The specification suggests use of a LOINC evaluation tool to capture data and submit using SDC. While that is valuable, the examples include multiple references to components of an evaluation for each concern - e.g., Hunger-related ServiceRequest, Hunger-related Condition, Hunger-related Procedure, Hunger-related Task, etc. It would be much clearer if SDOH specified one or more FHIR Profiles that include MUST SUPPORT items to address each SDOH Domain such that the required elements can be clearly defined and include binding to established value sets. The current reference to MUST SUPPORT is too generic for clear understanding. Specific profiles might allow others to use SDOH criteria to stratify results of performance measures and to create clinical decision support recommendations.

Also, the examples information is helpful; however, if the examples included reference to the specific LOINC evaluation tool with evidence of the response code they would show how the determinants of the SDOH evaluation can be used as structured data. The examples as presented do not include codes suggesting that responses may be text strings and, therefore, not easily used for automated evaluation, CDS and measurement.