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 about 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.
-
- Usage note: Clinical Notes data elements are content exchange standard agnostic. They should not be interpreted or associated with the structured document templates that may share the same name.
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.
Data used to categorize individuals for identification, records matching, and other purposes.
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.
Unique identifier(s) for a patient's implantable device(s).
Physiologic measurements of a patient that indicate the status of the body’s life sustaining functions.
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 about 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.
-
- Usage note: Clinical Notes data elements are content exchange standard agnostic. They should not be interpreted or associated with the structured document templates that may share the same name.
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.
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.
Representing a patient’s smoking behavior.
Unique identifier(s) for a patient's implantable device(s).
Physiologic measurements of a patient that indicate the status of the body’s life sustaining functions.
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 about 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.
-
- Usage note: Clinical Notes data elements are content exchange standard agnostic. They should not be interpreted or associated with the structured document templates that may share the same name.
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.
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.
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.
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.
Unique identifier(s) for a patient's implantable device(s).
Physiologic measurements of a patient that indicate the status of the body’s life sustaining functions.
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 about 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.
-
- Usage note: Clinical Notes data elements are content exchange standard agnostic. They should not be interpreted or associated with the structured document templates that may share the same name.
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.
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.
Record of vaccine administration.
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.
Data used to categorize individuals for identification, records matching, and other purposes.
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.
Physiologic measurements of a patient that indicate the status of the body’s life sustaining functions.
USCDI V5
USCDI v5 was published on July 16, 2024, and includes 16 new data elements and two new data classes. Please read the USCDI v5 standard document and the ONC Standards Bulletin 24-2 for details.
Harmful or undesired physiological responses associated with exposure to a substance.
Information about 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.
-
- Usage note: Clinical Notes data elements are content exchange standard agnostic. They should not be interpreted or associated with the structured document templates that may share the same name.
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.
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.
Record of vaccine administration.
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.
Findings or other clinical data collected about a patient during care.
Provider-authored request for the delivery of patient care services.
Data used to categorize individuals for identification, records matching, and other purposes.
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.
Physiologic measurements of a patient that indicate the status of the body’s life sustaining functions.
Draft USCDI V6
ASTP/ONC published Draft USCDI v6 on January 14, 2025, and proposes to add 6 new data elements. Please read the Draft USCDI v6 standard document and the ASTP Standards Bulletin 25-1 for details. ASTP/ONC is accepting comments here through May 12, 2025, at 11:59 PM ET.
Harmful or undesired physiological responses associated with exposure to a substance.
Information about 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.
-
- Usage note: Clinical Notes data elements are content exchange standard agnostic. They should not be interpreted or associated with the structured document templates that may share the same name.
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.
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.
Record of vaccine administration.
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.
Findings or other clinical data collected about a patient during care.
Provider-authored request for the delivery of patient care services.
Data used to categorize individuals for identification, records matching, and other purposes.
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.
Physiologic measurements of a patient that indicate the status of the body’s life sustaining functions.
- 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.
Material substance originating from a biological entity intended to be transplanted or infused into another (possibly the same) biological entity.
Tests that result in visual images requiring interpretation by a credentialed professional.
Physical place of available services or resources.
Data related to an individual’s insurance coverage for health care.
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.
Provider-authored request for the delivery of patient care services.
Data used to categorize individuals for identification, records matching, and other purposes.
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.
Physiologic measurements of a patient that indicate the status of the body’s life sustaining functions.
- 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.
Narrative patient data relevant to the context identified by note types.
-
- Usage note: Clinical Notes data elements are content exchange standard agnostic. They should not be interpreted or associated with the structured document templates that may share the same name.
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.
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.
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.
- 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
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 about 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.
-
- Usage note: Clinical Notes data elements are content exchange standard agnostic. They should not be interpreted or associated with the structured document templates that may share the same name.
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.
Health data as reflected in a patient's Explanation of Benefits (EOB) statements, typically derived from claims and other administrative data.
Desired state to be achieved by a patient.
Desired state to be achieved by a person or a person’s elections to guide care.
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.
Record of vaccine administration.
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.
Findings or other clinical data collected about a patient during care.
Provider-authored request for the delivery of patient care services.
Data used to categorize individuals for identification, records matching, and other purposes.
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.
