from David Navarrosenior director of Data Science, Harmony Healthcare IT
Twitter: @HarmonyHIT

What is USCDI?

US Interoperability Master Data (USCDI) is a standardized set of classes (categories) of health data and data components for interoperable exchange of health information. The USCDI serves as a minimum guide for provider organizations on what classes of data and items will be stored and made interoperable, prescribing specific concepts such as LOINC, SNOMED, ​​CPT, and ICD10 to be used to store patient observations. .

The Office of the National Coordinator (ONC) has adopted the USCDI as the content standard for the 21st Century Treatment Act. Certified healthcare IT developers must maintain USCDI v1 by the end of 2022, which includes 15 data classes:

  1. Evaluation and treatment plan
  2. Care team members
  3. Clinical notes
  4. Goals
  5. Health concerns
  6. Immunizations
  7. laboratory
  8. Medications
  9. Patient demographics
  10. Problems
  11. Procedures
  12. Origin
  13. Smoking status
  14. Unique device identifier for implantable patient devices
  15. Signs of life

How is the USCDI updated?

The USCDI is constantly being reviewed. In fact, the ONC has a process for health IT stakeholders to follow in order to offer updates. This may mean adding new data classes, such as those listed above, or data items that can be added to an existing class. For example, when switching from USCDI v1 to USCDI v2, there were more than 600 data classes and elements have been submitted from the healthcare IT community during the development cycle of version 2. The result was three new data class additions and 22 data element updates.

The process of proposing an update involves submitting new data items and classes to the USCDI ONDEC (ONC New data element and class) Submission system.

The submission of a proposed change must include:

  • Information on the cases of use
  • Applicable standards and technical specifications
  • Existing use and exchange in the industry
  • Potential challenges in including proposed data elements

The ONC then evaluates the proposed data elements and assigns them one of the following levels:

  • Comment – The data may not have a well-defined use case or value for potential users
  • Level 1 – Limited existing use in electronic systems, limited exchange between systems
  • Level 2 – Extensive existing use in systems and exchanges between systems would improve interoperability across the country

The ONC then published data elements on the USCDI website for comments from health stakeholders. Updates and comments may be made to address the relocation of proposed data items to the next version of the USCDI standard. Submitted documents that reach level 2 will be considered for inclusion in the new version of the USCDI standard.

Although there may be a long list of proposed updates, ONC is taking a sensible approach to how much to add to future versions of USCDI due to the wide applicability of USCDI to certified health technologies, interoperability transactions and its potential impact on user experience and workflow.

How are new versions of the USCDI included in initiatives such as the 21st Century Treatment Act?

Although only version 1 is required to date to meet the requirements of the Medicines Act, the ONC has created a voluntary Standards Version Improvement Process (SVAP) to enable healthcare IT developers to include newer versions of implementation standards and specifications as part of the requirement for a “Real World Testing” condition and to support the certification of the Medicines Act. This means that using SVAP, certified health IT developers are allowed to use a more advanced version of USCDI standards than is currently widely used.

The impact of the USCDI is not limited to health IT products certified under the ONC Health IT certification program.

The USCDI is also used to align interoperability requirements and national priorities for IT and health on a large scale in industry initiatives. In fact, CMS and other federal, state, local, and tribal partners refer to the USCDI for a number of health information exchange purposes.

This article was originally published on Harmony Healthcare IT blog and is republished here with permission.

USCDI: Supporting Interoperability Requirements of the Cures Act

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