  • Identify cohorts of individuals that have a common relationship to another entity (e.g., covered by the same payer)

This implementation guide was developed by the Gravity Project, which specifically focuses on using HL7 FHIR to define standards for the exchange of SDOH-related information. Both the project and this implementation guide are focused on the U.S. environment. This implementation guide leverages content from the US Core Implementation Guide and binds to US-specific terminology. However, the basic constructs and interaction patterns may well be applicable outside the U.S.

Additional information regarding the background and use of this IG can be found on the Gravity Confluence Technology Pages

Content and organization

The implementation guide is organized into the following sections:

Note to Implementers

Implementers should pay specific attention to the following sections:

Support for external terminologies for ServiceRequest and Procedure

If implementers of this IG wish to use terminologies that are not part of the required value sets for specific elements that have a type of CodableConcept (such as ServiceRequest.code and Procedure.code) they may include a specific Coding that specifies a system (URL that is defined and supported by the terminology author) as well as the specific code (define in the terminology) as long as the meaning of the code is a concept that is logically the same as, or contained in the concept, of the required code.

The following is an example for a ServiceRequest or Procedure where the external terminology

URL is : http://terminologysystem and the code is : SummerProgram

	"code" : {
  	  "coding" : [
 	       "system" : "",
        "code" : "467681000124101",
        "display" : "Assistance with application for Summer Food Service Program"
      "coding" : [
          "system" : "http://terminologysystem",
          "code" : "SummerProgram",
          "display" : "Summer Food Service Program"

Intellectual Property

This publication includes IP covered under the following statements.

Cross Version Analysis

This is an R4 IG. None of the features it uses are changed in R4B, so it can be used as is with R4B systems. Packages for both R4 ( and R4B ( are available.




Package hl7.fhir.r4.examples#4.0.1

Example resources in the R4 version of the FHIR standard


No dependencies found

Package hl7.fhir.uv.sdc#3.0.0

The SDC specification provides an infrastructure to standardize the capture and expanded use of patient-level data collected within an EHR.<br/>This includes two components:<br/>* Support more sophisticated questionnaire/form use-cases such as those needed for research, oncology, pathology and other clinical domains.<br/>*Support pre-population and auto-population of EHR data into forms/questionnaires for uses outside direct clinical care (patient safety, adverse event reporting, public health reporting, etc.). (built Tue, Mar 8, 2022 18:32+0000+00:00)


Package hl7.fhir.uv.subscriptions-backport#0.1.0

The Subscription R5 Backport Implementation Guide enables servers running verions of FHIR earlier than R5 to implement a subset of R5 Subscriptions in a standardized way. (built Mon, Dec 14, 2020 16:30+0000+00:00)


Package us.nlm.vsac#0.9.0



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HL7 International - Patient Care