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With new interoperability standard, ONC tries to tackle health inequity

The USCDI v3 standard makes it easier to share data on health assessments, insurance status, and demographics to help advance health equity.
By admin
Aug 8, 2022, 8:00 AM

Last month, the Office of the National Coordinator for Health IT (ONC) released the latest version of the United States Core Data for Interoperability standard. With USCDI v3, ONC introduced data elements that better indicate a patient’s health insurance coverage and identify potential health needs in the name of addressing issues of health inequity.

The USCDI standard identifies the structured and unstructured data elements that are most frequently shared among healthcare organizations and the technology applications that they use. Under the Cures Act Final Rule, released in March 2020, electronic health record systems are required to share data that maps to the USCDI standard.

In all, USCDI v3 includes 24 new data elements that fit into one of six categories, or classes. Two of the data classes are new, with one pertaining to health assessments and the other to health insurance coverage, while the Patient Demographics class also received several updates.

Related story: 3 steps to improving health equity in the safety net environment

ONC said these additional data elements to the interoperability standard are meant to align with an Executive Order issued in the early days of the Biden Administration to better support health equity in underserved communities. Here’s a quick breakdown of what they entail and why they’re important.

Health Status and Assessments. These data elements describe four health assessments that can be conducted as part of a patient visit: Disability status, mental or cognitive status, functional status, and pregnancy status. Sharing this information helps healthcare organizations identify and address potentially unmet care needs, which has been shown to improve patient outcomes in the long run.

  • An estimated 20% of American adults experience mental illness each year, but just 46% of individuals receive treatment. Left untreated, these patients have a 40% higher risk of developing cardiovascular and metabolic diseases.
  • Research shows that prenatal care early in the first trimester reduces the likelihood of adverse health outcomes for both mother and child, but 15% of American women report not receiving prenatal care as early as they’d like.
  • Routine collection of functional status (the ability to perform daily activities) when patients are discharged from the hospital has been linked to an improved ability to predict outcomes as well as future healthcare utilization, such as long-term care admission.

Health Insurance Information. Capturing insurance coverage information is valuable because insurance coverage is a known barrier to healthcare access due to high out-of-pocket medical costs, especially for preventive care associated with chronic conditions. In addition, uninsurance rates remain higher for Black and Hispanic Americans than for White Americans, particularly in states that haven’t expanded Medicaid.

Patient Demographics/Information. Capturing additional patient information has three key benefits, ONC said: It supports linking records to family members, it provides data that’s valuable for public health reporting, and it supports care coordination among multiple care providers.

ONC updates the USCDI standard on a periodic basis. Submissions for v4 will be accepted until Sept. 30, with a draft of v4 expected in January 2023. A public comment period will follow, and the final version of v4 is expected in July.


Brian Eastwood is a Boston-based writer with more than 10 years of experience covering healthcare IT and healthcare delivery. He also writes about enterprise IT, consumer technology, and corporate leadership. 

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