Activity performed for or on a patient as part of the provision of care.

Data Element

Additional Information

SDOH Interventions
A service offered to a patient to address identified Social Determinants of Health concerns, problems, or diagnoses (e.g., Education about Meals on Wheels Program, Referral to transportation support programs). SDOH data relate to conditions in which people live, learn, work, and play and their effects on health risks and outcomes.

Applicable Vocabulary Standard(s)

Applicable Standards
  • SNOMED International, Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT®) U.S. Edition, March 2021 Release
  • Current Procedural Terminology (CPT®) 2021, as maintained and distributed by the American Medical Association, for physician services and other health care services
  • Healthcare Common Procedure Coding System (HCPCS) Level II, as maintained and distributed by HHS.


NACHC, PRAPARE and Care Plans

NACHC is strongly supportive of the use of both the Goals and Interventions concepts already present in UCSDIv2 although does not agree with the proposal to break up goals into multiple data elements based on the domain of the care plan.
  • The intent of the Care Plan DAM is to normalize problem list items with other health concerns and social needs on a relatively equal footing and to refocus the care plans around the patient’s stated goals. The effect of creating a separate concept for SDOH goals undoes the intent of Goals as described by the DAM. While it seems that coded elements would improve interoperability, in fact coded goals in the sense of social services and health concerns reduces the patient-centered nature of the Goals concept and instead encourages care team members to document a generic “goal” which is not the one stated by the patient but instead the closest coded concept.
  • The use of coded terms should not be prohibited, but the emphasis of the goals field should be on the patient’s stated goals in addition to those which might be added by care team members (e.g. increased ROM to 90* or Hba1c <7)
 Please see attached document for a detailed summary of our comments on SDoH

2022-04-30 NACHC USCDIv3 Letter of Support_1.pdf

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