USCDI Export for the Public
Classification Level Sort descending | Data Class | Data Class Description | Data Element | Data Element Description | Applicable Standards | Submitter Name | Submitter Organization | Submission Date |
---|---|---|---|---|---|---|---|---|
USCDI V1 | Patient Demographics/Information | Data used to categorize individuals for identification, records matching, and other purposes. |
Previous Address | Includes street name, number, city/town, state, and zip code. |
||||
USCDI V1 | Patient Demographics/Information | Data used to categorize individuals for identification, records matching, and other purposes. |
Phone Number Type | |||||
USCDI V1 | Patient Demographics/Information | Data used to categorize individuals for identification, records matching, and other purposes. |
Email Address | |||||
USCDI V1 | Clinical Notes | Narrative patient data relevant to the context identified by note types.
|
Procedure Note | Encompasses non-operative procedures including interventional cardiology, gastrointestinal endoscopy, osteopathic manipulation, and other specialty’s procedures. |
Logical Observation Identifiers Names and Codes (LOINC®) version 2.67
|
|||
USCDI V1 | Care Team Members | Information about a person who participates or is expected to participate in the care of a patient. |
Care Team Member | |||||
USCDI V1 | Clinical Notes | Narrative patient data relevant to the context identified by note types.
|
History & Physical | Documents the current and past conditions and observations of the patient. |
Logical Observation Identifiers Names and Codes (LOINC®) version 2.67
|
|||
USCDI V1 | Clinical Notes | Narrative patient data relevant to the context identified by note types.
|
Pathology Report Narrative |
Contains a consulting specialist’s interpretation of the pathology report. |
||||
USCDI V1 | Clinical Notes | Narrative patient data relevant to the context identified by note types.
|
Imaging Narrative |
Contains a consulting specialist’s interpretation of diagnostic imaging data. |
Logical Observation Identifiers Names and Codes (LOINC®) version 2.67
|
|||
USCDI V1 | Assessment and Plan of Treatment | Health professional’s conclusions and working assumptions that will guide treatment of the patient. |
Assessment and Plan of Treatment | |||||
USCDI V1 | Clinical Notes | Narrative patient data relevant to the context identified by note types.
|
Consultation Note |
Contains the response to request from a clinician for an opinion or advice from another clinician. |
Logical Observation Identifiers Names and Codes (LOINC®) version 2.67
|
|||
USCDI V1 | Clinical Notes | Narrative patient data relevant to the context identified by note types.
|
Discharge Summary Note | A synopsis of a patient’s admission and course in a hospital or post-acute care setting. |
Logical Observation Identifiers Names and Codes (LOINC®) version 2.67
|
|||
USCDI V1 | Clinical Notes | Narrative patient data relevant to the context identified by note types.
|
Laboratory Report Narrative |
Contains a consulting specialist’s interpretation of the laboratory report. |
||||
Draft USCDI V2 | Unique identifier(s) for a patient's implantable device(s). |
|
Marti Velezis | FDA/CDRH/Indira Konduri (FDA/CDRH/OPEQ/ORP/DRPIII) | ||||
Draft USCDI V2 | Activity performed for or on a patient as part of the provision of care. |
Procedures |
Optional:
|
|||||
Draft USCDI V2 | Representing a patient’s smoking behavior. |
Smoking Status | Representing a patient’s smoking behaviors. |
|
||||
Draft USCDI V2 | The metadata, or extra information about data, regarding who created the data and when it was created. |
Author Time Stamp | ||||||
Draft USCDI V2 | Information about a person who participates or is expected to participate in the care of a patient. |
Care Team Member Identifier | Al Taylor | ONC | ||||
Draft USCDI V2 | Tests that result in visual images requiring interpretation by a credentialed professional. |
Diagnostic Imaging Test | The name of the test performed which generates visual images (radiographic, photographic, video, etc.) of anatomic structures; and requires interpretation by qualified professionals. |
• Logical Observation Identifiers Names and Codes (LOINC®) version 2.69 |
Swapna Abhyankar | Regenstrief Institute, LOINC Document Ontology Subcommittee | ||
Draft USCDI V2 | Analysis of clinical specimens to obtain information about the health of a patient. |
Values/Results | Documented findings of the analysis of a tested specimen. Includes both structured and unstructured (narrative) components. |
|||||
Draft USCDI V2 | The metadata, or extra information about data, regarding who created the data and when it was created. |
Author Organization | Organization associated with author. |