Physiologic measurements of a patient that indicate the status of the body’s life sustaining functions.
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
Submitted by erjones on
Vizient Comments on Draft USCDI Version 5
Please see attached for comments on USCDI v 5 from Vizient.
Submitted by zhornbe on
AdvaMed Imaging Division comments on USCDI version 5
The AdvaMed Medical Imaging Division represents the manufacturers of medical imaging
equipment, including, magnetic resonance imaging (MRI), medical X-Ray equipment, computed
tomography (CT) scanners, ultrasound, nuclear imaging, radiopharmaceuticals, and imaging
information systems. Our members have introduced innovative medical imaging technologies for
use by healthcare providers, and they play an essential role in our nation’s health care infrastructure
and the care pathways of screening, staging, evaluating, managing, and effectively treating patients
with cancer, heart disease, neurological degeneration, COVID-19, and numerous other medical
conditions.
We are encouraged to see the Office of the National Coordinator for Health Information
Technology (ONC) continue its work to improve USCDI and enhance interoperability in
healthcare—a goal our members share. We submit the attached comments and recommendations in
support of that shared goal.
Submitted by acepregulatory on
ACEP Comments on USCDI v5
April 15, 2024
Micky Tripathi, PhD, MPP
National Coordinator
Office of the National Coordinator for Health Information Technology (ONC)
Department of Health and Human Services
Hubert Humphrey Building, Suite 729
200 Independence Avenue SW
Washington, DC 20201
RE: United States Core Data for Interoperability (USCDI) Version 5 Draft
Dear Coordinator Tripathi:
On behalf of our nearly 40,000 members, the American College of Emergency Physicians (ACEP) appreciates the opportunity to comment on version 5 of the United States Core Data for Interoperability (USCDIv5).
ACEP believes that it is important to establish a foundation of standards to build interoperable electronic health information that supports patient care across health systems and supports the idea of a common data framework specifically for quality measurement by centering the data elements that are critical for measure development. Increased interoperability and ease of quality measurement will reduce administrative burden on emergency physicians and other health care professionals, allowing delivery of the highest quality of patient care to remain our focus. We offer the following specific comments on the data elements most pertinent to emergency physicians and their patients.
Emergency Department Note
ONC proposes to incorporate a new data element, “Emergency Department Note,” that summarizes the care delivered in the emergency department (ED) to distinguish data from other Progress Notes, for the purposes of coordination of care and care continuity.
ACEP agrees with the rationale of the submission that these clinical notes may be particularly useful in supporting the ONC goals of addressing needs of underserved communities and public health interoperability needs related to emergency response and concurs that ED notes represent a unique and critical connection between inpatient and outpatient care settings that can provide additional information regarding patients’ health status at the presentation for care to inform care pathways. However, in its proposed form, the data element is very loosely defined; there is no differentiation between notes entered in triage, by a nurse, or by the emergency clinician, nor is there metadata such as time of note creation associated with the data element. These additions would better facilitate the use of natural language processing and other tools to digitally capture structured clinical data from the note. These data points are imperative to interpreting the notes and determining outcomes testing and improvement.
Restrictions on Use and Privacy Concerns
ONC states that they are unaware of any restrictions on data use and that the Centers for Medicare and Medicaid Services (CMS) and ONC govern current processes to securely transfer this data. Though CMS and ONC have processes for secure transfer of data, there remain significant barriers to access of ED Notes, as well as all other clinical data from certain hospitals for clinical registry and data reporting purposes. Both technical and administrative barriers can prolong data acquisition for months to even years. ONC should consider establishing standards for legal and administrative requirements necessary to access electronic health record (HER) data securely for the purposes of data reporting.
Implementation Challenges
ONC states that they do not anticipate any challenges on data standardization as ED notes are “regularly captured” and exchanged as part of EHR systems. ACEP disagrees with this assessment. EHR implementation is varied across health systems; notes are stored in multiple formats, rendering incompatibility with accurate and precise data abstraction (e.g., a discharge summary in the form of PDF/flat file is difficult to utilize for measure calculation). Further, the method by which clinicians capture notes is not standardized – some clinicians use layman’s terms versus medical vocabulary, verbal note dictation versus written notes – and a wide array of artificial intelligence (AI) note-taking tools with variable language models are becoming more available. Given the rapidly changing AI landscape compared to the proposed timeline for USCDIv5 implementation, as best practices for clinician note-taking to facilitate natural language processing and data abstraction continue to be developed and explored, definitive standardization based on current note-taking processes could cause future incongruence between standards and practice.
