Overview
In July, the Office of the National Coordinator for Health IT (ONC) released Version 3 of the United States Core Data for Interoperability (USCDI), including several new data classes. This release builds on version 2 with meaningful improvements to increase health equity and information sharing and opens new opportunities for health tech.
The United States Core Data for Interoperability (USCDI) Version 3 includes 24 new data across 6 data classes – laboratory, medications, patient demographics/information, procedures, health status & assessment, and health insurance information.
Health Insurance & Coverage Information
The health insurance information data class standardizes the format of a patient’s health insurance and coverage for sharing between technology systems and providers. The data class includes:
- Coverage status
- Coverage type
- Relationship to subscriber
- Member identifier
- Subscriber identifier
- Group number
- Payer identifier
Insurance information has been a consistent struggle to share across systems. With the increase in digital health applications that handle patient care, the ability to share coverage information is now imperative. This new data class opens the possibility of improving eligibility, prior authorization, and reimbursement workflows. It may also enable patients to share their health insurance and coverage information digitally more easily.
Health Status & Assessments
The health status and assessments data class represent assessments of health-related matters performed in a care setting. This data class expands and standardizes the Health Concerns Version 2 Data Class, which will become the new Health Status and Assessment Data Class in Version 3. The data elements for statuses covered in the data class include:
- Disability Status
- Mental/Cognitive Status (Mental Status in Draft v3)
- Functional Status
- Pregnancy Status
The ability to share patient health statuses easily between providers has the potential to improve care delivery and continuity. Aggregating health statuses across populations creates better public health reporting and can uncover opportunities to improve care equity.
Other Updates
In addition to the new data classes for health insurance and coverage information and health status and assessments, Version 3 makes meaningful improvements with new and updated data elements to the laboratory, medication, procedure, and patient demographic/information data classes.
The Patient Demographics data class in Version 2 expands context and scope and will become Patient Demographics/Information in Version 3. It includes new data elements for Date of Death, Related Person Name, Related Person Relationship, Occupation, and Occupation Industry. These expansions and additional data elements provide a more holistic view of the patient, improve the linkage between related persons, and provide better public health reporting.
The Medications Data Class in Version 3 now includes new data elements for Dose, Dose Unit of Measure, Indication, and Fill Status. The optimal terminology for the Medications Data Element is also now identified as the National Drug Identifier (NDC) code. The new data elements are necessary for CMS reporting and ePrescribing and will make it more readily accessible for technology systems to develop solutions for improved efficiency.
The Procedure data class contains a new data element for Reason for Referral and the Vital Signs data element, Weight-for-Length Percentile, from “Birth – 36 Months” to “Birth – 24 Months.
What Do These Changes Mean?
The additions and changes in USCDI Version 3 are incremental improvements to healthcare data exchange standards and, along with the 21st Century Cures Act, help solidify the movement to connect healthcare and make data accessible.
Disparate systems, communication barriers, and messy data result from digitalizing patient records to EMR and EHR systems. We can now collaborate, create standards, and connect healthcare to improve care accessibility, delivery, and equity.
