Changes to the USCDI standard indicate new developments in medicine and healthcare policy, and influence the data that health tech developers use.
The USCDI standard - a government-sponsored set of health tech data elements - has just expanded for the third year in a row.
USCDI v3 (the third and latest version of USCDI) was finalized in July 2022 by ONC, the government’s interoperability arm. This version of USCDI has grown to include 94 data elements, from the initial 52 data elements in USCDI v1.
“The USCDI is incredibly important for pushing healthcare interoperability forward,” says Particle Sales Engineer Nick Allen. “Access to new data types, ranging from disease-specific biomarker trends to care journey timelines, will enable technologists to deliver clinical insights in new and efficient ways.”
Since electronic health platforms generally support USCDI elements, these changes are a good indication of where medicine and healthcare policy is heading. We’re taking a look at the newest updates to USCDI, and what’s ahead for the future.
USCDI v3 “focuses on promoting equity, reducing disparities, and supporting public health data interoperability”, ONC officials wrote. It added two new data classes and 24 new data elements.
Some of USCDI v3’s noteworthy changes were:
ONC’s goal for this first USCDI update was to add ways to further health equity, with a focus on reporting social determinants of health (SDOH), gender identity and sexual orientation. USCDI v2 grew to 3 new data classes and 22 data elements.
Some of USCDI v2’s noteworthy changes were:
That’s up to you. Proposals are open through September 30, 2022 on the ONC New Data Element and Class (ONDEC) submission system. Like past update cycles, there will be a draft release, a review period, and a final release.
What ONC is looking for, however, are changes that
Interestingly, the draft version of USCDI v2 included 13 fewer data elements than the final standard; and the draft version of USCDI v3 included 4 fewer new data elements than the final release. In both instances, the review period served to increase, not reduce, the number of additions to the USCDI standard.
There are currently three levels of USCDI data elements, of increasing importance:
Level 2 elements are the most important. Once a data element reaches this level, it may be incorporated into the actual USCDI standard.
In general, the more use cases that an element has, the greater likelihood that it will be placed in a higher level.
To become an element, ONC asks whether a vocabulary, terminology, content, or structural standard exist for this data element - as all elements must be expressed with standard computer-processable healthcare terminology, like SNOMED CT.
ONC also considers the implementation burden of an element. Updates to USCDI should not be overly burdensome to incorporate into existing platforms.
Healthcare stakeholders can submit elements for consideration in the USCDI. Condition-specific advocacy groups, medical societies, and for-profit organizations all weigh in on the submission and comment process. ONC seeks a predictable
Submitters are asked to determine whether proposed data elements meet USCDI’s aims of improving patient care, population health, reducing care costs, or assisting providers. It is repeatedly referred to by ONC as a “predictable, transparent and collaborative process”.
While the USCDI will play an important role in health informatics for years to come, its role will change before the release of USCDI v4.
In October 2022, the data elements that healthcare providers must exchange will no longer be limited to those defined in the USCDI v1. The Cures Act had required that healthcare providers electronically share data upon request, but initially limited that data to the USCDI v1 elements to ease providers into compliance.
Now that USCDI has matured, the Department of Health and Human Services is also increasingly promoting its use across the federal government. In this way, USCDI continues to set the standard for healthcare data.
The Sequoia Project, a quasi-governmental organization that contributes to interoperability, agrees that USCDI will still be a major part of health IT, nothing that USCDI will “generally be expected to be found in [a] portal” whereas organizations may not have control over nonstandard health information that doesn’t conform to the USCDI.
“Holding both health IT vendors and EHRs accountable to the USCDI will give data seekers a more complete picture of a patient’s overall health journey,” adds Particle’s Sales Engineer, Nick Allen. “These ONC data sharing requirements are especially important for newcomers to the digital health space as they aim to care for patients in novel ways.”
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