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

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.

The metadata, or extra information about data, regarding who created the data and when it was created.

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.

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.

The metadata, or extra information about data, regarding who created the data and when it was created.

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.

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.

The metadata, or extra information about data, regarding who created the data and when it was created.

USCDI V4

USCDI v4 added 20 data elements and one data class to USCDI v3. Please reference the USCDI v4 standard document and the ONC Standards Bulletin 23-2 for details. To review the prioritization criteria ONC used to select the USCDI v4 data elements, refer to the ONC Standards Bulletin 22-2.

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.

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.

Desired state to be achieved by a person or a person’s elections to guide 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.

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.

The metadata, or extra information about data, regarding who created the data and when it was created.

Draft USCDI V5

Draft USCDI v5 includes 13 new data elements and two new data classes. Please reference the Draft USCDI v5 standard document and the Standards Bulletin 2024-1 for details. ONC is accepting feedback on the proposed new data elements on the Draft USCDI v5 website until Monday, April 15, 2024 at 11:59 p.m. ET. Feedback will be considered as ONC develops the final version of USCDI v5, which we anticipate publishing in July 2024.

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.

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.

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.

Desired state to be achieved by a person or a person’s elections to guide 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.

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.

Findings or other clinical data collected about a patient during care.

Provider-authored directive for the delivery of patient care services.

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.

The metadata, or extra information about data, regarding who created the data and when it was created.

Level 2 data elements meet the following criteria:
  • Represented by a terminology standard or SDO-balloted technical specification or implementation guide.
  • Data element is captured, stored, or accessed in multiple production EHRs or other HIT modules from more than one developer.
  • Data element is electronically exchanged between more than two production EHRs or other HIT modules of different developers using available interoperability standards.
  • Use cases apply to most care settings or specialties.

Level 2

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

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

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

Findings or other clinical data collected about a patient during care.

Provider-authored directive for the delivery of patient care services.

Data used to categorize individuals for identification, records matching, and other purposes.

Condition, diagnosis, or reason for seeking medical attention.

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

The metadata, or extra information about data, regarding who created the data and when it was created.

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

Level 1 data elements meet the following criteria:
  • Represented by a terminology standard or SDO-balloted technical specification or implementation guide.
  • Data element is captured, stored, or accessed in at least one production EHR or HIT module.
  • Data element is electronically exchanged between two production EHRs or other HIT modules using available interoperability standards.
  • Use cases apply to several care settings or specialties.

Level 1

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

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

Data used to categorize individuals for identification, records matching, and other purposes.

The metadata, or extra information about data, regarding who created the data and when it was created.

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

Level 0 data elements meet the following criteria:
  • Not represented by a terminology standard or SDO-balloted technical specification or implementation guide.
  • Data element is captured, stored, or accessed in limited settings such as a pilot or proof of concept demonstration.
  • Data element is electronically exchanged in limited environments, such as connectathons or pilots.
  • Use cases apply to a limited number of care settings or specialties, or data element represents a specialization of other, more general data elements.

Level 0

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.

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.

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

Findings or other clinical data collected about a patient during care.

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.

The metadata, or extra information about data, regarding who created the data and when it was created.

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

Washington DOH comments on USCDI v5

Promoting universally collected Newborn Delivery data elements:

The data class, Newborn Delivery Information has the following set of data elements that are collected universally for all institutional deliveries by every Health Care Organizations.  

  • APGAR score
  • Gestational Age at Birth
  • Pregnancy Outcome
  • Birth Weight

The given data elements are generally recorded in electronic health records (EHRs) being used by health care organizations providing obstetrics services. The values in the above elements are referenced in the assessment of childhood development and would be part of one’s personal health records. So, the elements are recommended for inclusion in the USCDI version 5.

Academy of Nutrition and Dietetics comments on USCDI v5

The Academy of Nutrition and Dietetics express its gratitude for the chance to provide feedback on USCDI v5. We have attached our comprehensive comments for your consideration. 

Academy of Nutrition and Dietetics USCDIv5 2023 Comments.pdf

American Association of Physicists in Medicine-Re:Draft USCDI v4

Attached are the American Association of Physicists in Medicine's (AAPM) comments and recommendations to further strengthen USCDI v4. Thank you for the opportunity to submit comments.

2023-06-16_AAPM-Comments_ONC-USCDI-v4_Signed.pdf

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

The TN Department of Health…

The TN Department of Health wishes to express support in Allina Health's comments, specifically related to Medication Adherence and Specimen Identifier. 

Medication Adherence: this field lends itself to potentially inaccurate information due to reliance on patient self-reporting capability. Furthermore, capturing this information in this structured data field will cause redundancy in clinician documentation that is likely occurring elsewhere in the medical record, in greater detail.

Specimen Identifier: this field in its current state presents challenges due to ambiguity and lack of a define naming convention. Recommend development of standards prior to implementation.

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