ONC Releases US Core Data for Interoperability Draft Version 2

The Office of the National Coordinator for Health Information Technology (ONC) has released the Draft United States Core Data for Interoperability Version 2 (USCDI v2) to enhance interoperability and patient data exchange between patients, providers, and other users.

The first version of the USCDI was adopted as a standard in the ONC Final Rule. It set a foundation for increased patient data sharing in order to boost patient care

ONC defined USCDI as, “a standardized set of health data classes and constituent data elements for nationwide, interoperable health information exchange.”

“We recognize that these criteria may change each year based on trends within the submissions received, high priority target areas, and other factors,” wrote ONC. “We aim to provide relevant details on a given year’s priorities in order to provide greater transparency into the process and ensure continued alignment of USCDI submissions to high priority target areas for health IT and health care.”

The new data classes and elements are:

• Care team members: provider name, provider identifier
• Encounter information: encounter type, encounter diagnosis, encounter time
• Problems: date of diagnosis, date of resolution
• Diagnostic imaging: diagnostic imaging order, diagnostic imaging report

ONC gathered 664 data elements in 44 new and existing data classes from 64 stakeholders by way of the ONC New Data Element and Class (ONDEC) submission system for USCDI v2. Nearly 110 data elements met level 2 criteria but ONC said integrating all data elements into this draft would overwhelm providers and health IT developers.

Thus, ONC prioritized specific level 2 data elements that are most relevant, broadly applicable, have defined use cases, and offer a clear value proposition, the agency wrote.

“To prioritize data elements for Draft USCDI v2, we assessed whether a level 2 data element could fill a significant gap within USCDI v1 and was already supported by current versions of the C-CDA and FHIR US Core implementation guide,” ONC explained.

ONC said a key priority of this draft was the spread of COVID-19. Health IT developers and clinicians reported to ONC that COVID-19 strained significant resources and took up valuable time. This limited their respective abilities to train and integrate system updates to meet changing program requirements. With providers, public health entities, and health systems allocating resources to fight the pandemic, health IT developers were unable to make necessary changes to their systems.

“While developers of certified health IT will not be compelled to upgrade their certified health IT when the final USCDI v2 is published, the intent behind the annual, incremental expansion of the USCDI and the annual SVAP cycle is to support updates to baseline standards and transparently identify where future regulatory direction could go,” explained ONC.

“As a result, careful consideration will be made in terms of the overall impact on and ability of health IT developers and their customers to design, upgrade, and implement new versions of USCDI and standards specified in SVAP.”

To ensure a maximum impact without overburdening health IT developers, USCDI v2 will have a modest expansion. USCDI v2 shows where a level 2 data element could integrate within an existing USCDI v1 data class that was initially supported by the Consolidated Clinical Document Architecture (C-CDA) and Health Level Seven International (HL7) Fast Healthcare Interoperability Resources (FHIR) US Core Implementation Guide.

ONC opened public comment on January 12, 2021 for USCDI v2 and comments will be accepted through April 15, 2021 on the main draft page or on individual class or data element pages, ONC said. The agency said it will consider recommendations and comments prior to final publication in July 2021.