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
Please read the USCDI v3 standard document and the ONC Standards Bulletin 22-2 for details. Consistent with EO 14168 and OPM guidance, ASTP/ONC is exercising enforcement and issuing certification guidance for the ONC Health IT Certification Program with respect to certain data elements in USCDI v3. For more information see https://www.healthit.gov/topic/uscdi-v3-data-elements-enforcement-discretion.
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 V3.1
Please read the USCDI v3.1 standard document and the ONC Standards Bulletin 22-2 for details. USCDI version 3.1 updates USCDI version 3 with the following changes: consistent with Executive Order 14168, the Sex, Sexual Orientation, and Gender Identity data elements have been removed or updated in the Patient Demographics/Information Data Class.
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.
Information that guides 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.
Usage notes: Orders convey a provider’s intent to have a service performed on or for a patient, or to give instructions on future care.
Data used to categorize individuals for identification, records matching, and other purposes.
Information that guides 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 V6
ASTP/ONC published USCDI v6 on July 24, 2025, which includes 6 new data elements. Please read the USCDI v6 Standard Document and the ASTP/ONC Standards Bulletin 25-2 for details. ASTP/ONC welcomes input on future versions during the USCDI feedback period, open through September 29, 2025, at 11:59 PM ET. During this time, ASTP/ONC is accepting new data element submissions through ONDEC, and comments on existing data elements may be entered via the updated commenting feature on the USCDI data element pages.
Harmful or undesired physiological responses associated with exposure to a substance.
Information that guides treatment of the patient and recommendations for future treatment.
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.
Family member health condition(s) that are relevant to a patient's care.
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.
Provider-authored request for the delivery of patient care services.
Usage notes: Orders convey a provider’s intent to have a service performed on or for a patient, or to give instructions on future care.
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.
- 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.
Usage notes: Orders convey a provider’s intent to have a service performed on or for a patient, or to give instructions on future care.
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.
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.
Usage notes: Orders convey a provider’s intent to have a service performed on or for a patient, or to give instructions on future care.
Data used to categorize individuals for identification, records matching, and other purposes.
Information that guides 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 bkeeler89 on
Redox Engine Comments on Draft USCDI v2
Redox is a platform for healthcare applications to integrate to healthcare organizations regardless of EHR, as well as nationwide networks like Carequality, HIEs, and state registries. Our interest in USCDI is based on being well-positioned to see existing gaps for the most common workflows across this broad variety of stakeholders.
General comments on updates
We feel the proposed changes are appropriate but decidedly conservative and iterative. The change represents minor updates to two data classes (Care Team Members and Problems) and two net new data classes (Encounters and Imaging)
- For the updates to existing classes, we feel these should already be implicit when implemented. For instance, Problems are represented as Conditions in FHIR, which have the facet of OnsetDate already, so these updates in USCDI v2 are just prescriptive requirements to guide imprecise or careless vendors.
- In regards to the creation of Encounters class, we would expect to see this data class extended to properly encompass a patient’s outpatient appointments. With the current data class and element definitions, we do not feel that vendors will necessarily expose the Appointment resource or sufficient detail around scheduled encounters, such as scheduled provider or visit type (which may differ/be more granular than encounter type). Giving patients access and visibility into their appointment, both historic and future, adds tremendous power to patient facing applications in helping them understand and manage those administrative details (and benefits healthcare organizations in perhaps reducing no-show rates).
- In regards to the creation of Diagnostic Imaging class, we support and endorse this addition. We would like to see the further addition of the image itself. Although we recognize the difficulty of expanding scope to data included in the PACS system of the healthcare organization, the impact for patients will be tremendous. Allowing portability of radiology and other imaging will drastically change the current CD/DVD driven workflows and ease transitions of care between organizations. We also support exposing all clinical images/files (not just diagnostic) stored to the patient chart.
Data elements already available commonly and standardly in EHRs
Several data classes in Level 2 that are not in USCDI V2 such as Social History or Orders are made available standardly to patients and other providers today (and for several years) via the VDT provisions of Meaningful Use and CDA exchange via Carequality and Commonwell. There are also additional Level 2 elements that should be readily available in EHR systems such as Encounter Location. We believe that these would be low lift for healthcare providers and their vendors, but of value for the patient.
