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=Breast Radiology Profiles=
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=SDOH Data Element Profiles=
  
 
==Owning Workgroup==
 
==Owning Workgroup==
HL7 Clinical Interoperability Council (CIC)
+
HL7 Patient Care (PC WG)
  
 
==Committee Approval Date:==
 
==Committee Approval Date:==
May 2019
+
Sept 2019
  
 
==Publishing Lead==
 
==Publishing Lead==
Richard Esmond (richard.esmond@gmail.com)
+
Cheng Liu (CLiu@max.md)
  
 
==Contributing or Reviewing Work Groups==
 
==Contributing or Reviewing Work Groups==
   HL7 Clinical Information Modeling Initiative (CIMI)
+
   HL7 Vocabulary (VOCAB)
  HL7 Imaging Integration / DICOM
 
  
 
==FHIR Development Project Insight ID==
 
==FHIR Development Project Insight ID==
1363
+
TBD
  
 
==Scope of coverage==
 
==Scope of coverage==
The breast radiology implementation guide intends to formalize the radiology-specific data-elements sufficient to support breast cancer diagnosis, treatment and research, focusing on the key data necessary to facilitate clinical decision-making for medical and surgical oncologists, pathologists and the referring physician community of general practices Obstetrics and gynecology (OB/GYN) clinicians who order the vast majority of screening mammography procedures.
+
The Gravity Social Determinant of Health (SDOH) Data Element FHIR implementation guide (IG) intends to formalize the SDOH-specific data-elements sufficient to support screening, diagnosis, care planning, treatment and secondary uses such as research, risk adjustment, and quality measurement. The FHIR implementation guidance focuses on data elements determined to be relevant by the Gravity Project Community to three core use cases:
 
+
{| class="wikitable"
The implementation guide is expected to incrementally cover a wide variety breast radiology use cases, while supporting secondary data use in for clinical research, cancer registry reporting.</span>
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|Document  SDOH data in conjunction with the patient encounter.
 +
|-
 +
|Document  and track SDOH related interventions to completion.
 +
|-
 +
|Gather  and aggregate SDOH data for uses beyond the point of care (e.g., population  health management, quality reporting, and risk adjustment/risk  stratification).
 +
|}
 +
The implementation guide is expected to cover these three core use cases first for one SDOH domain (Food Insecurity) and over time it will expand to cover the data elements for these three use cases in other SDOH domains, e.g. Housing Stability & Quality, Transportation Access.
  
 
==Content location==
 
==Content location==
<i><span>https://github.com/HL7/fhir-breast-radiology-ig</span></i>
+
<i><span>https://github.com/HL7/fhir-food-insecurity-ig</span></i>
  
 
==Proposed IG realm and code==
 
==Proposed IG realm and code==
us/breast-radiology
+
IG Realm is US
 +
 
 +
Codes for the IG will be sdoh-cc for the use cases driven out of the Clinical Care setting. Eventually as other IGs are added for use cases driven out of other settings, the collection will include an sdoh-o for the "over view" IG that will gather specifications promoted to be "common technical specifications" that are shared among the different sdoh-xx ig's, for example sdoh-cbo (Community Based Organizations) or sdoh-ph (Public Health) or sdoh-rr (Registry/Research). 
 +
 
 +
<br />
  
 
==Maintenance Plan==
 
==Maintenance Plan==
The CIC WG is aware and willing to maintain the content in the future. Among participants, at least MITRE, MRS and PenRad are committed to the maintenance of the content.
+
The PC WG is aware and willing to maintain the content in the future. The Gravity Project engages a large multistakeholder group committed and funded to evolve and maintain the content.
  
This IG comprises FHIR Profiles for breast radiology core data elements long established to be critical for breast cancer diagnosis and staging within the scope of radiology.
+
This IG comprises FHIR Profiles for Food Security core data elements for which the Gravity Project is developing stakeholder consensus around the definition and use of the data in care activities including: screening, clinical assessment, diagnosis, goal setting, intervention planning and intervention performing.
  