Clinical Tests
Data elements capturing Clinical Tests continue to be constrained to three measures, lacking the granularity necessary to fully analyze the results and impact of the clinical tests. Therefore, we request an expanded level of data capture for the Encounter Information, Medication (e.g., segregation of medications by home medications, ED administered and prescribed), Clinical Tests, and Procedures (individual sections for orders and results) sections. Precise and accurate measure calculation, clinician attribution, and research of emergent clinical quality care gaps will be severely restricted if these limited measurements are the data baseline.
We note that the Clinical Tests data element has not been updated from the current version of USCDI (USCDI v3) being implemented across the health information technology community. As USCDI v3 continues to be implemented, our members have found that there is an overlap in this data element and other elements, leading to improper standardization. To most effectively fulfill the goals of ONC, focus should be set on proper realization of the most current, standardized version of USCDI. As the versions of USCDI build upon each other, comments on v5 may be premature before effective standardization and implementation of the current version.
We appreciate the opportunity to provide comments. If you have any questions, please contact Erin Grossmann, ACEP’s Manager of Regulatory and External Affairs, at egrossmann@acep.org.
Sincerely,
Aisha T. Terry, MD, MPH, FACEP
ACEP President
Submitted by knicholoff@ehra.org on
EHR Association Comments on Draft USCDI v5
On behalf of our 29 member companies, the HIMSS Electronic Health Record (EHR) Association appreciates the opportunity to provide feedback to the ONC on the Draft USCDI v5. Our comments are attached.
Submitted by rclark@carequest.org on
CareQuest Comments on Referral Data Element for USCDI Version 5
CareQuest Institute for Oral Health recommends creating a separate data class for Referral with its own data elements including Reason for Referral. A referral can also be an intervention as part of a patient’s treatment plan to address a health problem or diagnosis. When a CCD document is generated and shared externally, a referral should display as part of the patient’s treatment plan or order to request additional care and is not always a procedure that was completed as part of the provision of care from that visit.
Health records are also sent to HIEs or are exchanged with other entities such as QHINS, QIOs to be made available to the patient’s care team when requested. It would be helpful to have additional information included about the referral to provide more context to the care team member reviewing the summary of care document. This will also better support coordination of care for both the Primary Care providers as well as other specialties such as Oral Health providers.
In most cases, this may be the only record to which a provider would have access. Therefore, data elements in the USCDI should also furnish the provider with enough information to administer the appropriate service that is needed, thereby closing the loop on the referral.
For broader sharing of electronic health information and to be inclusive of all specialties such as Oral Health, the USCDI is critical toward establishing the basic standards to support both patient care and care coordination for all providers in a community.
Submitted by saneel.vasram@… on
CodeX FHIR Community Comments on Draft USCDI Version 5
The following comments have been submitted on behalf of the CodeX HL7 FHIR Accelerator Program’s Community Members. CodeX is a member-driven HL7 FHIR Accelerator hosting a growing community working together to enable FHIR-based interoperability that drives substantial improvements around the most important challenges and opportunities in patient health focusing on clinical specialties and real-world implementation. CodeX brings over 60 organizations together to provide an open, transparent, and non-biased community for standards development and implementation.
We are happy to provide comments through this process and welcome the opportunity to work with ONC on USCDI to enhance support for clinical specialties in HL7 FHIR.
Further information can be found at codex.hl7.org.
Submitted by Solarf3050 on
HL7 Comments on Draft USCDI Version 5
Comments from Health Level Seven International (HL7) regarding the Draft USCDI v5 and related new data classes and elements is attached. Thank you for the opportunity to provide feedback!
