- United State Core Data for Interoperability (USCDI) is a standardized set of health data classes and data elements for nationwide (US), interoperability health information exchange. USCDI is updated annually.
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- Certification of Electronic Health Record exchange APIs requires use of USCDI version 2; use of version 3 will be required as of December 31, 2025. Current adoption of certification by EHRs can be searched here: adoption by EHRs.
- Timeline – Initial input closes September; version for public comment February – April; publishes every July.
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- NOTE: The HL7 US Core Implementation Guide is released about one year after USCDI.
- USCDI+ is not required for EHR certification but includes specialized use cases, such as public health. You can create an account to add comments.
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- Intended to fill the gaps for quality, public health, providers, behavioral health, etc.
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- Much more flexible – but on an annual time frame to make it easier for vendors.
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- Established domains, including maternal health, public health, behavioral health, Cancer, Quality, and other use cases are available to focus on data needs for broad or targeted conditions and unique federal program requirements.
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- USCDI+ Cancer is currently working on several cancer use cases and recently closed its public comment period for cancer registry data elements. Please see the following link for information from the May 2024 USCDI+ Cancer Data Exchange Summit: Cancer Research Data Exchange Summit (Overview) | Events Registration and the Cancer Registry listening session held in August 2024: USCDI+ Knowledge – Announcement: Cancer Registry Listening Session – August 29th – USCDI+ Service Portal.
- US Core Implementation Guide (HL7) defines the minimum constraints on FHIR to implement USCDI. The latest version can be found here: HL7.FHIR.US.CORE\Home – FHIR v4.0.1. It provides more specificity and guidance than USCDI. Many other HL7 standards are built off of the US Core Implementation Guide. Note: The update cycles for USCDI and US Core are different, so the standards are not always 100% aligned.
- US Public Health Profiles Library (HL7) is a collection of reusable architecture and content profiles representing common public health concepts and patterns. It is intended as a complement to the US Core Implementation Guide to meet reporting requirements for public health. The latest version can be found here: Home Page – US Public Health Profiles Library v1.0.0.
- Minimal Common Oncology Data Elements (mCODE): HL7.FHIR.US.MCODE\Home – FHIR v4.0.1. Uses ~30 FHIR profiles that cover patient, disease, health assessment, genomics, cancer treatment and outcomes. mCODE defines relationships between the profiles and is intended to be used in implementation guides that further specify what information is required for a patient for different uses.
- Making Electronic Data More Available for Research and Public Health (MedMorph) has two separate Implementation Guides of interest:
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- MedMorph Implementation Guide: HL7.FHIR.US.MEDMORPH\MedMorph Home Page – FHIR v4.0.1 provides a common method for obtaining data for research and public health. It is aligned with HL7 FHIR and TEFCA. It defines API mechanisms, methods to trigger workflows, reporting and privacy services.
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- Central Cancer Registry Reporting Content Implementation Guide specifies how the MedMorph Reporting IG is to be used to enable automated, standardized exchange of cancer surveillance data from ambulatory health provider EHR systems to Central Cancer Registries. It makes use of mCODE. See HL7.FHIR.US.CENTRAL-CANCER-REGISTRY-REPORTING\Detailed Specification – FHIR v4.0.1.
- Cancer Pathology Data Sharing Implementation Guide provides HL7 FHIR resources to define standards for cancer pathology information exchange from a hospital or facility-based laboratory information system to a hospital or facility-based electronic health record (EHR) system. See HL7.FHIR.US.CANCER-REPORTING\Home Page – FHIR v4.0.1.
- Assistant Secretary for Technology/Office of the National Coordinator (ASTP) Interoperability Standards Platform: Sets policies, standards and implementation specifications for use in healthcare interoperability in the US for clinical, public health, and research purposes.
- ASTP Data Briefs include information on Health IT adoption and use statistics, such as use of APIs and electronic public health reporting Databriefs | HealthIT.gov.
- ASTP provides a variety of recorded events. Several recent events of particular interest:
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- ONC Tech Forum: Aligning USCDI, FHIR US Core, C-CDA and other Heath IT Standards | HealthIT.gov (November 2023) This is a helpful introduction to requirements for EHR certification, the cycle for USCDI updates, and relationship between policy (USCDI, HTI-1) and implementation (HL7’s US Core).
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- ONC Tech Forum: Modernizing Public Health Data Exchange: Lessons Learned and Tools for the Road Ahead | HealthIT.gov (September 2023) two-day meeting.
- 2023 ONC Annual Meeting | HealthIT.gov (December 2023) two-day meeting.
- ASTP’s blog: Health IT Buzz | The Latest on Health Information Technology from ONC includes articles on public health and research. You may subscribe for regular updates.
- The Centers for Medicare & Medicaid Services public health reporting requirements for eligible clinicians and other information can be found on the CDC interoperability page: Public Health Data Interoperability (cdc.gov).
