- United States Core Data for Interoperability (USCDI) | Interoperability Standards Advisory (ISA) (healthit.gov) is a standardized set of health data classes and data elements for nationwide (US), interoperability health information exchange. USCDI is updated annually.
- 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 by EHRs can be found here: adoption by EHRs.
- Timeline – initial input closes September; version for public comment February – April; publishes every July.
- 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.
- Intended to fill the gaps for quality, public health, providers, behavioral health, etc.
- Much more flexible – but on an annual time frame to make it easier for vendors.
- Established domains, including maternal health and public health.
- 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.
- 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:
- MedMorph Implementation Guide: HL7.FHIR.US.MEDMORPH\Background – 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.
- MedMorph 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.
- Office of the National Coordinator (ONC) Interoperability Standards Advisory: Interoperability Standards Advisory (ISA) | Interoperability Standards Advisory (ISA) (healthit.gov) sets policies, standards and implementation specifications for use in healthcare interoperability in the US for clinical, public health, and research purposes.
- ONC Data Briefs include information on Health IT adoption and use statistics, such as use of APIs and electronic public health reporting Databriefs | HealthIT.gov.
- Health IT Events includes a variety of recorded events. Several recent events of particular interest:
- 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).
- 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.
- ONC’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.
- 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
