The USCDI+ initiative supports the identification and establishment of domain or program-specific data element lists that operate as extensions to the existing USCDI. USCDI+ is a service ONC provides to federal and industry partners to establish, harmonize, and advance the use of interoperable data element lists that extend beyond the core data in the USCDI in order to meet specific programmatic and/or use case requirements. This approach allows HHS to assure that USCDI+ extensions are built from the same core USCDI foundation, align to harmonized data standards and taxonomies, and create the opportunity for aligning similar data needs across programs and use cases.

ONC released the USCDI+ draft data elements for comments in summer 2024, with a deadline of October 2024 for public comments. ONC is now releasing specific use cases for public comment. APHL will continue to monitor use cases as they are released and will organize review and comment from the public health community as appropriate

USCDI+ Core Data Set

October 2024

APHL commented on the USCDI+ core data set in October 2024. Our overall comments are available here. Our collected comments are available in a spreadsheet (see below). Each comment was entered into the USCDI+ Platform on HealthIT.gov.

JPHIT commented on USCDI+ separately, though APHL was a contributing member to the JPHIT comments. JPHIT comments are available here.

One of APHL’s comments was that it is unclear how ASTP ONC will deal with USCDI+ elements that are overarching across many use cases. Are they keeping track that these are defined consistently across those? How would one approach dealing with 2 use cases, if that is not the case?

APHL also commented on the need for a specimen collection date/time in USCDI. Procedure time is not the same.

USCDI+ Cancer

USCDI+ Cancer Update presentation from Oct 2024

APHL did not provide comments on the Cancer use cases.

4 planned use cases:

• Enhancing Oncology Model EOM (published)

• Cancer Registry CRM; In Dev - Comments due 9/23/24

  • 84 comments, 26 commenters; 60 consolidated comments

• Clinical Trials Matching CTM; In Dev – Comments due in October 2024

• Immunotherapy related adverse events irAE; In Dev - Comments due in November 2024

HL7 FHIR Connectathon in July 2025 – targeting USCDI+ Cancer Testing

USCDI+ Respiratory Illness and ARDS

The focus is on clinicals trials of interventions to treat Acute Respiratory Distress Syndrome (ARDS). There is a gap around ventilator settings in particular that this use case seeks to address. Lab data is not an emphasis. The data is intended to flow from the EHR to clinical trial databases and registries focused on intervention treatment for ARDS.

Listening Session Slides: USCDI+ for Respiratory Illness