Interoperability Resources

Interoperability Resources

This page contains links to resources to learn more about healthcare interoperability standards, U.S. policies and public health use cases. Healthcare interoperability standards and policies are rapidly changing and updates to this page will be made as needed.

  • 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 3 (as of December 2023), but adoption by EHRs is currently at version 2.
    • 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.
  • 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

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