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ONC Updates USCDI, Interoperability Standards for SDOH

New ONC standards aim to improve interoperability of three new data classes: sexual orientation, gender identity, and social determinants of health.

HHS Office of the National Coordinator for Health Information Technology (ONC) has released updated the USCDI interoperability standards to support the nationwide exchange of sexual orientation, gender identity, and social determinants of health (SDOH) data.

The United States Core Data for Interoperability version 2 (USCDI v2) aims to lay the groundwork for the standardized use of SDOH data, as well as sexual orientation and gender identity (SO/GI) information, across the healthcare continuum.

"USCDI version 2 builds on the feedback we received from a wide variety of stakeholders," Micky Tripathi, PhD, national coordinator for health information technology, said in a public statement.  

"We heard that this new version of the USCDI should reflect America's diversity and include data elements like sexual orientation, gender identity, and social determinants of health while helping to address disparities in health outcomes for minoritized, marginalized, and underrepresented individuals and communities,” he continued.

While the update encourages healthcare professionals to record these data, it does not require patients to share such data or for providers to collect it, HHS noted.

"The updated US Core Data for Interoperability takes an important step in reflecting the needs of all patients who access the nation's healthcare system," said Rachel Levine, MD, HHS assistant secretary for health.

Promoting interoperability of these data will help healthcare professionals meet the needs of marginalized communities, such as LGBT patients and individuals facing SDOH.

"For accurate, compassionate, and safe care, it is important for a patient's sexual orientation and gender identity to be part of their care coordination and this new version helps prioritize next steps for the healthcare community as well as help identify patients' specific nonmedical needs — like housing, transportation, and poverty — that affect health to coordinate care and assistance to improve health outcomes,” Levine explained.

The health IT community submitted over 600 data classes and elements, including merged and duplicated data elements, for USCDI version 2's development cycle. USCDI version 2 includes three new data classes and a total of 22 new data elements. As the industry evolves, the USCDI will continue to grow, HHS noted.

USCDI version 2 will be available for consideration as part of ONC's Standards Version Advancement Process (SVAP) this fall. The SVAP allows health IT developers to update their certified health IT to support newer versions of the USCDI (among other standards) to provide those updates to customers before they are required by regulation.

Additionally, the release of USCDI version 2 will prompt standards development organizations to update implementation guides and other requirements to support the update’s new data elements.

ONC's Cures Act Final Rule published in May 2020 and a subsequent interim final rule extending the compliance deadline published in April 2021, requires that certain developers of certified health IT provide their customers with upgraded certified health IT that supports USCDI version 1 by December 31, 2022.

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