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  1. FHIR Specification Feedback
  2. FHIR-35282

Conflicting guidance for Observation category for SDOH assessments

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    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Medium Medium
    • US Core (FHIR)
    • 4.1.0 [deprecated]
    • Cross-Group Projects
    • STU
    • US Core Social History Assessment Observation Profile [deprecated]
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      Background:

      See the commenter Description

      The US Core Screening Response Observation Profile and US Core Social History Assessment Observation Profile are designed to be broader than Social Determinants Of Health. They can be used for generic screenings and social history assessment. Hence there categorization was not limited to The LOINC “grouping” code: LG41762-2 “Social Determinants Of Health”

      Reasoning:

      We agree with the commenter that the guidance for Observation category for SDOH assessments is misleading and should be clarified.

      Proposed Changes:

      Will clarify in the implementation notes for both profiles (new content emphasized):

      • See SDOH Guidance for how this profile can used to represent SDOH assessments.
        • "For Social Determinants Of Health the category LG41762-2 “Social Determinants Of Health” *SHOULD* be used as an additional categorization. (see examples below)"

      Will clarify in SDOH guidance:

      Change:

      "The LOINC “grouping” code: LG41762-2 “Social Determinants Of Health” is used to categorize SDOH for Assessments, Problem, and Service Requests."

      to:

      "The LOINC “grouping” code: LG41762-2 “Social Determinants Of Health” is used to categorize SDOH for Problems, and Service Requests and *SHOULD* be used for Assessments."

      Show
      Background: See the commenter Description The US Core Screening Response Observation Profile and US Core Social History Assessment Observation Profile are designed to be broader than Social Determinants Of Health. They can be used for generic screenings and social history assessment. Hence there categorization was not limited to The LOINC “grouping” code: LG41762-2 “Social Determinants Of Health” Reasoning: We agree with the commenter that the guidance for Observation category for SDOH assessments is misleading and should be clarified. Proposed Changes: Will clarify in the implementation notes for both profiles (new content emphasized): See  SDOH Guidance  for how this profile can used to represent SDOH assessments. "For Social Determinants Of Health the category LG41762-2 “Social Determinants Of Health” * SHOULD * be used as an additional categorization. (see examples below)" Will clarify in SDOH guidance: Change: "The LOINC “grouping” code: LG41762-2 “Social Determinants Of Health” is used to categorize SDOH for Assessments, Problem, and Service Requests." to: "The LOINC “grouping” code: LG41762-2 “Social Determinants Of Health” is used to categorize SDOH for Problems, and Service Requests and * SHOULD * be used for Assessments."
    • Brett Marquard/Eric Haas: 15-0-0
    • Clarification
    • Non-substantive

    Description

      HL7.FHIR.US.CORE\SDOH Guidance - FHIR v4.0.1 says

      The LOINC “grouping” code: LG41762-2 “Social Determinants Of Health” is used to categorize SDOH for Assessments, Problem, and Service Requests.

      However, when I look at the Observation.category value sets in the following two profiles, I don't see that aforementioned LOINC LG41762-2 code.

       

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            Unassigned Unassigned
            michelle.m.miller Michelle Miller
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              Created:
              Updated:
              Resolved: