ONC Adds Public Health Reporting Specifications to Interoperability Guidance

ONC has added health IT specifications for ePrescribing and public health reporting to its Interoperability Standards Advisory (ISA) Reference Edition.

ONC’s 8th annual update of the Interoperability Standards Advisory (ISA) Reference Edition includes new specifications related to ePrescribing and public health reporting, according to a HealthITBuzz blog post written by Andrew Hayden.

ISA is a catalog of curated health IT data standards and implementation specifications based on feedback from industry stakeholders.


ONC added CDC Immunization Information System (IIS) code set standards and Health Level Seven (HL7) IIS implementation guidance to the “COVID-19 Novel Coronavirus Pandemic” interoperability need, officials said.

“To better support CDC’s COVID-19 reporting requirements, we’ve added a newer release of HL7 Laboratory Test Compendium Framework to Support the Transmission of a Laboratory’s Directory of Services to Provider’s Health IT or EHR System,” Hayden noted.


ONC has also added National Council for Prescription Drug Programs’ Real-Time Prescriptions Benefit Standard Version 12 to the Content/Structure section of ISA. This is set to improve interoperability between pharmacy benefit payers and prescriber systems, Hayden said.

Public Health Reporting

The 2022 ISA includes an HL7 Laboratory Results Interface implementation specification for newborn screening results and birth defect reporting to public health agencies.

Hayden also noted that ONC added a FHIR Laboratory Report emerging data standard to ISA’s “Electronic Transmission of Reportable Laboratory Results to Public Health Agencies” interoperability need to raise awareness of the potential use of FHIR for public health reporting.

Social Determinants of Health (SDOH)

ONC officials added PACIO Workgroup implementation guides and the CMS Data Element Library to the “Representing Patient Cognitive Status and Representing Patient Functional Status and/or Disability” interoperability need.

“Publication of the Cognitive Status and Functional Status Implementation Guides in HL7 propel health IT interoperability to better serve some of the most vulnerable populations, such as the elderly and disabled,” Hayden wrote.

“We’ve added a new interoperability need, Work Information Templates, and populated it with HL7 Occupational Data for Health and Clinical Document Architecture implementation specifications,” he added.

ONC also added LOINC codes to the “Representing Depression and Representing Social Connection and Isolation,” in efforts to provide a source of applicable value sets.

Additionally, the agency added the Gender Harmony Project to ISA’s “Representing Patient Gender Identity” section to highlight ongoing industry efforts to represent Sexual Orientation/Gender Identity information for various clinical uses.

“ONC will be keenly following the project, especially as it pertains to changes desired by the industry in future versions of United States Core Data for Interoperability,” Hayden said.

“There are many other revisions to ISA, including re-wording of interoperability need names, updating standard/implementation specification adoption levels and replacing broken links,” he added. “We’ve also populated Appendix II with additional models and profiles and updated Appendix IV with state and local public health agency interoperability program links.”

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