The Standard

openEHR International and HL7 International  announced the successful conclusion of a highly productive joint workshop focused on exploring and advancing collaboration between their respective health data standards communities. The event, held in Amsterdam June 2-3, 2025, brought together leaders from both organizations with experts from the wider community in a spirit of shared commitment to improving global health and research through enhanced interoperability.

Both openEHR and HL7 Fast Healthcare Interoperability Resources (FHIR^®) are community-driven standards, developed and enabled by dedicated global communities with diverse stakeholders including clinicians, informaticians, developers and vendors. This shared foundation provides a powerful springboard for joint efforts to enable better health care delivery, foster innovation and accelerate vital research and development worldwide.

Discussions were overwhelmingly constructive, and characterized by a mutual curiosity and openness from members of both communities. The workshop culminated in the identification of five key strategic areas for future collaborative work, and underpinning enabling themes where closer strategic alignment between the openEHR and HL7 FHIR ecosystems can yield significant benefits for the wider health care community.

Thanks to the dedicated efforts of Gravity Project’s community members, volunteers, and staff, we made significant progress in advancing standards for Social Determinants of Health (SDOH) in 2024 that will shape the future of health data sharing.

Key Achievements

Gravity focuses on developing consensus-based standards that enhance data interoperability for SDOH. Our terminology, technical, and implementation workstreams all made notable progress in 2024 that we can leverage this year.  We provided valuable resources and guidance to help implementers adopt Gravity terminology effectively.

One of our standout initiatives was a six-week discovery project in February 2024, where over 20 cross-sector stakeholders collaborated to explore social care payment and reporting standards. This effort not only resulted in a comprehensive report but also fostered a deeper understanding of the landscape surrounding social care.

In its SDOH Playbook, “US Playbook to Address the Social Determinants of Health,” the White House explained that supporting flexible funding to address social needs, such as those offered through health-related social needs (HRSN) reimbursement programs, improves health outcomes: “Increasing funding flexibility and offering technical assistance that empowers organizations to utilize funding from a variety of sources will better equip them to address unmet social needs.”

The success of these reimbursement programs requires the existence of exchange and data standards that serve the interests of all stakeholders. Payers and community-based organization (CBOs) currently experience complexities and pain points that have presented challenges and made it difficult to meet the HRSN reimbursement programs’ full potential exist as these benefits roll out today.

As momentum has grown among states and payers for the reallocation of healthcare funds to address HRSNs, Gravity Project decided to undertake a discovery effort to understand and define the existing landscape for CBO reimbursement and identify the components of the CBO reimbursement process and where national standards play a role. 

"Unite Us is proud to work with the Gravity Project. Together, we are making it easier for community-based organizations to participate in Medicaid reimbursement programs, expanding the availability of these benefits to more individuals seeking care,” Emily Anders, director of payments strategy for Unite Us, said.

April 25 Session Focuses on the Observation Screening Response Profile

Join us on April 25, 2024, at 2:30 – 4 p.m. ET for the next Gravity Project Implementation Affinity Group meeting, which features more real-world implementations and a key to their success: the Observation Screening Response profile.

Bringing Observation Screening Response into Focus for Gravity Implementers

Building upon the implementation approach and presentation by New York State Qualified Entities in February, this month’s Gravity Implementation Affinity Group session focuses on more real-world implementations and a key to their success: the Observation Screening Response profile.

The benefits of using this profile include explicit categorization of question/answer pairs by social determinants of health (SDOH) domains, flagging of positive findings, and using a common language (Gravity standardized terminology) to share and communicate these findings.

This session will highlight Observation Screening Response, including guidance on using key elements (e.g., Observation.category and Observation.interpretation) and using Observation Screening Response to create Observation Groupings.

This blog post was created through discussion over the past year among various payers, federal entities, providers, quality organizations, and HL7 staff with a focus on the importance of standardized data collection and management of race and ethnicity data. The discussion below represents a synthesis of these themes and identifies ways HL7 can help support the field.

High-quality, reliable, data are key to facilitating achievement of health equity, “the state in which everyone has a fair and just opportunity to attain their highest level of health”. This includes the collection, analysis and sharing of race and ethnicity data. However, misaligned approaches to standardized data collection present challenges to action. In addition, many organizations lack awareness of or experience challenges in applying standards when collecting and exchanging such data. In this blog, we explore existing resources that can help facilitate standardized data collection and management – HL7 is here to help.

The collection of high-quality race and ethnicity data is essential to address preventable differences - disparities - in health and healthcare. Such data are used to drive assessments, identify gaps, and the support decision-making that leads to actions to close gaps while improving outcomes. There are documented use cases by payers, providers, policymakers, and industry, for research, quality improvement and care delivery purposes. These use cases demonstrate how creating more inclusive datasets can support efforts to reduce health disparities and increase access to higher-quality care for historically marginalized communities. For example, race and ethnicity data can help provide transparency on disparate access to and uptake of services that can lead to targeted quality improvement and enhanced services for under-resourced populations. For this to occur, reliable, accurate, and consistent data are needed.

Five new Steering Committee members will bring unique insights to an upcoming slate of HL7 FHIR use cases in oncology, cardiovascular health, and genomics.

CodeX, the HL7® Fast Healthcare Interoperability Resources (FHIR®) Accelerator™ working to advance the adoption of FHIR as the standard to obtain high-quality, computable data for patient care and research, including the domains of oncology, cardiovascular health, and genomics, announced an expanded steering committee and new members of its leadership team.

“These experts in their fields are committed to helping CodeX develop and implement a strategic vision for the future with integrity, fairness, and equity. We embrace the HL7 ethos of collaboration and community to collectively solve interoperability challenges,” said Su Chen, M.D., program manager and clinical director of CodeX & digital health clinical principal at MITRE. In her role, Chen serves as chair of the CodeX Steering Committee.

Opportunity in partnership with Kaiser Permanente, HL7 and others!

As grounding, the Gravity Project is a national consensus project that develops and tests data standards to represent and exchange social risk data in electronic systems. Together, with a broad collective of stakeholders, Gravity Project defines the language needed to comprehensively address social risks in clinical and community-based settings. To date, the terminology team has completed 17 social risk domains. This has included building critical screening, diagnosis, goal, and intervention concepts for food insecurity, housing instability and homelessness, transportation insecurity, and beyond. In addition, Gravity data standards are included in the United States Core for Data for Interoperability (USCDI), and their value sets serve as a reference for emerging social risk quality measures. (relevant press releases and publications)

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.

Learn about HL7's Fonteva Implementation