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I am trying to map clinical data specifically social history ( alcohol use, drug use, living environment etc.) to FHIR. I am unable to find an example for the same on FHIR documentation. Only useful guidance I was able to find it that Social History gets mapped to Observation.

Any help in this regards would be great.

Thanks Gaurav

Gaurav Daga
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3 Answers3

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On FHIR standards, the social history is a part of the resource Observation.

Uses for the Observation resource include:

  • Vital signs such as body weight, blood pressure, and temperature
  • Laboratory Data like blood glucose, or an estimated GFR
  • Imaging results like bone density or fetal measurements
  • Clinical Findings - such as abdominal tenderness
  • Device measurements such as EKG data or Pulse Oximetry data
  • Clinical assessment tools such as APGAR or a Glasgow Coma Score
  • Personal characteristics: such as eye-color
  • Social history like tobacco use, family support, or cognitive status
  • Core characteristics like pregnancy status, or a death assertion

The following Observations show examples of social history observations:

Flavio Wuensche
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Unfortunately we don't have any examples of this yet in the FHIR. A social history would actually be captured using List and the List would then point to Observation for all of the relevant (and current) statements you want to make in the social history (employment, disability, living arrangement, etc). You might look at the family history examples on List, with a recognition that you'll generally be pointing to Observation instances instead of FamilyMemberHistory instances. (You can also submit a change request asking for social history to be added as an example to List.)

Lloyd McKenzie
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With the help from Michelle Miller and Eric Haas, I was able to locate Social History examples. Below here is the link : http://hl7.org/fhir/us/core/Observation-some-day-smoker.json.html

[In case link is broken in future, below here cut-paste of the same ]

{ "resourceType" : "Observation", "id" : "some-day-smoker", "status" : "final", "category" : [ { "coding" : [ { "system" : "http://hl7.org/fhir/observation-category", "code" : "social-history", "display" : "Social History" } ], "text" : "Social History" } ], "code" : { "coding" : [ { "system" : "http://loinc.org", "code" : "72166-2", "display" : "Tobacco smoking status" } ], "text" : "Tobacco smoking status" }, "subject" : { "reference" : "Patient/example", "display" : "Amy Shaw" }, "issued" : "2016-03-18T05:27:04Z", "valueCodeableConcept" : { "coding" : [ { "system" : "http://snomed.info/sct", "code" : "428041000124106", "display" : "Current some day smoker" } ], "text" : "Current some day smoker" } }

Hope this helps

Gaurav Daga
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