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.
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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.
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.
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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.
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.
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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.
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 Riki Merrick APHL on
General suggestions
- We suggest to include all data elements are marked as required/SHALL/must support in both HL7® FHIR® US Core and HL7® CDA® C-CDA for the document types referenced in the 2015 Certification Edition Cures Update as well as in the V2 IGs cited in any meaningful use regulation in the USCDI v2.
- Vocabulary standards
- We suggest to rename the term “applicable standards” in USCDI to “vocabulary standards” or “terminology standards” as they only intent to reference vocabulary/terminology standards, not syntax or transport standards, which are defined elsewhere. The term “applicable standards” is just too broad and too misleading as to what standards are being referenced from within USCDI vs. outside of USCDI on how to communicate/access/exchange USCDI data.
- We suggest that the applicable standards, i.e., vocabulary standards, referenced in USCDI are updated to reflect the most current version available at time of publishing USCDI v2
Submitted by SamanthaBurch on
American Hospital Association Comments on USCDI Draft V2
General Comments
The American Hospitals Association (AHA) appreciates the open, transparent process ONC has established to solicit new data classes and elements for potential inclusion in future versions of the US Core Data for Interoperability (USCDI) and gather feedback from a broad range of stakeholders as well as the federal Health IT Advisory Committee (HITAC). Hospitals and health systems see the value in structured data elements to support a variety of important use cases including care coordination, public health, quality reporting, value-based care, health equity, and more.
Overall, the AHA is supportive of the USCDI draft version 2 as presented by ONC. The limited expansion from version 1, consistent with ONC’s guiding principles of minimal burden and complementing existing USCDI data elements, represents an appropriate bridge to future versions, while filling important gaps in data elements that exist today. This approach recognizes the continued limitations on resources on the part of hospitals and health systems to undertake new IT projects, such as voluntary upgrades to new versions of the USCDI, while continuing to focus on COVID response, vaccine distribution, data reporting, telehealth, new interoperability regulatory requirements and other key priorities.
As health care providers work with their EHR vendors to implement version 1 of the USCDI, we encourage ONC to engage closely with the field to identify and address implementation challenges as they arise. We further encourage ONC to ensure there are clear definitions for all data elements and all associated standards are identified. This will assist in supporting a common understanding of each data element across health care organizations.
Timing of Future Versions. While the AHA appreciates the process set forth by ONC to annually accept submissions of additional data classes and elements from stakeholders, we question whether the approach of finalizing a new USCDI version every year allows enough time to fully evaluate, define, implement and improve on each version. With the USCDI version 1 now adopted in regulation and linked to the information blocking requirements in the Cures Act Final Rule through October 6, 2022, we request that ONC provide clarity to the field on its regulatory approach to adoption of future USCDI versions.
Level 2 Data Classes and Elements
SDOH. The AHA supports the addition of data classes and elements to future versions of the USCDI that will enable standardized capture of social determinants of health (SDOH) and other equity data. EHRs can be an important tool to support collection of the data necessary to gain key insights at the patient and population health levels and build data-driven interventions. We look forward to submitting additional specific comments in response to the ONC’s information collection request on SDOH data elements.
Submitted by ddoneski on
NASL Comments on USCDI V2
The National Association for the Support of Long Term Care (NASL) is a national trade association representing the providers of ancillary care and services and products to the long term and post-acute care (LTPAC) sector. NASL members include rehabilitation therapy companies; providers of clinical laboratory services and portable x-ray; suppliers of complex medical equipment and other specialized supplies; and health information technology (health IT) companies that develop and distribute full clinical electronic medical records (EMRs), billing and point-of-care health IT systems and other software solutions serving the majority of LTPAC providers (i.e., assisted living, home health, inpatient rehabilitation facilities, long term care hospitals and skilled nursing facilities). NASL also is a founding member of the Long Term & Post-Acute Care Health IT Collaborative, which formed in 2005 to advance health IT issues by encouraging coordination among provider organizations, policymakers, vendors, payers and other stakeholders.
