United States Core Data for Interoperability (USCDI)

The United States Core Data for Interoperability (USCDI) is a standardized set of health data classes and constituent data elements for nationwide, interoperable health information exchange. Review the USCDI Fact Sheet to learn more.

A USCDI Data Class is an aggregation of Data Elements by a common theme or use case.

A USCDI Data Element is a piece of data defined in USCDI for access, exchange or use of electronic health information.  

USCDI ONC New Data Element & Class (ONDEC) Submission System

With the publication of Draft USCDI v4, ONC is accepting feedback on its content until April 17, 2023. ONC plans on releasing a final USCDI v4 in July 2023.

USCDI V1

Please reference the USCDI version 1 document to the left for applicable standards versions associated with USCDI v1.

Harmful or undesired physiological responses associated with exposure to a substance.

Health professional’s conclusions and working assumptions that will guide treatment of the patient.

Information on a person who participates or is expected to participate in the care of a patient.

Desired state to be achieved by a patient.

Health related matter that is of interest, importance, or worry to someone who may be the patient, patient’s family or patient’s health care provider.

Record of vaccine administration.

Analysis of clinical specimens to obtain information about the health of a patient.

Pharmacologic agents used in the diagnosis, cure, mitigation, treatment, or prevention of disease.

Condition, diagnosis, or reason for seeking medical attention.

Activity performed for or on a patient as part of the provision of care.

Metadata, or data that describes other data.

Representing a patient’s smoking behavior.

USCDI V2

The USCDI v2 contains data classes and elements from USCDI v1 and new data classes and elements submitted through the ONDEC system. Please reference the USCDI Version 2 document to the left for applicable vocabulary standards versions associated with USCDI v2 and to the ONC Standards Bulletin 21-3 for more information about the process to develop USCDI v2 and future versions.

Harmful or undesired physiological responses associated with exposure to a substance.

Health professional’s conclusions and working assumptions that will guide treatment of the patient.

Information on a person who participates or is expected to participate in the care of a patient.

Narrative patient data relevant to the context identified by note types.

Non-imaging and non-laboratory tests performed that result in structured or unstructured findings specific to the patient to facilitate the diagnosis and management of conditions. (e.g., electrocardiogram (ECG), visual acuity exam, macular exam, or graded exercise testing (GXT))

Tests that result in visual images requiring interpretation by a credentialed professional.

Information related to interactions between healthcare providers and a patient.

Desired state to be achieved by a patient.

Health related matter that is of interest, importance, or worry to someone who may be the patient, patient’s family or patient’s health care provider.

Record of vaccine administration.

Analysis of clinical specimens to obtain information about the health of a patient.

Pharmacologic agents used in the diagnosis, cure, mitigation, treatment, or prevention of disease.

Condition, diagnosis, or reason for seeking medical attention.

Activity performed for or on a patient as part of the provision of care.

Metadata, or data that describes other data.

Representing a patient’s smoking behavior.

USCDI V3

USCDI v3 contains data classes and elements from USCDI v2 and new data classes and elements submitted through the ONDEC system. Please reference the USCDI Version 3 document to the left for applicable vocabulary standards versions associated with USCDI v3 and to the ONC Standards Bulletin 22-2 for more information about the process to develop USCDI v3 and future versions.

Harmful or undesired physiological responses associated with exposure to a substance.

Health professional’s conclusions and working assumptions that will guide treatment of the patient.

Information on a person who participates or is expected to participate in the care of a patient.

Narrative patient data relevant to the context identified by note types.

Non-imaging and non-laboratory tests performed that result in structured or unstructured findings specific to the patient to facilitate the diagnosis and management of conditions. (e.g., electrocardiogram (ECG), visual acuity exam, macular exam, or graded exercise testing (GXT))

Tests that result in visual images requiring interpretation by a credentialed professional.

Information related to interactions between healthcare providers and a patient.

Desired state to be achieved by a patient.

Assessments of a health-related matter of interest, importance, or worry to a patient, patient’s family, or patient’s healthcare provider that could identify a need, problem, or condition.

Record of vaccine administration.

Analysis of clinical specimens to obtain information about the health of a patient.

