The Washington Gravity Project Workgroup
What is the Gravity Project?
The Gravity Project is a national and international effort for “documenting and sharing SDH-related assessment, diagnosis, and treatment information using modern coding and exchange standards has the potential to improve whole person care and health outcomes.”i As a part of the HL7 FHIR Accelerator Program “creates and maintains a consensus-building community to expand available Core Social Determinant of Health (SDOH) Data for Interoperability and accelerate standards-based information exchange by using HL7 FHIR”ii
The project covers three SDoH domains – Food Insecurity, Housing and Transportation. The standards being developed are tool agnostic and intended to be applicable to all Social Determinants domains in the future.
This project is sponsored by SIREN, The Robert Wood Johnson Foundation and EMI Advisors and consists of a large group of stake holder, including Contra Costa Health Services, University of Victoria, NIH, Johns Hopkins, New York Department of Health, the FDA and many others participating regularly in community meetings to:
a) submit data elements from different screening tools (validated or not),
b) to review concepts and determine which ones are similar or the same
c) and adjudicate which concepts are appropriate for the data set for the three identified domains.
What are the deliverables of the Gravity Project?
Through this process the aim of this project is to create a consensus-built structure for the documentation and data sets for the three identified domains.
In addition to this process, The Gravity Project has also developed an intervention framework to identify they kinds of interventions being coded for in this data set. You can find a copy of the framework on the last page of this report.
During this work, the project has established a set of data use principles for electronic health information exchange which can be found in the Resources section of this report.
Also found in the Resources Section of this report is a link to Food Insecurity Data Elements, Definitions, Intervention Examples, Screening Tools Assessed and contacts. Food Insecurity was the first of the three domains to be addressed by the Gravity Project.
Use Case packages, educational and instructional materials on SNOMED CT, LOINC, ICD-10, CPT and HCPCS codes, and groups doing relevant work on social determinants of health are also information that is included as supporting materials for the project. Links to these pages can be found in the Resources section of this report.
What is the Gravity Project Schedule?
Community Meetings: Meetings are held for 1 hour on Thursdays from 4:00pm-5:00pm ET / 1:00pm-2:00pm PT.
What is the Connectathon?
The Connectathon will test the structure developed by the Gravity Project using real and dummy codes for SDoH. There are three two-day long (or longer) virtual events where CHCs can participate in different “roles” such as PMEHR App, Screening App, Clinical R/R Actor, Patient, or Observer. As a “Clinical R/R” actor you will be testing the temporary coding and structure on your EHR and as “patient” you will be filling out screening tools or forms to provide feedback on the patient experience. You will also be able to see how the patient data flows through the system, is accessed by the provider “role” and how patients might access their data after it has been collected.
Are held twice monthly and are separate from the Gravity community collaborative meetings. Meetings are held for 1 hour on Wednesdays from 3:00pm-4:00pm ET / 12:00pm-1:00pm PT.
These meetings are for technical implementers using FHIR who are testing and implementing the data set(s) and content developed by the larger community.
The Association's Role in the Gravity Project
The Association is a member of the community stakeholder’s group. Our role is to collect screening tools, surveys, information on interventions, community resources and other important data elements and concepts and push them up to the community group in a standardized format for adjudication. In this way we can free up Health Center staff time and while still allowing your interests to be well represented as this national data set develops.
The Association may also consider participation in a future Connectathon in the “patient” role.
The Health Center Roles in the Gravity Project
Health centers can best have their interests represented in the Gravity Project by simply assigning one contact person to provide The Association with the requested materials. These materials will be simple to provide and will include things like a copy of any current SDoH surveys you are using that are applicable to the current domain (Housing, Food Insecurity, or Transportation). More complex requests may include information about things like the kinds of resources you are referring your patients to (meals on wheels, Food banks, etc.) or wish to refer your patients to, the kinds of diagnosis you think are appropriate for you community (levels of food insecurity, for example) or the kinds of observations you have made about your patient population in general (for example, is a household questions appropriate for some domains for groups of people living together who are not related).
As a Health Center, you can also choose to participate in one of the Connectathon’s listed above.
Karie manages data collection and analysis projects in support of The Association's strategic priorities, provides data training and assistance, works on Social Determinants of Health data efforts and is heading up the PCA's research projects.