Health Cloud Data Model

• Healthcare systems, such as EHRs, lab systems, and billing systems, are often built by different vendors and require a common way to communicate. HL7 provides that standard format and protocol.  
• Salesforce Health Cloud offers a comprehensive set of objects and fields that support various healthcare business processes. This model is built to represent patient, caregiver, clinical data, care plans, and provider relationships in a way that aligns with real-world healthcare workflow and standards like HL7 and FHIR.

Throughout a patient’s journey, various processes and events take place—such as scheduling appointments, receiving lab results, using medical devices during treatment, getting prescriptions, and processing insurance claims and so on. To support these processes, Salesforce provides different kind of data models that are linked together to reflect the complete healthcare experience such as:

Data Model	Description
Household Data Model	The household data model maps the relationships between patients or members and the people and organizations who participate in their care.
Clinical Data Model	The clinical data model aligns with FHIR and supports many of the HL7 message types. This data model captures information from an Electronic Health Record (EHR) system via integration middleware. It displays information commonly associated with EHRs such as patient or member encounters, chronic conditions, allergies, medications, and immunizations.
Health Insurance and Claims Data Model	The Health Insurance and Claims data model provides objects for managing the ways healthcare is paid for. These objects represent information about members and their employers, insurance coverage, and dependents. This data model includes objects for claims submitted to a member’s health insurance company by an entity or person who provides a service, medication, or device to the member.
Care Program Data Model	A Care Program is like a blueprint for treating patients who share a common condition or need such as diabetes, heath disease, post-surgery recovery or behavioral health. It includes Goals & care plans, Task and interventions, assessment, care team coordination, and patient enrollment. The Care Program data model helps you capture those activities so you can use Health Cloud to plan and track them better.
Integrated Care Management Data Model	Provides objects to store clinical data related to a patient or member’s care plans. This data model is USCDI and FHIR R4-aligned, which helps with your system’s interoperability.
Social Determinants of Health Data Model	Social Determinants of Health are non-medical factors that affect a person's overall health, like (Housing, Food security Transportation, Employment, Education Social support. These are critical to understanding and improving a patient’s health, especially for care teams managing chronic conditions or vulnerable populations. Salesforce Health Cloud helps care teams track non-medical factors like housing, food, and transportation that affect a patient’s health. It uses assessments to identify risks, creates care plans and referrals to connect patients with community services, and helps improve outcomes by addressing the whole person — not just the medical side.
Provider Data Model	The Provider data model represents healthcare providers, including individual practitioners and facilities, the network they participate in, and their specialties and credentials.
Intelligent Appointment Management Data Model	Provides objects to help you work with multiple scheduling source systems operating on different electronic health record platforms.
Utilization Management	Utilization Management (UM) is the process of reviewing and approving healthcare services to make sure they are medically necessary, appropriate, and covered by insurance before treatment is given. It includes objects like Care Request, CareRequestItem, CareRequestReviewer, etc.
Benefits Verification	Supports providers, payers, and life sciences organizations in determining patients’ insurance coverage and the benefits they are entitled to, especially for specific procedures, visits or prescriptions. It includes objects like Member (Person account), Payer (Person Account), Case (BV), Member Plan, Coverage Benefit etc.