Data elements offering largest value to patients still missing
We strongly believe that to increase the value of USCDI to healthy but unengaged patients, core administrative data is among the most important to define and expose, such as the aforementioned Appointment information. Additionally, Insurance (defined in Level 2), Advanced Directives (Level 1), Referral (comment), additional patient demographics (multiple levels) and financial information are core to the patient experience and have the greatest potential to increase patient engagement in healthcare activities once exposed, aggregated and understood. We strongly believe that to increase the value of USCDI to the sickest, most chronic patients, specialty-specific data is also among the most important to define and expose, such as the Ophthalmic Data (Level 2), pregnancy/obstetrics data (comment under Observation), and oncology data (comment under Observation)
Public Health considerations
Much of the commentary surrounds public health response and tracking trends at the population level but the updates do little to help in that regard. With the inclusion of the Level 2 proposed elements on Immunizations and Laboratory sections, the USCDI updates could make an impact in the ongoing efforts to fight the pandemic and expected improvements to public health infrastructure to come. Given this dataset will also be implemented for bulk data exchange, this may also be beneficial for CEHRT requirements, in that some could be replaced by relatively small USCDI expansion (Syndromic surveillance, vaccine registries, etc.)
Submitted by Summit Healthc… on
Comments re: USCDI v2 DRAFT
Summit Healthcare Association submits its comments to the proposed USCDI v2:
- Under the data class “Encounter Information,” data element “Encounter Type” – how does one indicate observation status? It does not appear to fall under any listed SNOMED encounter type.
- Under the data class “Problems,” data element “Date of Resolution” – This may be problematic for routine, acute conditions such as the common cold or flu, for which patient is seen for treatment, but is not seen follow up. Therefore, in this instance, how would one determine the date of resolution?
Submitted by HDuncan.CAP on
CAPComments_USCDI.02
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
Submitted by cbush on
Division of Vital Statistics Support for Death and Birth items
The Division of Vital Statistics (DVS) within CDC’s National Center for Health Statistics (NCHS) supports inclusion of submitted mortality and natality data elements into USCDIv2. The mortality data elements include Cause of Death Information, Autopsy Performed, and Date and Time pronounced dead. These mortality data elements requested not only support multiple public health use cases, but they also support the clinical information reported on death certificates. This will inform mortality reporting about public health challenges, determine life expectancy and compare death trends with other countries.
The natality data elements include Clinical Notes for Newborn, Pregnancy History, Apgar Score, Estimated Date of Delivery, Gestational Age at Birth, Last Menstrual Period (LMP), Number of Fetal Deaths This Delivery, and Patient Birth Place. Currently there are natality elements that have progressed to level 2, and to compliment the reporting of natality holistically are a reason these Comment Level items should also be included within the Level 2 inclusion. These data elements track health trends that includes pregnancy risk factors and preterm births.
The inclusion of these elements in USCDIv2 would have a significant impact on mortality and natality reporting by reducing the burden of duplicative data entry and streamlining the process flow. The primary objective is to improve the timeliness, quality, and sustainability of vital statistics reporting. The inclusion of these elements would not only support national level reporting but also benefit State partners who are the first line of receiving these data and clinical providers who are on the first line of sending these data. DVS has been working with State partners and their electronic registration systems as part of modernization efforts. Inclusion of these elements would support interoperability among the vital statistics ecosystem. DVS and State partners have been focusing working towards using the HL7 FHIR standards that adhere to the US Core resources within their implementation guides when possible.
Submitted by djdonovan on
Highmark Health Letter of Support for Gravity Project Submission
This letter is written in support of The Gravity Project’s submission to the Office of the National Coordinator to advocate for the inclusion of Social Determinants of Health (SDOH) in the U.S. Core Data for Interoperability. As one of the nation’s largest integrated healthcare delivery systems, Highmark Health believes this integration is critical to improve the health and well-being of those we serve.
Public health professionals have long known that social and environmental determinants of health explain most of a person’s and population’s health status. The health care delivery sector is now understanding that the delivery of traditional health care accounts for only 20% of one’s health. The COVID-19 pandemic has highlighted this reality daily across the nation. The Gravity Project’s submissions would add critical domains such as food insecurity, housing instability, transportation insecurity, social isolation, and stress to the USCDI, integrated with core clinical activities such as assessments, diagnoses, interventions, and outcomes.
The need for inclusion of SDOH as a new data class in USCDI is a requisite to capturing social risk and supports a focus on and prioritization of use cases with a high impact on the triple aim, the widely accepted policy objective of HHS that refers to improving the experience of care, improving the health of populations, and reducing per capita costs of health care. The fact that SDOH accounts for 80 percent of health status at a population level and that there is no consistent method to document and communicate these factors during a health care encounter emphasizes the urgency of a national standard approach across the health care system. The implementation of these standards is necessary to drive reductions in missed appointments, cost savings from preventable health events, culturally competent care, increased care plan compliance, reduced administrative burden, promoting effective investment in community health programs, and leveraging critical data to improve patient outcomes.
Health care’s transition from a fee-for-service model to value-based care adds an additional imperative for SDOH, since these elements will become increasingly necessary to establish appropriate and equitable reimbursement of health care service providers and advance reimbursement models for community based organizations. Without standards and code sets, health plans will be challenged to evolve their value based reimbursement programs to include social risk.
