ONC Releases USCDI V3, Adds New Data Classes to Promote Health Equity

The Office of the National Coordinator for Health IT (ONC) has released the United States Core Data for Interoperability (USCDI) Version 3, which adds new data classes that include health status and insurance information.

ONC established USCDI to form a standardized baseline of health data classes and elements for the exchange, access and use of electronic health information for patient care. The agency has iterated on USCDI over time, beginning with 52 data elements in 16 classes in the first version first debuted in May 2020 and now expanding to 94 data elements in 19 classes in the third version.

The 24 new data elements span across six data classes — laboratory, medications, patient demographics/information, procedures, health status/assessments and health insurance information.

The last of those two classes — health status/assessments health insurance information — expand on ONC’s draft version three released earlier this year. The draft included health status as a new class, but upon hearing further stakeholder input, the final standard refers to the class as health status and assessments.

“In response to stakeholder input to make the description and scope of the ‘health concerns’ data class in USCDI V2 clearer and more representative of the types of data that could be included, USCDI V3 refers to this data class as health status/assessments,” spokespersons from ONC’s Standards Division told GovCIO Media & Research. “This new data class represents assessments of health-related matters performed during care that could identify a need or problem. Additionally, the health status/assessments data class provides a broader context than the USCDI V2 health concerns data class.”

The new data elements under the health status/assessments class include functional, disability, mental/cognitive and pregnancy statuses.

The health insurance information data class allows for health IT to capture and share important insurance coverage information in a standardized format. The new class includes seven new elements:

• Coverage status
• Coverage type
• Relationship to subscriber
• Member identifier
• Subscriber identifier
• Group number
• Payer identifier

ONC spokespersons said the updates reflected in USCDI V3 will continue to help the Biden-Harris administration meet its respective executive orders on advancing racial equity and driving data-driven decision-making for COVID-19 and public health threats.

“In addition to expanding the USCDI data classes and elements to address patient access and care needs, many of the added elements are also meant to mitigate health and health care inequities and disparities, address the needs of underserved communities, and support public health interoperability needs of reporting, investigation and emergency response,” the spokespersons said. “These important data will be more available during data sharing activities.”

The health insurance information class also opens the window for tech like electronic health records to capture and exchange health insurance coverage in a consistent way — a feature that can be useful for patient care and help identify health care disparities related to insurance coverage, ONC said.

The prior USCDI version included other elements and classes such as those around gender identity, sexual orientation and social determinants of health to help ONC meet its goals to develop health equity by design in health IT and information exchange.

Certified health IT developers will follow the Standards Version Advancement Process (SVAP) to implement the updated standards in next year’s SVAP cycle.

ONC is now accepting new submissions for data classes and elements for consideration in the next iteration and has already received data element submissions that were not yet mature enough. The agency anticipates further feedback this year so that these submissions are ready for consideration. The agency also hopes to receive feedback to further refine data classes and elements, as well as continue to support health equity and public health.

“We have asked the industry to submit and/or work on data submissions that not only further the advancement of patient care and access, but also can support, at the same time, areas such as mitigating health and health care inequities and disparities, addressing the needs of underserved communities, addressing behavioral health integration with primary care and other physical care, and supporting public health interoperability needs of reporting, investigation and emergency response,” ONC said.

The submission period for the next version ends Sept. 30.