In the first 'For Comment' cycle the terminology bindings are preliminary, and in some cases, defined in terms of local codes only.
+
In the first 'For Comment' cycle the terminology bindings are preliminary, and in some cases, defined in terms of placeholder codes only.
  
Our team is collaborating with the VA SOLOR groups, RSNA RadLex and Regenstrief (LOINC) to organize and fund the required unique concept authoring efforts that will be necessary to sufficiently define the data-elements and value-sets represented in the 'For Comment' and 'Informative' breast-radiology draft ballot cycles.
+
Our team is collaborating with SNOMED CT, Regenstrief (LOINC) and Code System SDOs who steward over ICD-10, CPT and HCPCs to organize and fund the required unique concept authoring efforts that will be necessary to sufficiently define the data-elements and value-sets represented in the 'For Comment' May 2020, and STU Sept 2020 ballot cycles.
  
 
==Short Description==
 
==Short Description==
Breast Radiology CIMI Logical Models and FHIR Profiles.
+
US Realm FHIR Profiles for data elements used to document an individual's social determinants of health (SDOH) which covers many different factors considered social risks and social needs, e.g. Food Insecurity, Housing Stability and Quality, Transportation Access and others. The IG covers three use cases identified from the clinical care setting: Gathering and Documenting SDOH information in a clinical setting; Documenting and Tracking to completion SDOH interventions; and Sharing individual's SDOH information with organizations for secondary uses.  
  
 
==Long Description==
 
==Long Description==
The first iteration of the CIMI logical models and FHIR Profiles for breast radiology reporting will be focused on the core modeling structures, patterns and informational relationships between these architectural elements. Our group has works extensively with the HL7 Orders and Observations workgroup to investigate the numerous 'cross cutting' concerns that confront many similar projects.
+
US Realm FHIR Profiles for data elements used to document an individual's social determinants of health (SDOH) which covers many different factors considered social risks and social needs, e.g. Food Insecurity, Housing Stability and Quality, Transportation Access and others. It looks at information needed, gathered , and shared in the full cycle of clinical care activities including: screening, clinical assessment, diagnosis, care planning, and intervention.  
  
This IG defines FHIR profiles for data elements that are either directly or indirectly used in the reporting of breast radiology.
+
This IG defines FHIR profiles for data elements that are envisioned to be recorded in the clinical care setting:
 +
 
 +
#Gathering and Documenting SDOH information in a clinical setting
 +
#Documenting and Tracking to completion SDOH interventions
 +
#Sharing individual's SDOH information with organizations for secondary uses
 +
 
 +
The first iteration of the SDOH Data Element Profiles IG focuses on the core modeling structures, patterns and informational relationships between these architectural elements for the Food Insecurity SDOH Domain. Subsequent iterations will expand the IG to cover two additional SDOH domains: Housing Instability and Transportation Access.
  
 
==Involved parties==
 
==Involved parties==
The breast-radiology IG is being authored through a formal collaboration under the HL7-CIC workgroup with a wide range of organizations and individual contributors that informally refer the themselves as the 'Cancer Interoperability' Group, which includes representatives from the FDA, NIH, CCO, SBI, HSPC, CiiC, ACS, various health IT vendors and interested solution vendors.
+
The SDOH IG is being authored through a formal collaboration under the FHIR Accelerator Program through the Gravity Project working together with the larger HL7 Community through HL7-PC and HL7-VOCAB workgroups. The effort engages a wide range of organizations and individual contributors that informally refer the themselves as the Gravity Community, which includes representatives from 13 different types of organizations, standards developers, various health IT vendors, and interested solution vendors.
  
