SDOH Problem

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Approval Status

  • Approval Status: Approved
  • Example Task Force: 6/6/2024
  • SDWG C-CDA R2.1: 6/6/2024

C-CDA 2.1 Example:

  • 2.16.840.1.113883.
  • 2.16.840.1.113883.
  • 2.16.840.1.113883.
  • 2.16.840.1.113883.
  • 2.16.840.1.113883.

Reference to full CDA sample:

  • Problems in empty CCD

Validation location


  • This example illustrates how to structure an Active SDOH problem with a translation to ICD10.
  • Some systems may document active SDOH issues in the Social History Section or the Health Concerns Section. Gravity and other industry initiatives may provide additional guidance on best practices.


  • Brett Marquard, (GitHub: brettmarquard)


  • SDOH, ICD10


  • SDOH Goal


Example: download example view on GitHub

<?xml version="1.0" encoding="UTF-8"?>

	<templateId root="2.16.840.1.113883."/>
	<templateId root="2.16.840.1.113883." extension="2015-08-01"/>
	<code code="11450-4" codeSystem="2.16.840.1.113883.6.1" displayName="Problem List"/>
	<title>Problem List</title>
				<tr ID="ProblemObs1">
					<td ID="Problem1">Nutrition impaired due to limited access to healthful
						<content>Onset: March 21 2014</content>
		<act classCode="ACT" moodCode="EVN">
			<templateId root="2.16.840.1.113883."/>
			<templateId root="2.16.840.1.113883." extension="2015-08-01"/>
			<id root="102ca2e9-884c-4523-a2b4-1b6c3469c397"/>
			<code code="CONC" codeSystem="2.16.840.1.113883.5.6"/>
			<!-- Since this is an active problem, the concern status is active. -->
			<!-- While clinicians can track resolved problems, generally active problems will have active concern status and resolved concerns will be completed -->
				<reference value="#ProblemObs1"/>
			<statusCode code="active"/>
				<!-- This equates to the time the concern was authored in the patient's chart. This may frequently be an EHR timestamp-->
				<low value="2014032124536-0500"/>
			<entryRelationship typeCode="SUBJ">
				<!-- SDOH Problem -->
				<observation classCode="OBS" moodCode="EVN">
					<templateId root="2.16.840.1.113883."/>
					<templateId root="2.16.840.1.113883." extension="2015-08-01"/>
					<templateId root="2.16.840.1.113883." extension="2022-06-01"/>
					<id extension="68993" root="1.2.840.114350.1.13.6289."/>
					<id root="093A5380-00CE-11E6-B4C5-0050568B000B" extension="1.1"/>
					<code code="55607006" codeSystem="2.16.840.1.113883.6.96"
						codeSystemName="SNOMED CT" displayName="Problem">
						<translation code="75326-9" codeSystem="2.16.840.1.113883.6.1"
							codeSystemName="LOINC" displayName="Problem"/>

					<statusCode code="completed"/>
						<low value="2014032124536-0500"/>
					<value xsi:type="CD" code="445281000124101"
						displayName="Nutrition impaired due to limited access to healthful foods (finding)"
						codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT">
							<reference value="#Problem1"/>
						<translation code="Z59.48" codeSystem="2.16.840.1.113883.6.90"
							displayName="Other specified lack of adequate food"/>
					<!-- Optional Author Element-->
						<templateId root="2.16.840.1.113883."/>
						<time value="20140302124536-0500"/>
							<id extension="666545666" root="2.16.840.1.113883.4.6"/>
							<code code="363LA2100X" codeSystem="2.16.840.1.113883.6.101"
								displayName="Physician Assistants &amp; Advanced Practice Nursing Providers; Nurse Practitioner, Acute Care"/>
								<streetAddressLine>6666 StreetName St.</streetAddressLine>
								<city>Silver Spring</city>
							<telecom value="tel:+1(301)666-6666" use="WP"/>
							<!-- Optional Organization Element-->
								<id root="2.16.840.1.113883.19.5"/>
								<name>Neighborhood Physicians Practice</name>
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