Please accept this recommendation on behalf of Highmark, for The Gravity Project’s submission to the USCDI. Should you have any questions or need additional insight please don’t hesitate to contact me at (412) 721-6800 or via email at Deborah.donovan@highmarkhealth.org.
Submitted by zbarber on
NYeC Support for Gravity Project Submission
The New York eHealth Collaborative (NYeC) supports the inclusion of key social determinants of health (SDOH) data elements as submitted by the Gravity Project in the U.S. Core Data for Interoperability (USCDI) Version 2. New York State has been a leader in requiring interventions and data collection to address SDOH in Value-Based Payment as part of the Medicaid program, which underscores the importance of this work. The Gravity Project’s submissions would add critical domains such as food insecurity, housing instability, transportation insecurity, social isolation, and stress to the USCDI, integrated with core clinical activities such as assessments, diagnoses, interventions, and outcomes. Widespread capturing of standardized SDOH data is critical to understanding and addressing health disparities and improving health outcomes for individuals and communities.
Submitted by sbzemel on
Support for the Gravity Project's submission on SDOH
Please see the attached letter for Providence St. Joseph Health's support to the Gravity Project's submission for two approaches for including social determinants of health data in the USCDI.
Submitted by Mark Savage on
UCSF Center for Digital Health Innovation's Comment on USCDI
Dear Dr. Rucker:
The University of California, San Francisco’s Center for Digital Health Innovation provides the attached comments on new data classes and elements for version 2 of the U.S. Core Data for Interoperability.
We appreciate the considerable work that ONC has devoted to the Common Clinical Data Set (CCDS) and its next evolution, the U.S. Core Data for Interoperability version 1. Version 1, however, was only a “modest expansion” of the Common Clinical Data Set. As a health care provider, we urge ONC to add numerous additional data elements now so that they, too, become available for better health care, for key national use cases such as COVID-19 and virtual care, and for the nationwide learning health system we need. According to ONC, technical specifications are already available for 46 of 50 data classes ONC listed for candidate and emerging status, and all 50 are “critical to achieving nationwide interoperability.”
To illustrate the importance of adding the missing data elements now, we tested them against two COVID-19 use cases and asked which missing structured data elements are necessary or important now for health care in the midst of the COVID-19 pandemic. Not surprisingly, most were necessary or important.
If you or your staff have any thoughts or questions about these comments, please feel free to contact me at Mark.Savage@ucsf.edu.
Yours truly,
Mark Savage
Mark Savage
Director, Health Policy
Center for Digital Health Innovation
University of California, San Francisco
C. 415.225.1676
Submitted by dvreeman on
Proposal for precise modeling of entities in the USCDI
The USCDI V1 is a landmark specification of core clinical data for nationwide exchange. Recognizing USCDI's significant promise for directing future interoperability efforts, we seek to improve its foundation for continued expansion.
In particular, we believe that improving the clarity of USCDI entity definitions (e.g. Data Class, Data Element) are necessary for the industry to interpret them consistently. We seek to add precision to their specifications to enable a principled approach for users to understand, implement, extend, and refine them with future submissions for new USCDI content.
To that end, we submit these recommendations, which includes a proposed model that is described in the accompanying appendix.
Help
1. Optional: Background Text / Cover Letter
The "Optional Background Text / Cover Letter" field provides space for additional context or introductory information related to your comment.
If you wish to provide context, explanation, or an introduction to your comment, enter this information in the field labeled "Optional Background Text / Cover Letter." This is entirely optional and is most useful when submitting multiple related comments or when additional background would help reviewers understand your feedback.
If you are only commenting on a single data class or element, you may leave this field blank.
2. Select the Data Class
To specify which data class your comment addresses:
- In the "Data Class" drop-down menu, select the appropriate data class you want to comment on.
- If you are providing a general comment that is not specific to a data element, select "General" from the options. Comments with this designation will be displayed on the USCDI landing page.
- Note that the Data Class field will automatically populate based on your current location in the platform:
- If you are on a data class page, the field will be set to that specific data class
- If you are on a data element page, the corresponding data class will be pre-selected
3. Select the Data Element
To specify which data element your comment addresses:
- In the "Data Element" drop-down menu, select the specific data element you want to comment on.
- The drop-down menu will display only the elements available under the data class you selected in the previous step.
- You can use the search function within the drop-down to quickly locate a specific data element.
- If you are commenting on the data class itself rather than a specific element, you may leave this field blank.
Note: Comments on a specific data element will appear on the respective data element page, while comments on a data class (without a specific element selected) will appear on the landing page for that data class.
Fig 1 The "Data Class" and "Data Element" dropdown menus allow users to specify the exact content they wish to comment on.