- Trusted Exchange Framework and Common Agreement (TEFCA) supports the development of a common agreement to enable nationwide (US) exchange of electronic health information across disparate health information networks. See: What Is the ONC Trusted Exchange Framework and Common Agreement? – ONC TEFCA RCE (sequoiaproject.org). ONC’s blog has frequent updates on the rollout of TEFCA.
- Health Data, Technology, and Interoperability: Certification Program Updates, Algorithm Transparency, and Information Sharing (HTI-1) Final Rule | HealthIT.gov implements provisions of the 21st Century Cures Act and includes updates to Electronic Health Record (EHR) certification criteria, standards and provisions to minimize information blocking. Latest version was enacted on December 13, 2023.
- (DRAFT) Health Data, Technology, and Interoperability: Patient Engagement, Information Sharing, and Public Health Interoperability (HTI-2) Proposed Rule | HealthIT.gov underwent a public comment period that closed October 4, 2024. It updates the requirements for certified electronic health records and includes implementation guide updates for ambulatory and pathology reporting to central cancer registries.
- Key Concepts and Initiatives in Interoperability, Parts 1 & 2: NAACCR Talk: NAACCR Online Education: Key Concepts and Initiatives in Interoperability. Part 1 was held on November 6, 2023 and covered interoperability definitions, U.S. standards for Electronic Health Record certification, and relationships between them. Part 2 was held on January 8, 2024 and reviewed policies related to interoperability. Both sessions were provided by CDC staff. Beginner
- The Public Health Interoperability Training Catalog (created by Altarum) provides a number of short videos on public health interoperability, including HL7 FHIR and TEFCA: Catalog | Public Health Interoperability (phinterop.org). Beginner – Intermediate
- ASTP offers several free interoperability training courses on their website: Interoperability Training Courses | HealthIT.gov
- Central Cancer Registry Reporting (CCRR) FHIR Implementation Guide (IG) NAACCR hosted Webinar and resources for HL7 Ballot comments
- December 4th, 2025 NAACCR CCRR FHIR IG Webinar Recording
- CCRR_IG_RegistryReview Spreadsheet
- NAACCR_CCRR_IG_2025_Webinar_Slides
- If you need the link to the survey to provide comments for HL7 ballot, contact Ashley Knealing.
NAACCR Resources
- Artificial Intelligence and Natural Language Processing in the Cancer Registry Field webinar
- Epi ‘Hour’ AI: The Good, The Bad, and The Potential Uses for Cancer Registry Analysts
NCI Resources
- Artificial Intelligence (AI) and Cancer – provides information about applications in cancer research and care along with the challenges and opportunities for AI in cancer research.
- AI in Cancer Research – includes funding opportunities, events, resources and tools, and research highlights.
- Informatics Tools Supported by ITCR – The Informatics Technology for Cancer Research (ITCR) funds open source tools that support cancer research.
- NCI-Department of Energy (DOE) Collaboration – Includes project overviews including the Modeling Outcomes Using Surveillance Data and Scalable AI for Cancer (MOSSAIC). In relation to MOSSAIC, an article was published on PubMed Central. Hsu, Elizabeth, et al. “Machine Learning and deep learning tools for the automated capture of cancer surveillance data.” Journal of the National Cancer Institute Monographs, no. 65, 2024, pp. 145-151. https://pmc.ncbi.nlm.nih.gov/articles/PMC11300011/#sec3
- Similarly, a more recent article was published on PubMed Central on the role of AI for cancer registration. Ding, Shuai, et al. “The Role of Artificial Intelligence in Advancing Population-Based Cancer Registration.” Sci Bull (Beijing), no. 6, 2026, pp. 1546-1555. https://pmc.ncbi.nlm.nih.gov/articles/PMC13037459/
CDC’s AI Strategy for FY 2026-2030. This page has related links to find more information related to their AI strategy. One particular page to pay attention to would be Artificial Intelligence – Resources for Public Health Partners which provides useful resources for implementing and utilizing AI in public health.
PubHealth Futures – advancing responsible AI in public health (currently working with state agencies, non-profits, local agencies, tribal health agencies, academic institutions, federal agencies, and territorial agencies).
Cancer Informatics for Cancer Centers (Ci4CC) main purpose is to use informatics, artificial intelligence, and data science to advance precision oncology by creating forums for collaboration and idea-sharing, organizes conferences, workshops, and initiatives focused on cancer data and technology, and promotes data-driven innovation. This is a great collaborative group that uses data and technology to make cancer research and treatment more effective and advanced.
NIST AI Risk Management Framework – National Institute of Standards and Technology (NIST) provides this AI risk management resource for considerations of AI development and startup.
ASTHO AI in Public Health: Resource Library – Association of State and Territorial Health Officials (ASTHO) website that provides a curated list of resources on AI use cases, research, risk mitigation, and more.
