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United States Core Data for Interoperability Plus (USCDI+) Quality - Draft Data Element List

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Overview: USCDI+ Quality

The Office of the National Coordinator for Health Information Technology (ONC) launched the USCDI+ initiative in Fall 2021 to help government and industry partners build on USCDI to support specific program needs. Since that time, ONC has developed several USCDI+ domains, including one for Public Health and one for Quality, through collaboration with the Centers for Disease Control and Prevention (CDC), the Health Resources and Services Administration (HRSA), and the Centers for Medicare and Medicaid Services (CMS).

One objective of the USCDI+ Quality domain is to identify opportunities to align policies for quality reporting programs across agencies in the Department of Health and Human Services. An additional objective is to harmonize quality data elements into a common list of data elements to streamline the development and reporting of quality measures. The USCDI+ Quality data element list includes the data in USCDI.

About the Draft Data Element List for USCDI+ Quality

The draft data element list for USCDI+ Quality provides a framework for a predictable, transparent process for evaluating and organizing data elements to support the exchange and use of data for quality measurement across programs, payors, and care settings.

Over the last year, ONC gathered input from a variety of sources to develop the first draft of the data element list for USCDI+ Quality. ONC and partners reviewed data requirements for electronic clinical quality measures (eCQMs) currently used in CMS’s eligible hospital/critical access hospital and eligible clinician quality reporting programs. ONC also reviewed data elements included in draft and published Health Level Seven International® Fast Healthcare Interoperability Resources® (FHIR®) Implementation Guides (IGs) for various use cases, such as long-term and post-acute care, oncology, and federally qualified health center reporting requirements. ONC also held a series of discussions with organizations in the public and private sector involved in measure development, measure evaluation, and quality reporting, to go beyond the current specifications in eCQMs to identify high priority data elements for inclusion in the draft data element list for USCDI+ Quality.

USCDI+ Quality will provide support to CMS's transition to a FHIR-based quality reporting system. Similar to the relationship between the USCDI and US Core IGs, the USCDI+ Quality data elements will provide a consistent construct for technical specifications and IGs needed by measure developers, measure implementers, and standards development professionals.

Two files are included in the draft data element list for USCDI+ Quality:

  • USCDI+ Quality Data Element List: Contains the data classes and data elements for inclusion in the first data element list for USCDI+ Quality. The intent of this list is for review by quality improvement leaders responsible for policy and programmatic decisions about measurement priorities and individuals developing quality measures and data standards. The file includes the current USCDI status of each element to illustrate how USCDI+ Quality complements USCDI. The final column provides the source of the data element and indicates use in existing CMS eCQMs.
  • USCDI+ Quality – eCQM Use Case Mapping: This a specific use case for CMS quality reporting programs and contains a crosswalk from the proposed data classes in the USCDI+ Quality Data Element List to data elements extracted from an analysis of eCQMs currently used in the CMS quality programs to concepts in the FHIR Quality Improvement (QI) Core IG expressed through profiles and corresponding data elements. In addition, there are crosswalks of the data elements to CMS eCQMs. The intent of this example is to provide a degree of technical guidance and insight to individuals translating prioritized data classes and data elements into detailed specifications and standards for quality measures.
The initial USCDI+ Quality comment period, May-June, 2023, closed on Friday, June 30, 2023. ONC Is working to update the USCDI+ Quality data element list and will release an updated list for review and comment later in 2023.
If you have any questions about the USCDI+ initiative, please contact USCDI.Plus@hhs.gov. 
Additional Information on Sources Referenced in the USCDI+ Quality Data Elements List
Last Updated: Sep 07, 2023