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 USCDI+ extensions are built 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.

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

In December 2023, ONC launched a new USCDI+ platform to support the organization, linking of domains, and functionality to solicit and receive feedback for all USCDI+ domains. The new platform provides an enhanced user experience that includes tools that enable users to see in and across USCDI+ datasets for comparison, analysis, and harmonization. The platform also includes the ability to filter and export data elements by information within the datasets (e.g., filter by USCDI version, particular vocabulary standards, and/or US Core Profiles, etc.), as well as advanced logic to help reduce duplicate data element submissions, and more. 

Visit to see the new platform, provide feedback on USCDI+ datasets or to submit new data elements for USCDI+ domains.

Three Pillars of USCDI+


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.


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.


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 public health actions.

In collaboration with federal partners, including the Centers for Disease Control (CDC), Food and Drug Administration (FDA), and the Assistant Secretary for Preparedness and Response (ASPR), ONC is currently developing data element lists to support the following use cases:

  • Case Reporting
  • Laboratory Data Exchange
  • Risk Factors and Drivers of Inequity Health Equity (coming soon)
  • Resource Reporting and Situational Awareness (coming soon)

These data element lists will form the foundation for development of re-usable concepts in public health standards and will support CDC-led initiatives under the new Office of Public Health Data, Surveillance and Technology (OPHDST).


USCDI+ Quality is intended to support Digital Quality Measurement and the development of FHIR based quality measures. ONC is currently working in partnership with CMS and HRSA to identify opportunities for policy alignment around quality reporting programs under existing authorities across HHS agencies. 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 element inputs for quality measurement related use cases including public health, safety, long-term and post-acute care, cancer, and maternal and child health. 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 data element list for review and comment in 2024.


The USCDI+ Cancer Program will define real-world data (RWD) elements to further cancer prevention, diagnosis, treatment, research, and care. Enhanced data exchange for research purposes and clinical care contribute to the U.S. government’s support of persons with cancer. This is an area of mutual interest and responsibility for agencies across HHS, as well as the White House Cancer Moonshot. This work is collaboratively managed by NCI and ONC with input from CMS, CDC and FDA and includes focus on the following use cases:

  • Clinical Trial Recruitment / Matching
  • Immune Related Adverse Event (irAE) tracking in Immunotherapy trials
  • Enhance the efficiency and timeliness of collection of cancer registry data
  • Enhancing Oncology Model (EOM) alignment

The aim of USCDI+ Cancer is to improve the underlying data quality issues, mitigate bias, and improve the reproducibility of methods.

USCDI+ Cancer’s goals are:

  • Support adoption and use of interoperable cancer health IT standards and digital health technologies 
  • Provide strategic, technical, and regulatory support to advance the development and adoption of cancer specific use cases to more broadly support the cancer community.
  • Promote Health IT alignment for federal partners (CMS, CDC, NCI, FDA) to establish use-cases that align with real-world data and infrastructure.   


Behavioral Health

USCDI+ Behavioral Health will provide technical, programmatic, and strategic assistance to our federal partners, including Substance Abuse and Mental Health Services Administration (SAMHSA).

USCDI+ Behavioral Health goals are to: 

  • Guide adoption and use of interoperable mental health and substance use disorder health IT standards and digital health technologies
  • Support SAMHSA by providing in-house and commercial contract resources expertise 
  • Provide technical expertise to SAMHSA in developing and implementing health IT technologies to support their mission  
  • Assess, review and analyze the current and future state of BHIT
  • Focus on data modernization guiding principles of reducing the reporting burden, improving data quality, and better-measuring program services and outcomes for SAMHSA grantees 


Maternal Health

USCDI+ Maternal Health was developed to establish a core set of data necessary for high quality care, equitable outcomes, and maternal health research. Data elements are focused on helping to understand how maternal health may impact outcomes in both mother and child.

USCDI+ Maternal Health goals are to:

  • Assess maternal health patients’ experience in accessing electronic health records 
  • Identify consistent set of data elements and lab tests required for prenatal screening for prevention of mortalities / co-morbidities for the mother and child
  • Provide patients with information to empower them to request better care and help them identify any preventable risks  
  • Determine approaches and mechanisms to pilot recommended minimum datasets across provider types no matter the circumstance or level of technical proficiency of the patient and/or provider

Health IT Buzz Blog Posts

December 7, 2023

New USCDI+ Platform Now Live; Public Health Datasets Available for Comment

Brett Andriesen, Liz Turi, and Katie Tully

October 8, 2021

Thinking Outside the Box: The USCDI+ Initiative

Ryan Argentieri, Elisabeth Myers, Steven Posnack, and Micky Tripathi


ONC is advancing USCDI+ efforts with support and input from federal and industry partners including and not limited to:

  • The Assistant Secretary for Preparedness and Response (ASPR)
  • The Centers for Medicare & Medicaid Services (CMS)
  • The Centers for Disease Control and Prevention (CDC)
  • The Health Resources and Services Administration (HRSA)
  • The National Institutes of Health (NIH)
  • The National Cancer Institute (NCI)
  • The U.S. Food and Drug Administration (FDA)
  • The Substance Abuse and Mental Health Services Administration (SAMHSA)