ONC Launches USCDI Initiative to Improve Dataset Interoperability

The Office of the National Coordinator for Health Information Technology (ONC) has launched a new initiative that will add to the existing United States Core Data for Interoperability (USCDI) and improve dataset interoperability and alignment standards for federal partners.

The USCDI+ initiative will aim to help federal partners identify and establish interoperable datasets that meet agency-specific requirements.

ONC acknowledged that the USCDI cannot always offer the consistency and alignment on datasets that some use cases require, which led them to launch USCDI+. The service will build off of the USCDI data and allow agencies to align data across different programs, according to ONC.

The USCDI+ initiative will follow the same principles as USCDI but will include several additional features. The approach will identify use cases, data specifications, and agency programmatic requirements for any dataset. It will also evaluate data according to objective criteria, such as level or standards maturity or industry priority and readiness.

The initiative will also have a discovery phase and charter component, ONC said.

USCDI+ will operate under three main standards: collaboration, harmonization, and specification.

The service will aim to collaborate with federal partners, the health IT community, and healthcare providers to support health IT advancement around datasets, standards, certification criteria, and implementation specifications. ONC aims to carry out this collaboration in harmony between all partners.

USCDI+ also intends to “specify foundational principals and process for the development of data sets, value set, and/or corresponding implementation specifications to ensure that the use and adoption of standards are aligned across federal programs, across specialties and site of service, and on a national scale,” ONC wrote.

ONC’s Cures Act Final Rule determined what data stakeholders can access and share through EHR. The first version of the USCDI set the standard for data exchange.

“Though the USCDI sets the floor of data availability, it’s not static,” ONC experts wrote in an accompanying blog post. “ONC has established an expansion process that creates a “rising floor” over time based on input from industry and federal partners and consideration of various factors such as impact, feasibility, and standards maturity.”

ONC updated the USCDI in July 2021 to include social determinants of health, sexual orientation, and gender identity data elements.

ONC experts touched on the growing number of requests to continue to expand the USCDI. They noted that USCDI growth may drive interoperability, but its expansion may also impact user experience and workflow due to its broad applicability to EHRs.

Instead of updating the USCDI, ONC created the USCDI+ initiative to expand on the existing dataset to respond to certain use case needs.

USCDI+ efforts will start with the Centers for Medicare and Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC). The service will add more partners when the program is more solidified.

ONC will follow similar USCDI processes and gather input from the Health IT Advisory Committee to mold the USCDI+ datasets and prompt public engagement.

“The USCDI+ program is another way that ONC is embracing our “coordinator” role to help our federal and industry partners successfully achieve their missions,” ONC concluded. “It will help the federal government more effectively use taxpayer dollars in health IT activities and will benefit industry with better alignment of data standards across federal programs.”