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.
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- 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 lwickiser on
Functioning
This is an important data class that stands the entire continuum patient's care. It is critical information for the transitions of care as well as the planning for patient's goals and getting back to "normal"
Submitted by lwickiser on
Advance Directives
The importance in this area of Advance Directives and patient self directed care is of utmost important when considering care planning for the patient. Consider moving to task force Level 2
Submitted by Karen_Hagerty on
Attached please find…
Attached please find comments from the Association for Clinical Oncology.
Submitted by msaito on
Comments on Draft USCDI v2 from Epic
Epic's comments on ONC's Draft USCDI v2 are attached. Thank you for your consideration.
Submitted by SR Cahill Fenw… on
Fenway Institute, 63 other organizations' comment on USCDI v2
April 15, 2021
Micky Tripathi, Ph.D., M.P.P., National Coordinator for Health IT
Steven Posnack, M.S., M.H.S., Deputy National Coordinator for Health IT
Office of the National Coordinator for Health Information Technology
Office of the Secretary, United States Department of Health and Human Services
Re: Request for Public Comment, Draft United States Core Data for Interoperability (USCDI) v2
Submitted electronically to https://www.healthit.gov/isa/united-states-core-data-interoperability-uscdi
Dear Dr. Tripathi and Mr. Posnack,
The Fenway Institute at Fenway Health and a coalition of 63 partner organizations working in health care, LGBTQIA+ equality, sexual and gender minority (SGM) health, and HIV prevention and care submit the following comment regarding ONC’s Request for Public Comment on the Draft USCDI v2 posted in January, 2021. The Fenway Institute is the research, education and training, and policy arm of Fenway Health, a federally qualified health center and Ryan White Part c HIV clinic in Boston, Massachusetts. We provide care to about 35,000 patients every year. Half of our patients are LGBTQIA+. About 2,300 of our patients are people living with HIV.
We were pleased to learn from Dr. Tripathi’s keynote address at ONC’s annual meeting March 29th that one of ONC’s “top goals” is “centering health equity.”[1] We share ONC’s vision about the promise of leveraging health IT to build a nationwide, interoperable, value-based, person-centered health system. The Fenway Institute has engaged with ONC since 2012 on issues related to the adoption and implementation of national sexual orientation and gender identity (SOGI) health IT standards. We appreciate your responsiveness to our priorities. In 2015, ONC adopted SOGI standards as required fields in the “demographics” section of the 2015 Edition Base Electronic Health Record (EHR) Definition certification criteria, making SOGI part of all Certified Electronic Health Record Technology (CEHRT) products. Further, in addition to being required fields for EHR certification, SOGI has also been included in the Interoperability Standards Advisory since it was first published in 2015. SOGI standards have achieved steadily increasing and high levels of maturity and adoption since 2015,[2] as reflected in the 2021 reference edition of ONC’s Interoperability Standards Advisory (pages 43-45).[3] We welcome the opportunity to review and comment on the current USCDI v1 and on the proposed USCDI v2.
Our comment is structured as requested in response to the three requests in ONC’s call for public comment.
- Review the current USCDI v1 and comment on whether any applicable standards should be updated in final USCDI v2.
We are grateful that ONC adopted SOGI elements in October 2015 based on research that the Fenway Institute and the Center for American Progress conducted with a diverse group of community health center patients, and which were recommended by a broad range of stakeholders, including the Mayo Clinic, the Trust for America’s Health, and Massachusetts General Hospital. We agreed with ONC in October 2015, when it required “that Health IT modules enable a user to record, change, and access SO/GI [sexual orientation and gender identity] to be certified to the 2015 Edition ‘demographics’ certification criterion.” In this final rule, ONC and CMS explained that:
The 2015 Edition proposed rule also included a criterion to record a patient’s sexual orientation and gender identity (SO/GI) in a structured way with standardized data. Where the patient chooses to disclose this information, the inclusion of this information can help those within the patient’s care team to have more information on the patient that can aid in identifying interventions and treatments most helpful to the particular patient. Additionally, sexual orientation and gender identity can be relevant to individual treatment decisions; for example, transgender men who were assigned female at birth should be offered a cervical exam, as appropriate.
