HL7 Gravity Project: An Ongoing Evolution

Highlighted here is a preview of what’s on the horizon as the Gravity Project matures and
recent examples of Gravity standards integration.

The Gravity Project®, an HL7® FHIR Accelerator, is evolving the way it advances social care data integration as a strategy to promote health equity while maintaining continuity with the mission and consensus-based processes that are core to the project. The project is a national public-private collaborative developing, testing, and implementing consensus-based social determinants of health (SDOH) data standards for use across the health, social services, public health, and research sectors. The Gravity community embodies a truly inclusive representation of over 2,500 stakeholder members of its public work groups and governance committees across the healthcare, health IT, community-based, federal and state agency, payer, academic, and patient/ consumer advocacy sectors.

In 2021, HL7 was awarded a cooperative agreement with the Office of the National Coordinator for Health Information Technology (ONC) to prioritize and expedite the development of standards specific to five gap areas including SDOH. Under this collaborative agreement, the Gravity Pilots Affinity Group was launched in September 2022 as a peer-to-peer learning forum for real-world testing of Gravity terminology and technical standards. Pilot sites are invited to demonstrate the use of social care coded terminologies (e.g., LOINC®, SNOMED-CT®, ICD-10®) and/or the HL7 SDOH Clinical Care FHIR Implementation Guide (SDOH CC IG), share implementation lessons learned with other pilot participants, seek/find partnerships for testing, and gain real-world experience.

On September 28th, 2022, the White House hosted the Conference on Hunger, Nutrition and Health where it announced the HL7 Sync for Social Needs Initiative–a coalition aimed at uniting leading health technology companies and health systems to standardize the sharing of patient data on SDOH, including food insecurity. All coalition participants are invited to participate in the Gravity Pilots Affinity Group and demonstrate the use of FHIR-based social risk screening results.

Earlier this year, Civitas Networks for Health, HL7, and the Gravity Project announced a letter of intent to establish a partnership that will leverage their synergies and strengths to chart a sustainable glide path for the implementation and dissemination of consensus-based SDOH standards. Together, we are in the process of evaluating and planning program improvements to set the Gravity Project to thrive. At the same time, we have several exciting updates to share with the HL7 community.

What’s on the Horizon This Year and Next?

•  Civitas Support for Gravity Standards Implementation. In October 2022, Civitas Networks for Health announced it was awarded a grant from Robert Wood Johnson Foundation (RWJF) to further the implementation and dissemination of Gravity Project SDOH standards for public health, health systems, and community organizations. The 12-month project kicked off on November 1, 2022, to provide opportunities for shared learning, training, technical assistance, and in-person multi-stakeholder convenings. Civitas will partner closely with Gravity Project leadership to support implementation work already underway and to build on existing work accomplished by the national collaborative to date.
• CMS Support for Gravity Workstreams. Starting November 2022, MITRE, under a FFRDC contract with CMS, will provide technical leadership and support to the Gravity Project terminology, technical, and pilots workstreams. This engagement will optimize the effectiveness and efficiencies of the federal government’s investment in the Gravity Project by promoting the use of standardized SDOH data within federal programs, advancing the technical standards, and conducting real-world pilots within the industry.
• Kaiser Permanente Grant and Matching Campaign. HL7 has received a $75K grant from Kaiser Permanente to support the launch of the Gravity Digital Inequity/Access & Digital Literacy Domain in January 2023! The Gravity Project is seeking organizations to match Kaiser Permanente’s contribution to initiate the new domain. We need at least three entities to commit $75K each to execute the work fully. Please contact jillian.annunziata@emiadvisors.net if you are willing to help with a match.

Recent Gravity Project Accomplishments

• HL7 SDOH Clinical Care FHIR Implementation Guide STU2 Publication. The HL7 SDOH Clinical Care FHIR IG was balloted as an STU2 in January 2022 and tested at the January 2022 and May 2022 HL7 FHIR Connectathons and the July 2022 CMS FHIR Connectathon. The STU2 IG is scheduled for HL7 publication in November 2022.
•  Gravity SDOH Data Elements. The Gravity Project has successfully completed the terminology build for seventeen social risk domains working hand in hand with leading coding stewards at Regenstrief, SNOMED-CT International, ICD-10 Coordination & Maintenance Committee (CM), and the American Medical Association (AMA). The June 2022 ICD-10-CM codes submission was approved for implementation this October 1st, 2022. The full ICD-10-CM release is available here.
• Interoperability Standards Advisory (ISA) Updates. As part of the USCDI version 3 release, the ONC has updated the Interoperability Standards Advisory (ISA) with the Gravity Project aligned with broad social SDOH VSAC value sets for each SDOH activity (screening, diagnosis, goal setting, and interventions).

The consensus-based standards of the HL7® Gravity Project constitute a freely accessible public good. We appreciate the current and future partnerships and sponsorship that the Gravity community relies on to expand connections across the ecosystem to evolve the work.

To learn more about the Gravity Project, please visit: https://thegravityproject.net/

To learn more about the value proposition for engagement and how to become a Gravity sponsor, contact gravityproject@emiadvisors.net.

For more information on the HL7® FHIR Accelerator Program, please visit: https://www.hl7.org/about/fhir-accelerator/