Social Determinants of Health Data Matter for National COVID-19 Response Efforts
The Gravity Project is pleased to announce the publication of its consensus recommendations for food insecurity, housing instability and homelessness data elements. The Gravity Project is a national cross sector grassroots informed collective charged with building consensus data elements and data standards for the capture, exchange, and use of social determinants of health (SDOH) information. The Gravity food insecurity and housing data elements are the result of a year of development with input from its over 1,000 participants with intentional representation from key stakeholders such as patients, providers, community based organizations, payors, technology vendors, and federal and academic food insecurity and housing subject matter experts.
Social determinants of health—the circumstances in which we are born, grow, live, work and age—are estimated to account for 80-90% of health. There is growing interest from the healthcare sector to integrate social risk evaluation and intervention to advance the triple aim: improved health outcomes and quality of care while containing costs. In 2018, Gravity founders University of California San Francisco (UCSF) Social Interventions Research and Evaluation Network (SIREN) conducted an assessment of existing SDOH data and found much work was needed to advance the documentation and use of this data. Enter, the Gravity Project. The Office of the National Coordinator for Health Information Technology (ONC), a Gravity Project sponsor, noted the growing recognition across healthcare that by capturing and accessing SDOH data during the course of care, providers can more easily address non-clinical factors, such as food, housing and transportation insecurities, which can have a profound impact on a person’s overall health.
The coronavirus pandemic has only magnified the importance of these data collection strategies. The virus’ disproportionate toll on minority and low income communities, and the unprecedented economic devastation resulting from pandemic containment strategies, make clear we can no longer afford to overlook the use of SDOH data.“The Gravity Project’s work to document and integrate social risk in clinical care has never been more urgent than now,” said Tom Giannulli, Integrated Health Model Initiative (IHMI) Chief Medical Information Officer of the American Medical Association (AMA), one of Gravity’s founding sponsors and in-kind contributor. “With COVID-19, doctors see the intersection of social determinants and health status daily. The AMA is proud to contribute our expertise and to sponsor Gravity’s critical work.”
By facilitating capture and exchange of data about food insecurity, housing instability, transportation access issues, and other similar barriers to health, Gravity will greatly expand the health care sector’s ability to effectively care for the full needs of individuals and communities.
The food insecurity consensus data recommendations are being translated into code through the partnership of international and national terminology organizations such as Regenstrief, the ICD-10 Coordination and Maintenance Committee, and SNOMED International. The gold standard tools of the U.S. Department of Agriculture (USDA) modules were also recently incorporated in the LOINC by Regenstrief June release. As an HL7 FHIR Accelerator, Gravity is simultaneously turning the community consensus on data elements and value sets into a FHIR implementation guide and corresponding reference implementation for use in pilots and implementations in 2021. As the nation moves to FHIR-based Application Programming Interfaces (APIs) for interoperability in January 2021, guided by the ONC and Centers for Medicare and Medicaid Services (CMS) Interoperability Rules, the Gravity Project will have core food, housing, and transportation data integrations ready for use.
Gravity Project Sponsors
Critical to its success, the Gravity Project is led and supported by a broad coalition of organizations and federal partners representing the key constituencies needed to develop national consensus on social determinants data standards. Gravity sponsors are committing their resources and expertise because the work demonstrates value and has a direct impact. Highmark Vice President of Social Determinants of Health Strategy and Operations, and Gravity Project Executive Committee member Deborah Donovan said, “Highmark remains focused on the health and vitality of the communities we serve. The Gravity Project’s development of data standards and exchange of SDOH data will be critical to our ability to understand the social needs of our members, patients and communities, and make decisions that best support our customers.”
You can find the full list of Gravity Project Sponsors by clicking here.
Resources
To learn more about the Gravity Project, please visit: https://www.hl7.org/gravity/
For more information on the food insecurity data elements and new code submissions, please visit: https://confluence.hl7.org/display/GRAV/Food+Insecurity
For more information on the housing instability and homelessness data elements , please visit: https://confluence.hl7.org/display/GRAV/Housing+Instability+and+Homelessness
For more information on the HL7 FHIR Accelerator Program, please visit: https://www.hl7.org/about/fhir-accelerator/
To learn more about the ONC and CMS final rules, please visit: https://www.hhs.gov/about/news/2020/03/09/hhs-finalizes-historic-rules-to-provide-patients-more-control-of-their-health-data.html\
About Gravity Project
Initiated by the Social Interventions Research & Evaluations Network (SIREN), with funding from the Robert Wood Johnson Foundation and in partnership with EMI Advisors LLC, the Gravity Project is a multi-stakeholder public collaborative creating consensus-driven standards that address social care in clinical settings, integrate SDOH data into digital infrastructure, and develop standards for collecting and exchanging individual-level SDOH data.