Finally, we strongly agreed with this statement:
CMS and ONC believe including SO/GI in the “demographics” criterion represents a crucial step forward to improving care for LGBT communities.[4]
We therefore request that the Patient Demographics requirements of USCDI v1 be expanded to include sexual orientation, gender identity, intersex status, name used, and pronouns in USCDI v2.
USCDI v1 Patient Demographics include:
Patient Demographics
• First Name
• Last Name
• Previous Name
• Middle Name (incl Middle Initial)
• Suffix
• Birth Sex
• Date of Birth
• Race
• Ethnicity
• Preferred Language
• Current Address
• Previous Address
• Phone Number
• Phone Number Type
• Email Address
In addition to collecting and tracking demographic data such as the patient’s sex, age, race, ethnicity, geography, and preferred language, knowing a patient’s sexual orientation, gender identity, intersex status, named used, and pronouns is important for health care providers and public health researchers.
Knowing a patient’s current gender identity and sex assigned at birth, as well as their anatomical inventory, is important for informing clinical decision support as well as understanding healthcare organization and population-level health disparities.[5] There are striking disparities in accessing preventive services that correlate with sexual orientation and gender identity, as well as race/ethnicity and other factors. For example, lesbian and bisexual women are less likely to access cervical cancer screening and mammograms. This is also true of Black and Latina women. Lesbian and bisexual women may also be at elevated risk of breast and ovarian cancer related to nulliparity. The availability of data about sex, gender, and sexual orientation in an EHR is useful for healthcare systems in identifying and addressing disparities among sexual and gender minority patients, which are an NIH-recognized health disparity group.
2. Review and comment on the ONC proposed Draft USCDI v2 data elements and any applicable standards.
The Draft USCDI v2 Patient Demographics are identical to those in USCDI v1. Please expand them to include sexual orientation, gender identity, intersex status, named used, and pronouns.
In our June 2019 comment on the 21st Century Cures Act: Interoperability, Information Blocking, and the ONC Health IT Certification Program (RIN 0955-AA01), we urged ONC to include existing, national SOGI standards from the “demographics” section of the 2015 Base EHR Definition in the “Patient Demographics” section of the United States Core Data for Interoperability (USCDI). We stated that this would provide both regulatory and technical continuity between then existing health IT certification requirements and USCDI, thus advancing the overall goal of nationwide interoperability. SOGI standards have achieved much higher levels of maturity and adoption since their inclusion in the demographics section of the 2015 Base EHR Definition, and are thus ideal candidates for USCDI.
Given the existence of mature, widely adopted, national SOGI standards and previous regulatory health IT guidance including SOGI data as demographic fields, USCDI should include SOGI in its “Patient Demographics” section. It should also include intersex status, name used, and pronouns. In addition to being of clinical value for patients, providers, and other users of health IT, the availability of structured SOGI demographic data will ease processes of patient-matching and identity-proofing during transfers of care or instances of health information exchange.
In addition to the reasons described above for including SOGI in USCDI, increasing SOGI data collection has been a priority of the health care sector and the LGBT community[6],[7] for many years. This is why the Institute of Medicine (IOM)[8], the Joint Commission,[9] and CMS[10] recommend asking questions about SOGI in clinical settings and including these data in EHR systems to improve quality of care. It is also why the Bureau of Primary Health Care at HRSA requires community health centers to report the SOGI of their more than 20 million adult patients.[11] It is why the National Academies of Science, Engineering and Medicine[12] and the PhenX Toolkit[13] recommend collecting SOGI data.
The inclusion of these elements will ensure that USCDI is in alignment with other standards development organizations such as HL7 and SNOMED. HL7’s Gender Harmony Project, which has gone through the balloting process, has proposed the inclusion of the following data elements: gender identity, recorded sex or gender, sex for clinical use, name to use, and pronouns. SNOMED has established a sex and gender clinical group to review and update data elements with regard to sex, sexual orientation, gender identity and related anatomy. Fenway Health researchers are active participants in both the SNOMED and HL7 working groups.
