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 various Data Elements by a common theme or use case.

A USCDI “Data Element” is the most granular level at which a piece of data is exchanged.

For example, Date of Birth is a Data Element rather than its component Day, Month, or Year, because Date of Birth is the unit of exchange.

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

With the publication of USCDI v3, ONC is accepting submissions for new data elements through the ONDEC system and comments on existing data elements until September 30, 2022. ONC plans on releasing Draft USCDI v4 in January 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.

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.

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

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.

Data related to an individual’s insurance coverage for health care.

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.

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

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.

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.

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.

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.

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

Body Height

Will body height be equivalent to Body length for infants? Or will this be a separate addition later? We have these as two unique measurements. Thanks!

Body Height

Will body height be equivalent to Body length for infants? Or will this be a separate addition later? We have these as two unique measurements. Thanks!

CAP Comments on USCDI v4

The College of American Pathologists (CAP) appreciates the opportunity to comment on USCDI version 4. As the world’s largest organization of board-certified pathologists and leading provider of laboratory accreditation and proficiency testing programs, the CAP serves patients, pathologists and the public by fostering and advocating excellence in the practice of pathology and laboratory medicine. Data sharing through widely accepted standards is critical to ensure that health information is available and comprehensible across care settings for use in patient care, public health, and emergency (eg, pandemic) preparedness and response. For broader sharing of electronic health information, the USCDI is critical to establishing foundational standards to support patient care. In that spirit, the CAP recommends that USCDI align with the CLIA Test Report requirements1 in the Clinical Laboratory Improvement Amendments (CLIA) of 1988. CLIA requirements are required for clinical laboratories, and those elements should consequently be the basis for developing a foundation for the standardized sharing and reporting of laboratory information to support patient care. Aligning the USCDI with CLIA requirements will support interoperability by building on existing standards and patterns of use while avoiding contradictory or duplicative reporting requirements. Therefore, the CAP provides the following recommendations in the attached comment letter.

CAP USCDI v4 Comments.pdf

Benefits Data Trust's comments on draft USCDI v. 4

Attached please find Benefits Data Trust's comments on draft USCDI v. 4.  Thank you so much for the opportunity to submit a comment. 

BDT comment on USCDI v 4.pdf

HL7 Comments on USCDI Draft Version 4

Attached please see Health Level Seven (HL7) International's comments on ONC’s Draft United States Core Data for Interoperability (USCDI) Version 4 and related data classes standards and elements. We appreciate this on-going collaborative process and the opportunity to comment.

Master 2022 HL7 USCDI Draft v4 Consolidated Response 09.30.22.pdf

OCHIN Comments on draft USCDI Version 4.

Thank you for the opportunity to comment. Please see attached for the comments from OCHIN on consideration for version 4. 

HHS ONC Comments on draft USCDI Version 4.pdf