4. Optional: Propose New Data Class or Element
If you cannot find the appropriate data class or element for your comment:
- Instead of clicking the "Comment On An Existing Data Class Or Element" button, click the adjacent button labeled "Propose a New Data Class or Data Element."
- This will redirect you to the ONDEC (ONC New Data Element and Class) Submission System.
- In the ONDEC system, follow the provided instructions to submit your proposal for a new data class or element.
- Once your proposal is submitted through ONDEC, it will be reviewed separately from the commenting process.
Fig 2 The "Propose a New Data Class or Data Element" button redirects users to the ONDEC Submission System for proposing new data elements not currently available in the system.
5. Complete the Comment Form
Fill out the required fields in the comment form:
Subject: Enter a brief, descriptive title that summarizes your comment. This helps reviewers quickly understand the nature of your feedback.
Comment: In this field, provide the full details of your comment or feedback. Be as clear and specific as possible about your suggestions, concerns, or observations. Include any relevant details that support your position.
6. Optional: Add Additional Comments
If you need to comment on multiple data classes or elements:
- After completing your first comment, click the link labeled "Comment on another data element" at the bottom of the form.
- A new comment section will appear, allowing you to enter details for your additional comment.
- For each additional comment, you must select the appropriate data class and data element from the drop-down menus.
- Complete the Subject and Comment fields for your additional comment.
- Repeat this process for each additional comment you wish to submit.
Fig 3 The "Comment on another data element" link enables users to create multiple comments addressing different elements within a single submission.
7. Optional: Upload Supporting Files
The platform allows you to upload supporting documentation to enhance your comment:
- Locate the "File Upload" section at the bottom of the comment form.
- Click to upload any files (such as PDFs or documents) that provide additional context, evidence, or clarification for your comment.
Important: If you have already entered your comments using the form fields, there is no need to upload duplicate content in PDF format. The file upload feature is intended for supplementary materials only. Please avoid uploading files that contain the same information already provided in your comment text.
Fig 4 The "File Upload" section permits users to attach supporting documentation that supplements their written comments.
8. Optional: Save and Exit
If you need to pause your work and return to complete your comment later:
- Click the "Save and Exit" button at the bottom of the form.
- Your comment will be saved as a draft that you can access and complete later.
- When you return to the platform, you will see a red triangle with an exclamation mark next to the “Return to saved Comment” button, indicating that you have saved comments in draft status.
- Click this button to continue working on your draft.
- You will be taken to a review page where you can:
- Select "Submit Comment" to officially submit your feedback.
- Click "Edit" to return to the comment form and make changes
- Select "Discard Draft" to delete the saved draft and start fresh
Fig 5 A red triangle with exclamation mark indicator appears next to the “Return to saved Comment” button when draft comments are saved in the system.
9. Review and Submit
Once you have completed your comment:
- Click the "Review and Submit" button at the bottom of the form.
- This will take you to a review screen displaying your comment(s) in full.
- Review all information for accuracy and completeness.
- On this review screen, you have three options:
- Click "Submit Comment" to officially submit your feedback
- Click "Edit" to return to the comment form and make changes
- Click "Discard Draft" to delete the comment and start fresh
- The review screen also includes a "Print" button that allows you to create a printed copy of your comments for your records.
- If you choose to submit, your comment will be recorded in the system and made available for review by the appropriate stakeholders.
Fig 6 The review screen allows users to verify comment content and make any necessary modifications before final submission.
Submitted by Mark Savage on
UCSF's Center for Digital Health Innovation on USCDI v2
The University of California, San Francisco’s Center for Digital Health Innovation submitted the attached comments on new data classes and elements for version 2 of the U.S. Core Data for Interoperability. These comments were submitted October 23, 2020. Now that ONC has published its draft of USCDI v2 for public comment, UCSF's CDHI may submit additional comments as well.
We appreciate the considerable work that ONC has devoted to the Common Clinical Data Set (CCDS) and its next evolution, the U.S. Core Data for Interoperability version 1. Version 1, however, was only a “modest expansion” of the Common Clinical Data Set. As a health care provider, we urge ONC to add numerous additional data elements now so that they, too, become available for better health care, for key national use cases such as COVID-19 and virtual care, and for the nationwide learning health system we need. According to ONC, technical specifications are already available for 46 of 50 data classes ONC listed for candidate and emerging status, and all 50 are “critical to achieving nationwide interoperability.”
To illustrate the importance of adding the missing data elements now, we tested them against two COVID-19 use cases and asked which missing structured data elements are necessary or important now for health care in the midst of the COVID-19 pandemic. Not surprisingly, most were necessary or important.
If you or your staff have any thoughts or questions about these comments, please feel free to contact me at Mark.Savage@ucsf.edu.
Yours truly,
Mark Savage
UCSF CDHI to ONC on USCDI v2 (10-22-2020).pdf