The Office of the National Coordinator for Health IT has released the draft of the third version of the United States Core Data for Interoperability (USCDI), a standardized set of health data classes and data elements for nationwide, interoperable health information exchange.
It has been a busy week for ONC. A day after publishing the Trusted Exchange Framework and Common Agreement (TEFCA), it released the draft of version 3, which adds data elements in the Health Status, Procedures, Health Insurance, and Patient Demographics data classes.
Last July, ONC released version 2 of USCDI, which added data classes and elements to support electronic exchange of social determinant of health data and sexual orientation and gender identity (SO/GI) data, among other updated data elements.
Over the next three months, ONC is encouraging the public to evaluate the Draft USCDI v3 and submit comments to ONC on the data classes and elements that should be included. Feedback will be accepted until April 30, 2022, on the main draft USCDI v3 page or on individual data class or data element pages. ONC will consider these comments and recommendations in preparing the final USCDI v3 for publication in July 2022.
During the development of draft version 3, ONC received over 400 submissions of suggestions. ONC considered these submissions and applied established prioritization criteria to select the most mature data elements, including data elements submitted during previous USCDI submission cycles. ONC focused on factors that include promoting equity, reducing disparities, and supporting public health data interoperability.
Draft version 3 includes four data elements in the new data class Health Status: Disability Status, Mental Function (which includes the more specific Cognitive Status), Functional Status, and Pregnancy Status. The Health Status data class provides a broader context than the existing Health Concerns data class, which contains the single general data element Health Concerns. The Health Status data class also includes two existing data elements Health Concerns and Smoking Status which were reclassified from their own data classes as found in USCDI v2. The ability to capture and exchange data that represent these more specific health statuses represents a significant advance for health IT to improve care and to address inequities.
Another new data class, Health Insurance Information, provides an opportunity for health IT to capture and exchange key elements of healthcare insurance coverage. This information can be useful in the care of patients, for price transparency, and in the identification of disparities related to insurance coverage.
Tribal Affiliation is a new, self-reported data element extensively captured by the U.S. Indian Health Service to aid in determination of eligibility for IHS services, care-coordination with non-tribal medical facilities, and identification of disparities in health care in and across tribal populations.
To address public health reporting priorities, especially considering the current COVID-19 pandemic, ONC added Specimen Type and Result Status to the Laboratory data class. Occupation, Occupation Industry, and Pregnancy Status also support public health data requirements.
ONC also added Reason for Referral in the Procedures data class, as this data element is already part of the Certification Program requirements for Transitions of Care and is broadly implemented in health IT.