It is especially important that SOGI data collection and use be standardized and, at a minimum, encouraged, and even better, incentivized or required, so that we can increase our understanding of SGM health disparities with high quality clinical data. It is also important to cross tabulate SOGI data with other demographic data to understand the intersection of SGM disparities with those affecting members of racial and ethnic minority groups, people with disabilities, immigrants and non-English speakers, people living in rural areas, and any other disparity populations. Also, given the rapidly changing terminology in the field of sexual and gender minority health, we encourage ONC to allow for future updates to response options regarding sexual orientation and gender identity.
3. Review the Level 2 data elements that were not included in the Draft USCDI v2 and comment on their potential inclusion in the final USCDI v2 with any applicable standards.
For the reasons stated above, we believe that the Level 2 data elements of gender identity and sexual orientation should be included in the final USCDI v2, along with intersex status, name used, and pronouns.
Based on many years of experience collecting and using patient SOGI data in Electronic Health Records (EHRs), advocating for inclusion of SOGI in national health IT systems and surveys, and training health centers and other organizations in how to collect and use SOGI to improve quality of care, the Fenway Institute and our colleague organizations strongly encourage ONC to include SOGI standards in USCDI v2, including sexual orientation, gender identity, intersex status, named used, and pronouns.
The Fenway Institute and other health policy advocates, researchers, and providers would welcome opportunities to engage ONC staff, the ONC USCDI Task Force, and the ONC Health IT Policy Committee during this process. We are working to improve upon existing SOGI standards through the ability to accommodate new and up-to-date SNOMED codes with better technical functionality for interoperability and better cultural competency for LGBTQIA+ patients. We will also continue to engage HL7 to ensure ongoing review and adoption of updated codes into FHIR standards. In addition, the Fenway Institute and other health stakeholders listed below are engaging a number of other federal partners, including the Consensus Study Panel on Measuring Sex, Gender Identity, and Sexual Orientation for the National Institutes of Health, and the National Library of Medicine, to promote more mature and effective terminology for SOGI.
Thank you for the opportunity to comment on USCDI v2. Should you have any questions, please contact Sean Cahill, PhD, Director of Health Policy Research at the Fenway Institute, at scahill@fenwayhealth.org or 617-927-6016.
Sincerely,
The Fenway Institute
Advocates for Youth
AIDS Foundation Chicago
Association of Nurses in AIDS Care
BAGLY, Inc. (Boston Alliance of LGBTQ Youth)
Bayard Rustin Liberation Initiative
BiNet USA
The Boston Foundation
Boston Indicators at the Boston Foundation
Callen-Lorde Community Health Center
Cascade AIDS Project
The Center for American Progress
The Center for HIV Law and Policy
Center for LGBTQ Economic Advancement & Research (CLEAR)
Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health
Center Link: The Community of LGBT Centers
Chase Brexton Health Services
Community Research Initiative of New England, Inc.
CrescentCare
Equality Ohio
Equitas Health
FORGE, Inc.
GLBTQ Legal Advocates and Defenders
GMHC
God’s Love We Deliver, Inc.
Human Rights Campaign
HIV/STI Intervention & Prevention Studies, University of Minnesota
interact: Advocates for Intersex Youth
International Association of Providers of AIDS Care
John Snow, Inc.
Latino Commission on AIDS
Legacy Community Health
Let’s Kick ASS AIDS Survivor Syndrome
LGBT Elders of Color
LGBT Technology Institute
Los Angeles LGBT Center
Lyon-Martin Health Services
Massachusetts Transgender Political Coalition
Movement Advancement Project
MPact: Global Action for Gay Men’s Health and Rights
National Association of Community Health Centers
NASTAD
National Black Justice Coalition
National Center for Transgender Equality
National Coalition for LGBT Health
National Equality Action Team (NEAT)
National LGBT Cancer Network
National Working Position Coalition
New England Association of HIV Over 50
North Carolina AIDS Action Network
Prism Health
SAGE (Services and Advocacy for GLBT Elders)
SAGE New Orleans
School of Public Health, Rutgers University
The 6:52 Project Foundation, Inc.
