ONC has established the voluntary Standards Version Advancement Process (SVAP)1 to enable health IT developers’ ability to incorporate newer versions of Secretary-adopted standards and implementation specifications, as part of the “Real World Testing” Condition and Maintenance of Certification requirement (§ 170.405) of the 21st Century Cures Act. For the latest information on the approved standards for use, see the ONC Health IT Certification Program SVAP page.
Every year, working with industry stakeholders, ASTP follows a collaborative process to identify newer versions of adopted standards and implementation specifications for approval by the National Coordinator.
The table below lists the standards and implementation specifications (and their versions) that will be considered for advancement and those that have received National Coordinator approval via the SVAP. It does not include any minimum vocabulary standards as health IT can continue to be certified or upgraded to newer version(s) of identified minimum standard code sets, unless newer version(s) are explicitly prohibited by the Secretary. The table can be sorted by either "Current Standard/Implementation Specification" or "Regulatory Text Citation" by clicking on the column name.
For the 2025 SVAP cycle, ASTP is accepting comments on any standard that is referenced in eligible criteria.
Public comments for the 2025 SVAP cycle will be accepted through June 9.
| View / Comment | Current Standard / Implementation Specification listing in IBR (170.299) | Regulatory Text Citation for Standard / Implementation Specification Adopted Sort descending | Certification Criteria(on) References Standard / Implementation Specification | National Coordinator Approved Advanced Version(s) | View / Comment |
|---|---|---|---|---|---|
§ 170.202(a)(2) |
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§ 170.202(b) |
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§ 170.202(d) |
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§ 170.202(e)(1) |
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§ 170.204(a)(1) |
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§ 170.204(a)(2) |
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§ 170.205(a)(3) |
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§ 170.205(a)(4) |
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§ 170.205(a)(4) |
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§ 170.205(a)(5) |
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§ 170.205(a)(6) |
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§ 170.205(b)(1) |
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§ 170.205(d)(4) |
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§ 170.205(d)(4) |
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§ 170.205(e)(4) |
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§ 170.205(e)(4) |
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§ 170.205(g) |
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§ 170.205(g) |
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§ 170.205(h)(2) |
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§ 170.205(h)(3) |
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§ 170.205(i)(2) |
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§ 170.205(i)(2) |
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§ 170.205(k)(3) |
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§ 170.205(o)(1) |
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§ 170.205(p)(1) |
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§ 170.205(r)(1) |
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§ 170.205(s)(1) |
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§ 170.205(s)(1) |
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§ 170.213 |
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§ 170.213 |
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§ 170.215(a)(1) |
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§ 170.215(a)(3) |
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§ 170.215(a)(3) |
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§ 170.215(a)(4) |
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§ 170.215(b) |
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§ 170.215(b)(1) |
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§ 170.215(b)(1) |
1SVAP is permitted in ONC’s 21st Century Cures Act Final Rule in the Real World Testing CoC/MoC: § 170.405(b)(7) and (8) and ONC-ACB PoPC §170.523(t)
Comment
Submitted by Sasha_TerMaat on
Standards Version Advancement Process 2025
Thank you for the opportunity to provide feedback on the 2025 cycle of ASTP/ONC’s Standards Version Advancement Process (SVAP). Epic, as a developer of health IT, values ASTP/ONC’s collaborative feedback process when evaluating new standards and implementation specifications for industry adoption.
We request that NCPDP SCRIPT Standard Version 2023011 be allowed under SVAP for the (b)(3) Electronic Prescribing criterion. CMS Part D already allows this updated standard (CFR 423.160(b)(1)) and so ASTP/ONC should align with CMS’s requirement. Additionally, the electronic prescribing testing tool is currently in beta testing for this standard, so it is logical to add this to the list of eligible SVAP standards.
Regarding the (f)(7) Transmission to public health agencies – health care surveys criterion, we request the inclusion of Release 1.2 of the Implementation Guide as an allowed version for SVAP. Release 1.2 facilitates the collection of inpatient data, which is essential for this criterion. Previously, Release 1.2 was an allowed version per the Certification Companion Guide, and we updated our software accordingly. Although the certification companion guide indicates that Health IT modules certified using Release 1.2 may retain their certified status, developers who frequently release new versions face challenges in re-certifying using the base standard (Release 1) or the SVAP standards (Release 3 or 3.1). Few healthcare organizations use this interface, so support for Release 3 or 3.1 has not been prioritized. Without inclusion of 1.2 in SVAP, it seems that our only option is to revert to Release 1, which lacks inpatient data. We suggest that ONC maintain previous versions until a new “floor” version is required by the rule-making process.