Pharmacologic agents used in the diagnosis, cure, mitigation, treatment, or prevention of disease.

Condition, diagnosis, or reason for seeking medical attention.

Activity performed for or on a patient as part of the provision of care.

Metadata, or data that describes other data.

Draft USCDI V4

Draft USCDI v4 includes USCDI v3, 20 new data elements, and one new data class as indicated by the new data element. Please reference the  Draft USCDI v4 document and the ONC Standards Bulletin 23-1 for more information. ONC is accepting feedback through comments on this website through Monday, April 17, 2023 at 11:59 p.m. Eastern time.

Harmful or undesired physiological responses associated with exposure to a substance.

Information on a person who participates or is expected to participate in the care of a patient.

Narrative patient data relevant to the context identified by note types.

Non-imaging and non-laboratory tests performed that result in structured or unstructured findings specific to the patient to facilitate the diagnosis and management of conditions. (e.g., electrocardiogram (ECG), visual acuity exam, macular exam, or graded exercise testing (GXT))

Tests that result in visual images requiring interpretation by a credentialed professional.

Information related to interactions between healthcare providers and a patient.

Physical place of available services or resources.

Assessments of a health-related matter of interest, importance, or worry to a patient, patient’s family, or patient’s healthcare provider that could identify a need, problem, or condition.

Record of vaccine administration.

An instrument, machine, appliance, implant, software or other article intended to be used for a medical purpose.

Pharmacologic agents used in the diagnosis, cure, mitigation, treatment, or prevention of disease.

Conclusions and working assumptions that will guide treatment of the patient, and recommendations for future treatment.

Condition, diagnosis, or reason for seeking medical attention.

Activity performed for or on a patient as part of the provision of care.

Metadata, or data that describes other data.

In addition to “Comment” and “Level 1” criteria, Level 2 data elements demonstrate extensive existing use in systems and exchange between systems, and use cases that show significant value to current and potential users. These data elements would clearly improve nationwide interoperability. Any burdens or challenges would be reasonable to overcome relative to the overall impact of the data elements.

Level 2

Harmful or undesired physiological responses associated with exposure to a substance.

Material substance originating from a biological entity intended to be transplanted or infused into another (possibly the same) biological entity.

Information on a person who participates or is expected to participate in the care of a patient.

Tests that result in visual images requiring interpretation by a credentialed professional.

Information related to interactions between healthcare providers and a patient.

Assessments of a health-related matter of interest, importance, or worry to a patient, patient’s family, or patient’s healthcare provider that could identify a need, problem, or condition.

Conclusions and working assumptions that will guide treatment of the patient, and recommendations for future treatment.

Condition, diagnosis, or reason for seeking medical attention.

Activity performed for or on a patient as part of the provision of care.

Metadata, or data that describes other data.

Physiologic measurements of a patient that indicate the status of the body’s life sustaining functions.

In addition to “Comment” level criteria, Level 1 data elements demonstrate limited existing use in electronic systems, limited exchange between systems and more well-defined use cases and value to potential users. There may still be some burdens associated with development and implementation.

Level 1

Material substance originating from a biological entity intended to be transplanted or infused into another (possibly the same) biological entity.

Narrative patient data relevant to the context identified by note types.

Analysis of clinical specimens to obtain information about the health of a patient.

Pharmacologic agents used in the diagnosis, cure, mitigation, treatment, or prevention of disease.

Metadata, or data that describes other data.

Physiologic measurements of a patient that indicate the status of the body’s life sustaining functions.

A data element designated as "Comment" level is represented by health care standard terminology such as SNOMED CT® or implementation specifications such as HL7® FHIR® 4. It may not have a well-defined use case or value to potential users. There may be significant or unknown burdens associated with development or implementation.

Comment

Material substance originating from a biological entity intended to be transplanted or infused into another (possibly the same) biological entity.

Information on a person who participates or is expected to participate in the care of a patient.

Non-imaging and non-laboratory tests performed that result in structured or unstructured findings specific to the patient to facilitate the diagnosis and management of conditions. (e.g., electrocardiogram (ECG), visual acuity exam, macular exam, or graded exercise testing (GXT))

Tests that result in visual images requiring interpretation by a credentialed professional.

