Project US@ – Advancing Health Equity Requires Better Data

Carmen Smiley and Julie Pursley | August 9, 2022

One of the single greatest social determinants of health is where a patient lives.  It can determine their risk factor for a specific illness or chronic disease, such as asthma, and can also affect much broader measures of well-being and life expectancy. Thus, our ability as healthcare professionals to measure and act on such factors relies heavily on how we accurately capture and manage standardized patient addresses. The standardization of patient address data across healthcare strengthens our ability to measure the social, economic, political, and physical environments that impact health. It also improves our ability to identify and match patient records within and across health systems. Technical standards, specifications, operational guidance, and best practices must work together for handling high quality patient data to advance health equity. A health equity by design philosophy seeks to improve data integrity and better patient matching for all patients. 

The beneficial impact of address standardization on accurately matching and linking patient records was a driving force behind the 2021 launch of Project US@ (‘USA’), a unified effort to standardize patient addresses. This year, Project US@ worked with an internal resource, the HHS Equity Technical Assistance Center (ETAC), whose subject matter experts in equity reviewed Version 1.0 of the Project US@ Technical Specification and the accompanying AHIMA Companion Guide. The goal of the review was to help center equity in our work and consider specific needs of different communities, thereby ensuring that all communities benefit from the project. Central themes that emerged from the review were: 

  • Engaging and collaborating with partners as a critical way to put the value of equity into action 
  • Considering the value proposition of address matching for communities that have been marginalized by the healthcare system 
  • Ensuring that the people providing their data are treated as the rightful owners of the data and as such, are fully involved in the process of collecting, analyzing, interpreting, and using the data.  

 ONC and AHIMA are acting on these and other recommendations intended to support the advancement of health equity and improve patient matching in a number of ways: 

 We are hearing from consumer engagement subject matter experts and advocates to develop best practices and guidance for how to engage patients in their demographic data updates and maintenance to ensure the highest quality data is available when it is needed most; 

  • We are collaborating with federal agencies and industry partners to explore ways to improve the collection and management of address and other demographic data for American Indian and Alaska Native communities, active military and veteran communities, patients experiencing homelessness, and others; and 
  • We are working with subject matters experts in geolocation standards and data to explore ways to support patients experiencing homelessness, patients living in remote areas, and public health and population health efforts.  

 These and other additions will be in Version 2.0 of the Project US@ Technical Specification and the AHIMA Companion Guide, which are expected to be released in 2023.   

For more information on Project US@, see the ONC project website and AHIMA’s Policy Statement on Health Equity.   

 Attending the AHIMA22 Global Conference? Your blog authors will appear on a panel called “Connecting Technology People and Processes: Implementing ONC’s and AHIMA’s New Data Standards” on Tuesday, October 11.