The Office of the National Coordinator for Health IT (ONC) has released a draft version 2 of the United States Core Data for Interoperability (USCDI), which defines a standardized set of health data classes and data elements for health information exchange. Version 2 introduces incremental and modest changes, including nine new data elements and two new data classes.
The USCDI establishes a baseline set of data that can be commonly exchanged across care settings for a wide range of uses. Version 1 was adopted as a standard in the ONC Cures Act Final Rule published May 1, 2020. The standard was included as a required part of certain certification criteria in the 2015 Edition Cures Update and is also referenced in the context of information blocking. The final iteration of version 2 is expected to be published on July 1, 2021
At the Jan. 13 meeting of the ONC Health Information Technology Advisory Committee (HITAC), ONC Medical Informatics Officer Al Taylor, M.D., went to lengths to explain that the limited number of data elements added in version 2 was intentional. “It is a fairly modest change. It is not dramatic. This was intentional. It is in recognition that people are busy doing a lot of stuff, including responding to the pandemic,” he said. “We are going to be publishing versions approximately every year. We want to encourage incremental updates. We offer this as a small step toward improving interoperability and data exchange.”
Taylor described the list of data elements submitted as suggestions for addition was “overwhelming.” He said they got more than 600 submissions from 60 organizations submitted data elements for consideration.
ONC chose to add two new data classes — diagnostic imaging and encounter information and nine new data elements. “We had to implement a prioritization system,” he said. “Diagnostic imaging was one of the biggest concept gaps. Provider and encounter information were also major gaps.”
Here are the new data classes and elements:
Care Team Members
• Provider Name
• Provider Identifier
Diagnostic Imaging
• Diagnostic Imaging Order
• Diagnostic Imaging Report
Encounter Information
• Encounter Type
• Encounter Diagnosis
• Encounter Time
Problems
• Date of Diagnosis
• Date of Resolution
Over the next three months, ONC encourages the public to evaluate the draft version 2 and submit comments on the data classes and elements that should be included in the final version.
The Jan. 13 HITAC meeting also marked the final one overseen by Don Rucker, M.D., as national coordinator before the Biden Administration names a replacement, and he thanked the committee members for their hard work. Rucker also forward in describing some fertile areas for HITAC and ONC to work on. He suggested areas for further advancement include patient matching and identification. “We should think richly about patient matching as more than a number, but authentication, authorization of what data they are eligible to see and the consent process as an integrated whole,” Rucker said.
In addition, he said the public health emergency got him to focus on how we do health information exchange. “Today as we look around at HIEs, state and local ones, we have some extraordinary opportunities to expand that in a pro-competitive way, and get in group homes, shelters and jails, in a robust privacy-protecting way and hopefully efficiently. We need to work with HIEs and get that information to public health and CMS and FDA and all public agencies that need data.” He said it was well within HITAC’s purview to rethink reporting to government agencies and public health.