Submitted by ejones@nfprha.org on
Support for Adding SINC Data Element to UCSDI, Version 5
The National Family Planning & Reproductive Health Association (NFPRHA) is pleased to express its strong support for the University of California, San Francisco (UCSF) Person-Centered Reproductive Health Program’s submission to add the Self-Identified Need for Contraception (SINC) data element into the US Core Data for Interoperability (USCDI) set. Providing individuals who do not desire to become pregnant with access to contraceptive services is an essential component of a high-quality health care system that optimizes reproductive health and wellness. By including the SINC data element in the USCDI – which defines what data elements are available for interoperable health information exchange through certified electronic health records (EHRs) – and systemizing how patients’ desires for contraceptive services are captured in clinical settings, the U.S. will be one step closer towards improving contraceptive care delivery for all who want and need it. Access to high-quality contraceptive services has the potential to advance health equity, which is one of the key and enduring challenges for health care providers in the safety net.
As a non-partisan, nonprofit membership association whose mission is to advance and elevate the importance of family planning in the nation’s health care system and promote and support the work of family planning providers and administrators, especially in the safety net, NFPRHA is well-positioned to provide comment in support of adding the SINC data element to the USCDI set. NFPRHA’s membership includes more than 1,000 members that operate or fund more than 3,500 health centers that deliver high-quality family planning and sexual health services to millions of people every year in the U.S. NFPRHA represents the broad spectrum of publicly funded family planning providers including state and local health departments, hospitals, family planning councils, federally qualified health centers, Planned Parenthood affiliates, and other private non-profit agencies. These organizational members include 61 of the 79 grantee organizations currently funded by the US Office of Population Affairs (OPA) through the Title X family planning program, as well as other providers in the family planning safety net.
Improving contraceptive care delivery in the US is especially important given that the provision of such services has a history partially rooted in reproductive coercion and a fundamental devaluing of the bodily autonomy of people of color and those with no or low incomes. Asking about contraception and pregnancy prevention in health care settings carries the weight of this history. Therefore, NFPRHA believes it is critical that screening for contraceptive need is done in a manner that does not inadvertently perpetuate harm by communicating a sense of expectation or pressure to use contraception. The SINC question is a tool that supports health care providers to center patients’ own preferences and needs related to reproduction. Developed by the Person-Centered Reproductive Health Program at UCSF in consultation with race equity and Reproductive Justice leaders, the SINC screening tool – which consists of a primary question, “Do you want to talk about contraception or pregnancy prevention during your visit today,” and follow-up prompt – assesses whether the patient would like contraceptive care services as part of that day’s visit. By prioritizing that each patient receives the services they want and need as part of their visit, the SINC screening tool represents a welcome shift away from the traditional, potentially harmful approach of assessing patients’ service needs using a triangulated approach of categorizing them as “at risk” of unintended pregnancy based on factors that may or may not be relevant.
For these reasons, as well as the fact that the SINC screening tool can be used to define the denominator for an electronic Clinical Quality Measure (eCQM) of contraceptive provision and access, OPA has included SINC as an optional data element in FPAR 2.0, the new set of data elements for federal reporting of the Title X program. In response, SINC already is available for use in several EHR systems, such as OCHIN Epic and eClinical Works, and already is being used by large health care organizations and health departments, including Planned Parenthood affiliates and large municipal health departments. NFPRHA believes that all safety-net providers that receive Title X funding should have access to this data element as a standard element in their EHR systems. Should the Office of the National Coordinator for Health Information Technology (ONC) elect not to include the SINC data element in the USCDI set, Version 5, a subset of Title X providers may need to spend some of their limited resources to modify existing EHR systems to integrate the SINC data element into patient-centered clinical workflows and report SINC data to the federal government.
NFPRHA greatly appreciates the opportunity to provide comments to the ONC in support of the SINC data element. Furthermore, NFPRHA looks forward to partnering with UCSF and its partners, including OPA, to promote the uptake and widespread use of the SINC screening tool in clinical settings. If you require additional information about the issues raised in this letter, please contact Elizabeth Jones, Senior Director, Program, at ejones@nfprha.org.
Sincerely,
Clare Coleman
President & CEO, National Family Planning & Reproductive Health Association
Submitted by LisaRNelsonRI on
USCDI V5 Feedback
Thank you for the opportunity to submit feedback on USCDI V5 and on the USCDI framework in general. I appreciate the opportunity to contribute to this important national initiative.
Submitted by hbuitendijk on
USCDI v5 Proposal Feedback
Attached please find Oracle Health's feedback to the USCDI v5 proposed data elements.
USCDI v5 Draft - Response - Oracle.pdf