TPAN
Transgender Law Center
Transgender Legal Defense & Education Fund
Transhealth Northampton
Treatment Action Group
The Trevor Project
Unity Fellowship of Christ Church—NYC
VOCAL—NY
Whitman Walker Institute
[1] Jercich K, “ONC’s top goals: Interoperability, alignment, equity.” Health IT News. March 29, 2021. https://www.healthcareitnews.com/news/oncs-top-goals-interoperability-alignment-and-equity
[2] Grasso C, Goldhammer H, Funk D, King D, Reisner SL, Mayer KH, and Keuroghlian AS (2019).
Required Sexual Orientation and Gender Identity Reporting by US Health Centers: First-Year Data
American Journal of Public Health 109, 1111_1118, https://doi.org/10.2105/AJPH.2019.305130
[3] Office of the National Coordinator of Health Information Technology (2021). 2021 Interoperability Standards Advisory. Reference Edition. https://www.healthit.gov/isa/sites/isa/files/inline-files/2021-ISA-Reference-Edition.pdf
[4] Department of Health and Human Services, Centers for Medicare and Medicaid Services: 42 CFR Parts 412 and 495 [CMS-3310-FC and CMS-3311-FC], RINs 0938-AS26 and 0938-AS58. Medicare and Medicaid Programs; Electronic Health Record Incentive Program—Stage 3 and Modifications to Meaningful Use in 2015 through 2017. Released October 6, 2015. Page 408. https://s3.amazonaws.com/public-inspection.federalregister.gov/2015-25595.pdf Accessed March 24, 2021.
[5] Grasso C, Goldhammer H, Brown RJ, Furness BW (2020). Using sexual orientation and gender identity data in electronic health records to assess for disparities in preventive health screening services. International Journal of Medical Informatics Volume 142, October 2020, 104245. https://doi.org/10.1016/j.ijmedinf.2020.104245
[6] Cahill, S., & Makadon, H. (2013). Sexual orientation and gender identity data collection in clinical settings and in Electronic Health Records: A key to ending LGBT health disparities. LGBT Health. 1(1). 1-8.
[7] The Fenway Institute, the Center for American Progress, and 103 other health care organizations (2015, May 29). Public Comment on 2015 Edition Health Information Technology (Health IT) Certification Criteria, 2015 Edition Base Electronic Health Record (EHR) Definition, and ONC Health IT Certification Program Modifications published March 30, 2015. https://fenwayhealth.org/wp-content/uploads/ONC-Health-IT-Certification-Criteria-rule-Fenway-CAP-public-comment-FINAL-052915.pdf
[8] Institute of Medicine. Committee on Lesbian, Gay, Bisexual, and Transgender Health Issues and Research Gaps and Opportunities; Board on the Health of Select Populations; Institute of Medicine. The Health of Lesbian, Gay, Bisexual, and Transgender (LGBT) People: Building a Foundation for Better Understanding, Washington, DC: National Academies Press, 2011. http://www.nap.edu/catalog.php?record_id=13128. Accessed November 24, 2015.
[9] The Joint Commission. Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care: A Roadmap for Hospitals. Oakbrook Terrace, IL: The Joint Commission, 2010, page 11.
[10] Centers for Medicare and Medicaid Services (2015). Equity Plan for Medicare Beneficiaries. https://www.cms.gov/About-CMS/Agency-Information/OMH/OMH_Dwnld-CMS_EquityPlanforMedicare_090615.pdf
[11] Cahill S (2018). Legal and policy issues for LGBT patients with cancer or at elevated risk of cancer. Seminars in Oncology Nursing. 34(1):90-98.