The American College of Radiology (ACR) has will established and long standing guidelines that have been in common and broad use for almost two decades. The Radiological Society of North America (RSNA) and the Society of Breast Imaging (SBI) which the breast focused arm of the ACR are all represented on the subject matter expert team that is reviewing all content and will be used as the definitive source of truth for all our near-term deliverables.
+
<br />
  
 
==Expected implementations==
 
==Expected implementations==
  MITRE's Standard Health Record Collaborative
+
  MaxMD
  PenRad, Inc.  
+
  TBD - Just beginning to confirm our initial participants for the December 2019 and January 2020 Connectathons.
  Mammography Reporting System, inc (MRS).  
+
  Several implementers have expressed interest for the December 2019 and January 2020 Connectathons.
  
   PenRad and MRS represent well over fifty percent of the almost forty million screening mammography studies performed each year. PenRad and MRS are also committed to participating in FHIR Connectathons to proof the draft profiles.
+
==Content sources==
 +
   Social Intervention Research and Evaluation Network,
 +
  American Academy of Nutrition and Dietetics, American Medical Association
  
==Content sources==
+
The Gravity Project solicits input from over 250 different organizations from 13 different stakeholder groups.
  American College of Radiology Breast Reporting Guidelines
+
    
   College of American Pathology (CAP) Breast Reporting SDC Forms
 
  Society of Breast Imaging Reporting Guidelines
 
  In addition to sources specifically providing clinical content related to cancer and breast cancer, from a modeling perspective, CIMI models were also used as a source.</span>
 
  
 
==Example Scenarios==
 
==Example Scenarios==
  Capture and delivery of breast radiology reports to EHR systems
+
Gathering SDOH Screening Results. Documenting Clinical Assessment Observations of SDOH needs and risks. Documentation of SDOH related Diagnosis. Care Planning to record SDOH related goals, planned and completed interventions and evaluation of progress toward recorded goals.
  Reporting to cancer registries
+
 
  Reporting for clinical trials
 
  
 
==IG Relationships==
 
==IG Relationships==
The breast-radiology project is intended to target compliance with US Core v4.
+
The SDOH FHIR IG is intended to target compliance with a suite of FHIR R4-compliant standards. It also will be leveraging C-CDA On FHIR, Da Vinci CDex, SDC, BSER, and Da Vinci QDEM
  
 
==Timelines==
 
==Timelines==
   For Comment September 2019 Ballot
+
   For Comment May 2020 Ballot
  Informative Jan 2020 Ballot
+
   STU September 2020 Ballot
   STU May 2020 Ballot
 
  
  
 
==FMG Notes==
 
==FMG Notes==

Latest revision as of 16:54, 31 October 2019

Current version: https://confluence.hl7.org/display/FHIR/SDOH+FHIR+IG+Proposal



SDOH Data Element Profiles

Owning Workgroup

HL7 Patient Care (PC WG)

Committee Approval Date:

Sept 2019

Publishing Lead

Cheng Liu (CLiu@max.md)

Contributing or Reviewing Work Groups

  HL7 Vocabulary (VOCAB)

FHIR Development Project Insight ID

TBD

Scope of coverage

The Gravity Social Determinant of Health (SDOH) Data Element FHIR implementation guide (IG) intends to formalize the SDOH-specific data-elements sufficient to support screening, diagnosis, care planning, treatment and secondary uses such as research, risk adjustment, and quality measurement. The FHIR implementation guidance focuses on data elements determined to be relevant by the Gravity Project Community to three core use cases:

Document SDOH data in conjunction with the patient encounter.
Document and track SDOH related interventions to completion.
Gather and aggregate SDOH data for uses beyond the point of care (e.g., population health management, quality reporting, and risk adjustment/risk stratification).

The implementation guide is expected to cover these three core use cases first for one SDOH domain (Food Insecurity) and over time it will expand to cover the data elements for these three use cases in other SDOH domains, e.g. Housing Stability & Quality, Transportation Access.