For the (c)(3) Clinical Quality Measures – Report criterion, please include the CMS Implementation Guide for QRDA I and III for 2025. Currently, the Implementation Guides listed as eligible for SVAP are for 2023 and 2024, which are now outdated. Health IT developers update their systems annually to align with the latest implementation guide.
We are happy to answer any questions regarding our feedback and look forward to collaborating with ASTP/ONC to enhance standards-based health information exchange nationwide. Thank you for your consideration.
Submitted by Xueting on
Recommendation to Include Draft USCDI v6 Elements in SVAP
As a developer of a consumer-facing digital health platform powered by wearable devices, I strongly recommend that ONC consider including select data elements from Draft USCDI v6 in the Standards Version Advancement Process (SVAP) as early as possible.
Specifically, we urge the early inclusion of:
- Care Plan
- Unique Device Identifier (UDI) (expanded to non-implantable devices)
- Date of Onset
These elements are already supported by our platform and reflect real-world use cases across preventive health, chronic condition tracking, and patient-generated data feedback loops. While USCDI v4 is a strong foundation, it lacks semantic structures necessary to support key functionalities of modern wearable technologies—such as goal tracking, device-linked interventions, and early symptom pattern recognition.
Enabling these elements via SVAP will accelerate adoption, reduce reliance on custom interfaces, and promote interoperable patient data exchange across care settings. These v6 elements are technically mature and can meaningfully support public health goals today.
We appreciate the opportunity to provide this feedback and support ONC’s continued leadership in expanding data standards to reflect evolving patient needs and technology capabilities.
Sincerely,
Wearable Health Platform Developer
Submitted by Cardiac Imaging Inc. on
This is a great resource!!
The Standards Version Advancement Process (SVAP) is a crucial step in improving healthcare IT systems and ensuring they meet the latest standards. It's exciting to see such a structured approach to enhancing interoperability and advancing technology for better patient care. Kudos to the team for providing this clear and informative guide!
Submitted by FEHRMSVAP51 on
FEHRM Comments
The Federal Electronic Health Records Modernization (FEHRM) Program appreciates the opportunity to review and provide feedback on ONC’s 2024 SVAP. The FEHRM understands that the SVAP allows developers to incorporate newer digital health standards. The FEHRM reviewed the list of new standard versions under consideration and supports advancing:
United States Core Data for Interoperability (USCDI) version 4
Consolidated Clinical Document Architecture (C-CDA) Release 3
US Core 7.0.0
We appreciate the opportunity to comment on the SVAP. Please feel free to contact us if you have any questions or would like any further information.
Submitted by alec-matulka on
Epic Comments on SVAP 2024
Please see the attached document with Epic's feedback on SVAP 2024. Thank you for your consideration.
Submitted by Solarf3050 on
Health Level Seven SVAP Comments
Attached are the comments from Health Level Seven International on ONC’s Standards Version Advancement Process (SVAP). Thank you for the opportunity to provide feedback!
Submitted by Amanda Deering on
CDC/NIOSH - SVAP Comments 2024
Please see attached comments for consideration.
Submitted by chris.baumgart… on
WA State Department of Health - SVAP Comments
Please find attached our comments for the 2024 SVAP.
Submitted by Toni Wilken on
MEDITECH Comments on 2024 SVAP
On behalf of Medical Information Technology, Inc. (MEDITECH), thank you for the opportunity to provide feedback. Please see the attached comment letter on the 2024 Standards Version Advancement Process (SVAP).
Submitted by knicholoff@ehra.org on
EHR Association Comments on 2025 SVAP
The HIMSS Electronic Health Record (EHR) Association appreciates the opportunity to provide feedback on the 2025 Standards Version Advancement Process (SVAP). Our comments are attached.
EHR Association Comments to ASTP-ONC on 2025 Standards Version Advancement Process.pdf