The Office of the National Coordinator for Health Information Technology (ONC) released version 2 of the United States Core Data for Interoperability (USCDI) on July 9, 2021. The new USCDI includes three new data classes and 22 new data elements, including data elements for sexual orientation and gender identity and four data elements for social determinants of health (SDOH). ONC discusses the updated standards in the July 2021 issue of ONC Health IT Standards Bulletin. ONC intends that the collection, access, use and reporting of standardized SDOH, sexual orientation and gender identity data can help identify and address differences in health equity. In addition to the SDOH, sexual orientation and gender identity elements, version 2 of USCDI includes new data classes and elements for clinical tests, diagnostic imaging and encounter information. ONC also announced that suggestions for new data classes or elements for the next version of USCDI will be accepted until September 30, 2021.
New data elements for SDOH are included in the data classes for Assessment and Plan of Treatment; Goals; Problems; and Procedures. In all the data classes, SDOH data relate to conditions in which people live, learn, work, and play and their effects on health risks and outcomes.
SDOH Assessment: Structured evaluation of risk (e.g., PRAPARE, Hunger Vital Sign, AHC-HRSN screening tool) for any Social Determinants of Health domain such as food, housing, or transportation security.
SDOH Goals: Identifies a future desired condition or change in condition related to an SDOH risk in any domain and is established by the patient or provider, (e.g., Has adequate quality meals and snacks, Transportation security - able to access health and social needs).
SDOH Problems/Health Concerns: An identified Social Determinants of Health-related condition (e.g., Homelessness (finding), Lack of adequate food, Transport too expensive (finding)).
SDOH Interventions: A service offered to a patient to address identified Social Determinants of Health concerns, problems, or diagnoses (e.g., Education about Meals on Wheels Program, Referral to transportation support programs).
The data class for patient demographics includes data elements for sexual orientation and gender identity. Sexual orientation is defined as: A person's identification of their emotional, romantic, sexual or affectional attraction to another person. Coding for sexual orientation includes values for Lesbian, gay or homosexual; Straight or heterosexual; Bisexual; Something else; Don't know; and Choose not to disclose. Gender identity is defined as: A person's internal sense of being a man, woman, both, or neither. Coding includes values for Male; Female; Female-to-Male; Male-to-Female; Genderqueer, neither exclusively male nor female; Additional gender category or other; and Choose not to disclose.