The USCDI+ initiative supports the identification and establishment of domain or program-specific data element lists that operate as extensions to the existing USCDI. USCDI+ is a service ONC provides to federal and industry partners to establish, harmonize, and advance the use of interoperable data element lists that extend beyond the core data in the USCDI in order to meet specific programmatic and/or use case requirements. This approach allows HHS to assure that extensions build from the same core USCDI foundation, align to harmonized data standards and taxonomies, and create the opportunity for aligning similar data needs across programs and use cases.

ONC is advancing USCDI+ efforts for quality measurement and public health with the Centers for Medicare & Medicaid Services, the Centers for Disease Control and Prevention, and the Health Resources and Services Administration, with support and input from other federal and industry partners.  The USCDI+ process follows the same basic principles used for the USCDI, but with some additional components including: 

  • A discovery process and charter
  • Identification of use cases, data specifications, and programmatic incentives/requirements for use of any specific USCDI+ data element list
  • Evaluation of data classes/elements according to objective criteria, such as industry priority and readiness, level of standards maturity, and identified agency need 

Three Pillars of USCDI+

Collaboration: Collaborate across federal partners, health care providers, the health IT community, and other industry partners to inform and support health IT advancement for priority use cases including data element lists, standards, implementation specifications and potential certification criteria.

Harmonization: Achieve greater harmonization across relevant partners, including federal agencies, clinical stakeholders, the health IT community, and users of health IT on adopted data element lists, standards, implementation specifications and certification criteria.

Specification: Specify foundational principals and process for the development of data element lists, value sets, and/or corresponding implementation specifications to ensure that the use and adoption of standards are aligned across federal programs, across specialties and sites of service, and on a national scale.

USCDI+ Domains

Public health: USCDI+ Public Health is intended to capture the data needs of public health that fall outside the scope of USCDI and aims to improve availability and consistency of data necessary to support various aspects of public health. In collaboration with federal partners, including CDC, FDA, ASPR, and NIH, ONC has developed data element lists for the following subdomains supporting Public Health programs: Case-Based Surveillance, Laboratory Data Exchange, Multi-Directional Exchange with Healthcare and Other Partners, Resource Reporting & Situational Awareness, and Risk Behaviors and Drivers of Inequity Data element lists are currently available for review on our ONDEC+ platform. Please email to get access to the website.

Quality: In May of 2023, ONC published the first draft of the USCDI+ data element list for quality measurement (USCDI+ Quality) to serve as a baseline dataset to support electronically reported quality measures. This first data element list includes data mapped for the CMS electronic Clinical Quality Measures (eCQMs) as well as additional data points for use cases related to public health and quality, safety and quality, long-term and post-acute care quality measurement, cancer related quality measurement, and maternal and child health quality measures. ONC released the draft USCDI+ Quality data element list and overview guide on the eCQI Resource Center. The initial USCDI+ Quality comment period, from May – June 2023, closed on Friday, June 30, 2023.  ONC is updating the USCDI+ Quality data element list and will release an updated list for review and comment later in 2023.  View the initial USCDI+ Quality Data Element List:

Read the Blog Post on USCDI+

Learn More About USCDI