Submitted By: Raymonde Uy
/ National Association of Community Health Centers (NACHC)
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Data Element Information |
Use Case Description(s) |
Use Case Description |
Incarceration is a risk factor for many chronic conditions such as HIV and Hepatitis C
Legal problems are inextricably linked to health problems. Oftentimes, people are made ill or have their access to healthcare threatened because laws are not enforced or poorly written, and because benefits are wrongfully denied. (National Center for Medical-Legal Partnership) |
Estimate the breadth of applicability of the use case(s) for this data element
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All federally qualified health centers (FQHCs) using PRAPARE gather data about incarceration. This encompasses, in 2019, 29 million patients at 1400+ FQHCs with more than 13000 health care delivery sites. The evaluation of social determinants of health, however, should be considered a required component of a patient-centered, value-based approach to care and therefore should be potentially relevant for any patient or care setting. |
Healthcare Aims |
- Improving patient experience of care (quality and/or satisfaction)
- Improving the health of populations
- Reducing the cost of care
- Improving provider experience of care
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Maturity of Use and Technical Specifications for Data Element |
Applicable Standard(s) |
Z56.0 Conviction in civil and criminal proceedings without imprisonment
Z65.1 Imprisonment and other incarcerations
SNOMED:
(Include children concepts) 365565007 - Finding of legal affairs and legal constraints (finding)
LOINC:
93025-5 - Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences [PRAPARE]
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Additional Specifications |
http://build.fhir.org/ig/HL7/sdoh-cc/
http://build.fhir.org/ig/HL7/fhir-sdoh-clinicalcare/
https://confluence.hl7.org/display/GRAV/Implementation+Guide |
Current Use |
Extensively used in production environments |
Supporting Artifacts |
Community Health Centers, Health Center Controlled Networks and Primary Care Associations routinely capture these data elements in different electronic health record systems
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Extent of exchange
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5 or more. This data element has been tested at scale between multiple different production environments to support the majority of anticipated stakeholders. |
Supporting Artifacts |
Commercial vendors including Aunt Bertha, UNITEUS and NowPow consume PRAPARE data and use it to link individual patients to social interventions.
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Potential Challenges |
Restrictions on Standardization (e.g. proprietary code) |
None |
Restrictions on Use (e.g. licensing, user fees) |
The PRAPARE tool has very minimal licensing and user fees.
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Privacy and Security Concerns |
None |
Estimate of Overall Burden |
Low burden, especially for healthcare institutions that routinely cater to the target demographic and geographic catchment area. |
Submitted by RUy on 2023-09-21
Reaffirming support for SDOH data elements
The National Association of Community Health Centers (NACHC) remains steadfast in its commitment to advocating for and prioritizing Social Determinants of Health (SDOH) data elements. Recognizing the critical role that these factors play in shaping the clinical outcomes of community health center patients, NACHC continues to emphasize the need for comprehensive, accurate, and interoperable SDOH data. By reaffirming our support for these essential elements, we aim to drive informed decision-making, policy development, and targeted interventions that address the root causes of health disparities. This underscores NACHC's belief in the transformative potential of SDOH data in building healthier, more equitable communities.
See attached letter of support containing comments on data elements across USCDI submissions and versions.
2023-09-20 NACHC USCDIv5 Letter of Support_11.pdf