[12] National Academies of Sciences, Engineering, and Medicine 2020. Understanding the Well-Being of LGBTQI+ Populations. Washington, DC: The National Academies Press. https://doi.org/10.17226/25877
[13] RTI International (2021, February 23). PhenX Toolkit. Version 37.0. https://www.phenxtoolkit.org/domains/view/10000
Submitted by PatrickGery on
Moxe Health USCDI v2 Official Comment
Please see the attached for Moxe Health's comments on the proposed USCDI v2 specification. We appreciate your time in reviewing our thoughts and look forward to your response after all comment review is complete. Thank you!
Submitted by paul@commonwel… on
CommonWell on USCDI v2
On behalf of CommonWell Health Alliance, we are pleased to submit comments on the Office of the National Coordinator’s United States Core Data for Interoperability (USCDI) draft v2 as published January 2021. We support the ONC as it works to improve interoperability in the United States across providers, payers, patients and other stakeholders and we are aligned in the belief that we need standard data formats to accomplish the goal of seamless interoperability in healthcare nationwide.
CommonWell Health Alliance is a not-for-profit trade association made of various health IT and health care stakeholders. As a membership-based trade association, we provide an environment to openly work on interoperability improvements across many cornerstones of health care including but not limited to technology companies, payers, State and Federal agencies, providers, clearing houses, and patients. When the Alliance launched seven years ago, we started with services centered around Care Treatment and provided the ability for providers to query across other provider systems and retrieve data about a given patient. We have and continue to be a patient-centered network available nationwide and are proud to have added Patient Access use cases to give individuals the ability to find and access their data through patient portals, personal health records and other patient-centric applications.
CommonWell has a simple vision: health data should be available to individuals and caregivers regardless of where care occurs. Additionally, access to this data must be built into health IT at a reasonable cost for use by a broad range of health care providers and the people they serve. At CommonWell, together with our service provider and members, we have created and deployed a vendor-neutral platform that breaks down the technological and process barriers that inhibit effective health data exchange. We leverage existing standards and policies in order to enable scalable, secure and reliable interoperability as easily as possible for our members and their customers across the nation. We believe the ONC’s Strategic Plan aligns with our mission and vision.
We believe the proposed USCDI v2 draft appropriately balances expanding the standard healthcare dataset while not creating significant burden on developers and providers to incorporate the additional data into their products and resultant data flows.
That said, we would like to endorse one proposed addition from one of our connected providers. Fresenius Medical Care is a national provider of services and products for patients with End Stage Renal Disease (ESRD). Currently, dialysis information is not well represented in the standard data and this information can be critical as patients with ESRD encounter planned or emergent transitions of care. Fresenius will be sending in their own comments regarding the specific data elements. We fully support the additions of these elements. We do recognize that dialysis related elements are not fully profiled yet and would encourage the ONC and the standards organization that complement the ONC’s work to complete the appropriate profiles and include in the next readily available version of USCDI. If the profile development can be completed in the near term, we agree it would be appropriate in v2. If it takes more than a couple months, we strongly endorse this being included in v3.
Submitted by kamodeo on
American Academy of Ophthalmology Comments on USCDIv2
Please find comments from the American Academy of Ophthalmology in the attached document.
Submitted by MRMabry on
RadNet's Comments on Draft USCDI Version 2
RadNet appreciates the opportunity to comment on the draft USCDI version 2. Specifically, we support: (1) the proposed new “Diagnostic Imaging” data class which would consist of two new data elements, “Diagnostic Imaging Report” and “Diagnostic Imaging Order,” plus the existing data element for “Diagnostic Imaging Narrative” (included under Clinical Notes in USCDI version 1) subject to clarification and (2) the use of the LOINC® (Logical Observation Identifiers Names and Codes) as their respective standard.
Submitted by Fresenius Medi… on
Fresenius Comment on USCDI Draft Version 2
Fresenius Medical Care North America (FMNCA) welcomes the opportunity to comment on the draft version 2 United States Core Data for Interoperability (USCDI V2). FMNCA is resubmitting our comment to include an endorsement on behalf of CommonWell Health Alliance, a not-for-profit trade association made of various health IT and health care stakeholders.
FMCNA Comment on USCDI V2 Final eHealth Exchange and CommonWell Endorsment.pdf