Six Standards Advance as Part of SVAP 2023

Robert Anthony | July 12, 2023

ONC has now published the Approved Standards for 2023 (2023 SVAP standards) as part of ONC’s annual Standards Version Advancement Process (SVAP). The SVAP is designed to make the ONC Health IT Certification Program (the Program) responsive to industry needs and better aligned with standards version advancement. The SVAP helps expedite the use of newer versions of standards under the Program and improves the ability of health IT developers to provide relevant, timely, and innovative solutions to their clients.

Beginning September 11, 2023, health IT developers participating in the Program can voluntarily incorporate new versions of standards approved by the national coordinator into their certified Health IT Modules. To support implementation of the new 2023 SVAP standards, ONC will update the associated test data and tools, including the Cypress Testing Tool, the Edge Test Tool’s (ETT) C-CDA validators and the Inferno Framework’s “g.10 Standardized API Test Kit” by December 31, 2023.

Developers with products already certified to one or more certification criteria that include SVAP standards can advance to any of the 2023 SVAP standards without testing by informing their ONC-Approved Certification Bodies and their customers. However, developers wanting to certify a new product directly to one of the 2023 SVAP standards will have to wait until updated test tools are available in December 2023. Developers must also include all SVAP standard(s) in their upcoming Real World Testing plans.

For more information on the approved 2023 SVAP standards and their associated certification criteria, please see the 2023 SVAP Fact Sheet.

Notable Updates and Background on the 2023 Approved SVAP Standards

The Approved SVAP Standards for 2023 include the advancement of six standards. The United States Core Data for Interoperability version 3 (USCDI v3) is among the notable standards approved for the 2023 SVAP cycle, as are three HL7 standards related to C-CDA, FHIR, and QRDA. USCDI v3 will advance important health equity work via key patient demographic data and will be included in two of the HL7 standards. Also included in the 2023 SVAP cycle are annual updates of the CMS Implementation Guides for Quality Reporting Document Architecture (QRDA) (Categories I & III).

USCDI v3 is a set of standardized health data elements that are intended to improve the accuracy, completeness, and consistency of health information exchanged between different health IT systems. This version includes several updates and expansions to the previous version, USCDI version 2 (USCDI v2). The key changes in USCDI v3 include the addition of new data elements related to social determinants of health such as race, ethnicity, and language preference. There are also several new data elements related to clinical care such as allergies, adverse reactions, and immunizations. USCDI v3 also includes updates to existing data elements such as adding new value sets for laboratory tests and updating codes for medications. Additionally, the standard includes new guidance on how to use the data elements in a standardized way to improve interoperability between different healthcare systems.

The two HL7 standards that incorporate USCDI v3 include the HL7® CDA R2 Implementation Guide: C-CDA Templates for Clinical Notes Release 4.1-US and the HL7® FHIR® US Core Implementation Guide STU 6.1.0.  These standards will continue to guide industry toward consistent implementation of USCDI v3.

Other notable updates include the Centers for Medicare & Medicaid Services (CMS) QRDA Category I and III Implementation Guides included in the criterion to support CMS’ Hospital Inpatient Quality Reporting and the Medicare Promoting Interoperability Programs reporting requirements. Because of different reporting and publishing timelines, the SVAP advancement of new versions of the CMS QRDA Implementation Guides will always lag approximately six months behind CMS publication.

Coinciding with the annual advancement of the CMS QRDA Category I and III Implementation Guides (IGs), ONC, for the first time, has approved the HL7 QRDA I IG. This standard leverages the SVAP’s annual advancement process to ensure that developers maintain adherence to individual quality measures in CMS’ Promoting Interoperability reporting requirements.

Please make sure to review the SVAP Fact Sheet for more information on the Standards Version Advancement Process and how Certified Health IT developers can voluntarily update to these newer versions of adopted standards.

Approved Standards for 2023

United States Core Data for Interoperability (USCDI), Version 3, October 2022 Errata

HL7® FHIR® US Core Implementation Guide STU 6.1.0, June 30, 2023

HL7 CDA® R2 Implementation Guide: C-CDA Templates for Clinical Notes R2.1 Companion Guide, Release 4.1 – US Realm, June 2023

HL7 CDA® R2 Implementation Guide: Quality Reporting Document Architecture – Category I (QRDA I); Release 1, STU Release 5.3 with Errata – US Realm, December 2022

CMS Implementation Guide for Quality Reporting Document Architecture: Category I; Hospital Quality Reporting; Implementation Guide for 2023

CMS Implementation Guide for Quality Reporting Document Architecture: Category III; Eligible Clinicians and Eligible Professionals Programs; Implementation Guide for 2023