Desired state to be achieved by a patient.

Analysis of clinical specimens to obtain information about the health of a patient.

An instrument, machine, appliance, implant, software or other article intended to be used for a medical purpose.

Pharmacologic agents used in the diagnosis, cure, mitigation, treatment, or prevention of disease.

Conclusions and working assumptions that will guide treatment of the patient, and recommendations for future treatment.

Condition, diagnosis, or reason for seeking medical attention.

Activity performed for or on a patient as part of the provision of care.

For data class description and applicable standards supporting data elements, click to view the USCDI Version 1 (July 2020 errata) in PDF format below. 

Previous USCDI Versions

The USCDI ONC New Data Element and Class (ONDEC) Submission System supports a predictable, transparent, and collaborative process, allowing health IT stakeholders to submit new data elements and classes for future versions of USCDI. Click here for more information and to submit new data elements.

The USCDI standard will follow the Standards Version Advancement Process described in the Cures rule to allow health IT developers to update their systems to newer version of USCDI and provide these updates to their customers.

Comment

American Medical Informatics Association

Public Comment Letter attached from the American Medical Informatics Association 

AMIA USCDIv4 draft comments.pdf

NCQA USCDI v4 Comment Letter

The National Committee for Quality Assurance (NCQA) thanks you for the opportunity to comment on USCDI version 4. Our detailed comments are attached.

NCQA USCDI v4 Comment Letter.pdf

Allina Health comments on USCDI draft v4

On behalf of Allina Health, I am writing in response to the Draft Version 4 of the United States Core Data for Interoperability (USCDI) standards. Overall, we appreciate The Office of the National Coordinator for Health Information Technology’s (ONC) continued efforts with stakeholder outreach to help progress toward standardizing certain data elements in pursuit of an improved interoperable exchange of health information. Please see the attached document for the entirety of our comments. 

2023 04 17 USCDI v4 Comment Letter FINAL.pdf

ACLA Comments on Draft USCDI v4

The American Clinical Laboratory Association (ACLA)  appreciates the opportunity to comment on the draft of USCDI version 4.  ACLA is the national trade association representing leading laboratories that deliver essential diagnostic health information to patients and providers. ACLA members are at the forefront of driving diagnostic innovation to meet the country’s evolving health care needs and provide vital clinical laboratory tests that identify and prevent infectious, acute, and chronic disease.  ACLA works to advance the next generation of health care delivery through policies that expand access to lifesaving testing services. ACLA applauds the Office of the National Coordinator in releasing the Draft in order to further advance health information technology (HIT) interoperability, a critical and vital goal for improving the quality of care for patients. ACLA member laboratories appreciate the opportunity to comment on the Draft and hope these comments serve to continue to move interoperability forward. We thank the ONC for its consideration of our comments.

ACLA Final Comments USCDI V4_04.17.2023.pdf

USCDI Comments for Workers Compensation

This field is for general comments on the USCDI. To submit new USCDI data classes and/or data elements, please use the USCDI ONDEC system: https://healthit.gov/ONDEC

2023_04_17_Federal HIE Comments.pdf

CMS-CCSQ/CDC Joint Priorities for USCDI v4

Attached please find the CMS-CCSQ and CDC joint priority data elements and rationale for consideration for USCDI v4. Thank you for the opportunity to review and provide comment.

USCDIv4_CMS-CDC Joint Comment letter.pdf

CMS-CCSQ Priorities for USCDI v4

Attached please find CMS-CCSQ's priority data elements and rationale for consideration for USCDI v4.

CMS-CCSQ USCDI V4 Public Comment Letter.pdf

American Society of Anesthesiologists Comments on Draft USCDI v4

Please see the attached comments from the American Society of Anesthesiologists on the draft USCDI v4. Thank you for your consideration of our comments.

2023-04-17 ASA_USCDI v4 Comment Letter_1.pdf

Attached please find AHIP's…

Attached please find AHIP's comments on USCDI version 4.  Thank you for the opportunity to comment. 

AHIP Comments on USCDI V4_FINAL.pdf

ANI Comments

Please see the attached document for comments from the Alliance for Nursing Informatics.

ANI Comments on USCDI v4_FINAL.pdf