NASL appreciates the opportunity to share our comments regarding the Draft US Code for Data Interoperability Version 2.
Submitted by achu626 on
Comments Regarding Draft USCDI v2
Radix Health appreciates the opportunity to comment on the USCDI v2 draft. Radix Health specializes in enabling medical and hospital groups to reduce delays in care, maximize provider utilization, and ensure the right match between patient and provider. With this in mind, we offer our suggestions for improvements that affect the ability for systems to exchange data critical to patient access and scheduling.
Encounters
In its simplest form, electronic medical records help provide the who, what, when, and where for patients. Patients demographic records are often the foundation of healthcare data, and is the who. Whereas medications, problems, treatments, and diagnostics or results are often descriptive of the patient, this is the what. Encounter data allows you to describe the when and where.
As the standard currently stands, Radix recommends additional data elements to fully round out the encounter to better capture data that is pertinent to time and location. More specifically, appointment information is crucial to providing visibility into a patient's history, it can act as time markers with important context.
Encounters currently detail the type, time, place, and could benefit from a provider(s) component (level 2), status (level 1), as well as a note element (comment). These additional details would provide additional detail into a patient's history that could further assist in their care and health information portability.
Appointments
While many systems have a correlation between an encounter and an appointment, these are often times different concepts. Appointments can capture data up to the point of care, while most of it may be financial and administrative, they may also capture clinical data in more simple systems, like for therapy appointments that may come from lightweight systems that are not full featured EHRs.
In this case, an expansion of the Encounters Data to account for appointment elements like appointment type, appointment status, and appointment notes would help round out the data needs for patient access and scheduling needs. Appointment type, which may be unique from Encounter Type, would ultimately allow lighter weight systems to contribute meaningful data to standard, rather than adjusting it to the Encounter data components that may not be as accurate. Appointment status would help convey the differences in appointments (or encounters) that exist in a system. Appointment notes, like encounter notes, add extra detail to appointments that may be difficult to capture elsewhere.
Scheduling
One of the biggest challenges of healthcare is provider accessibility. This is most often due to the complicated nature for which many providers are scheduled. By making standards for how provider availability and accessibility can be accessed, we open up the opportunity for innovators to make patient access more simple. Making providers more accessible will increase health outcomes simply by reducing the friction for patients to see doctors.
Summary
A person's healthcare is ultimately controlled by the individual. Should they seek care, enabling the individual to more easily and more quickly access the care they need when and how they want it is critical to enabling better outcomes. Much of that care begins when a patient schedules an appointment. Making the process of scheduling appointments, or coordinating appointments across places of care, improve the chances of the patient following through with their care plan.
Submitted by zhornberger on
MITA Comments on USCDI draft V2
The Medical Imaging & Technology Alliance (MITA) is the leading trade association representing the manufacturers of medical imaging equipment and radiopharmaceuticals. We are encouraged to see the Office of the National Coordinator for Health Information Technology (ONC) continue its work to improve USCDI and enhance interoperability in healthcare—a goal MITA members share. We submit these comments in support of that shared goal.
Submitted by wgsuarez on
Need to Supplement Birth Sex in the Demographics Data Class
ISSUE
USCDI V1 demographic section uses Birth Sex as the data element required in the Standard. While there may be some use for this data element, Birth Sex alone does not capture the “sex, gender, physiologic, or anatomical information that is important for a given clinical decision or course of treatment for a patient.”* ONC requirements to use Birth Sex as the patient demographic standard presents problems particularly for patients who have under gone Gender Affirming Surgery. A patients may have a Legal Sex and Gender Identity that is different than the Sex Assigned at Birth. Yet, Sex Assigned at Birth is the only sex/gender category allowed in the USCDI standard.