Content location

https://github.com/HL7/fhir-food-insecurity-ig

Proposed IG realm and code

IG Realm is US

Codes for the IG will be sdoh-cc for the use cases driven out of the Clinical Care setting. Eventually as other IGs are added for use cases driven out of other settings, the collection will include an sdoh-o for the "over view" IG that will gather specifications promoted to be "common technical specifications" that are shared among the different sdoh-xx ig's, for example sdoh-cbo (Community Based Organizations) or sdoh-ph (Public Health) or sdoh-rr (Registry/Research).


Maintenance Plan

The PC WG is aware and willing to maintain the content in the future. The Gravity Project engages a large multistakeholder group committed and funded to evolve and maintain the content.

This IG comprises FHIR Profiles for Food Security core data elements for which the Gravity Project is developing stakeholder consensus around the definition and use of the data in care activities including: screening, clinical assessment, diagnosis, goal setting, intervention planning and intervention performing.

In the first 'For Comment' cycle the terminology bindings are preliminary, and in some cases, defined in terms of placeholder codes only.

Our team is collaborating with SNOMED CT, Regenstrief (LOINC) and Code System SDOs who steward over ICD-10, CPT and HCPCs to organize and fund the required unique concept authoring efforts that will be necessary to sufficiently define the data-elements and value-sets represented in the 'For Comment' May 2020, and STU Sept 2020 ballot cycles.

Short Description

US Realm FHIR Profiles for data elements used to document an individual's social determinants of health (SDOH) which covers many different factors considered social risks and social needs, e.g. Food Insecurity, Housing Stability and Quality, Transportation Access and others. The IG covers three use cases identified from the clinical care setting: Gathering and Documenting SDOH information in a clinical setting; Documenting and Tracking to completion SDOH interventions; and Sharing individual's SDOH information with organizations for secondary uses.

Long Description

US Realm FHIR Profiles for data elements used to document an individual's social determinants of health (SDOH) which covers many different factors considered social risks and social needs, e.g. Food Insecurity, Housing Stability and Quality, Transportation Access and others. It looks at information needed, gathered , and shared in the full cycle of clinical care activities including: screening, clinical assessment, diagnosis, care planning, and intervention.

This IG defines FHIR profiles for data elements that are envisioned to be recorded in the clinical care setting:

  1. Gathering and Documenting SDOH information in a clinical setting
  2. Documenting and Tracking to completion SDOH interventions
  3. Sharing individual's SDOH information with organizations for secondary uses

The first iteration of the SDOH Data Element Profiles IG focuses on the core modeling structures, patterns and informational relationships between these architectural elements for the Food Insecurity SDOH Domain. Subsequent iterations will expand the IG to cover two additional SDOH domains: Housing Instability and Transportation Access.

Involved parties

The SDOH IG is being authored through a formal collaboration under the FHIR Accelerator Program through the Gravity Project working together with the larger HL7 Community through HL7-PC and HL7-VOCAB workgroups. The effort engages a wide range of organizations and individual contributors that informally refer the themselves as the Gravity Community, which includes representatives from 13 different types of organizations, standards developers, various health IT vendors, and interested solution vendors.


Expected implementations

 MaxMD
 TBD - Just beginning to confirm our initial participants for the December 2019 and January 2020 Connectathons.  
 Several implementers have expressed interest for the December 2019 and January 2020 Connectathons.

Content sources

  Social Intervention Research and Evaluation Network,
  American Academy of Nutrition and Dietetics, American Medical Association
The Gravity Project solicits input from over 250 different organizations from 13 different stakeholder groups.
  

Example Scenarios

Gathering SDOH Screening Results. Documenting Clinical Assessment Observations of SDOH needs and risks. Documentation of SDOH related Diagnosis. Care Planning to record SDOH related goals, planned and completed interventions and evaluation of progress toward recorded goals.


IG Relationships

The SDOH FHIR IG is intended to target compliance with a suite of FHIR R4-compliant standards. It also will be leveraging C-CDA On FHIR, Da Vinci CDex, SDC, BSER, and Da Vinci QDEM

Timelines

  For Comment May 2020 Ballot
  STU September 2020 Ballot


FMG Notes