In this context, Birth Sex alone is not sufficient, nor appropriate, in some instances, to be required to be reported, as it does not reflect the current realities of many individuals. The concern is that the USCDI V2 retains the current limitation from USCDI V1 with respect to not including anything outside of Birth Sex, which is too limited and in many cases inappropriate or even potentially offensive. Two examples: 1) responding to a person’s request for information with their “birth sex” when the person have gone through gender affirming surgery, or considers him/herself to be a different sex than what was reported as “birth sex”; 2) sharing USCDI with other providers about a patient that is no longer in the same sex category as what was recorded in “birth sex”.
(*) = EPIC’s definition for clinically relevant sex
RECOMMENDATION
-- KP recommends against using only Birth Sex as a standard data element in the Demographics Section of the USCDI Version 2
-- KP recommends that in addition to Birth Sex, the USCDI v2 should include:
- Sexual Orientation: An individual’s inherent or immutable enduring emotional, romantic or sexual attraction to other people
- Gender Identity: An individual's personal sense or concept of self as a male, female, a blend of both, or neither. One's gender identity can be the same or different from their sex assigned at birth.
- Recorded/Legal Sex: Sex or Gender on an identity document where identity document examples include a passport, driver's license and birth certificate.
-- KP believes that the clinically relevant INFORMATION related to sex is NOT a single field or EPT item, but a detail inventory of organs the patient currently has, plus the relevant associated details (e.g. organ from birth vs. surgically constructed organ).
Submitted by RiplingerL on
AHIMA USCDI Draft v2 Comments
The American Health Information Management Association appreciates the opportunity to submit comments on the USCDI Draft version 2. AHIMA supports ONC's objective of advancing nationwide, interoperable health information exchange. Please find attached AHIMA's detailed comments on USCDI draft version 2.
Submitted by trujillos@ochin.org on
OCHIN Comments on Draft USCDI Version 2
On behalf of OCHIN, we appreciate the opportunity to submit the following comments in response to the draft U.S. Core Data for Interoperability (USCDI) version 2. OCHIN is a national, non-profit community-based health innovation and research network serving as a virtual nationwide health care system and a national leader in promoting high-quality health care in underserved communities across the country. OCHIN strongly supports the Office of the National Coordinator of Health Information Technology’s (ONC) efforts to drive interoperability through national standards. National standards are the foundation needed to improve the quality of care, bend the cost curve, and empower patients, while paving the way for payment and delivery transformations, particularly for community-based providers that do not have the resources to comply with varied local, regional, state, and national standards. Further, widely adopted national standards are essential to address structural inequality in health care as well as to mount timely, data-driven responses to public health emergencies. Please find OCHIN's specific recommendations included in the uploaded attachment. Sincerely, Jennifer Stoll
Submitted by trujillos@ochin.org on
OCHIN Comments on Draft USCDI Version 2
On behalf of OCHIN, we appreciate the opportunity to submit the following comments in response to the draft U.S. Core Data for Interoperability (USCDI) version 2. OCHIN is a national, non-profit community-based health innovation and research network serving as a virtual nationwide health care system and a national leader in promoting high-quality health care in underserved communities across the country. OCHIN strongly supports the Office of the National Coordinator of Health Information Technology’s (ONC) efforts to drive interoperability through national standards. National standards are the foundation needed to improve the quality of care, bend the cost curve, and empower patients, while paving the way for payment and delivery transformations, particularly for community-based providers that do not have the resources to comply with varied local, regional, state, and national standards. Further, widely adopted national standards are essential to address structural inequality in health care as well as to mount timely, data-driven responses to public health emergencies. Please find OCHIN's specific recommendations included in the uploaded attachment. Sincerely, Jennifer Stoll
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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 Solarf3050 on
Draft USCDI Version 2 Comments
Attached are Health Level Seven (HL7) International’s comments on ONC’s Draft United States Core Data for Interoperability (USCDI) Version 2 and related data classes standards and elements. We look forward to continuing this discussion and offer our assistance to ONC.
HL7 Response USCDI V2 Letter and Table 04.14.21 Final.pdf