Introduction - HackMD

source: https://hackmd.io/@erichaas/BkmQLcgd1e/%2FBbwXv2JsT1W992E7pIl2EQ parallel C-CDA design: https://confluence.hl7.org/spaces/SD/pages/325458754/USCDI+v6+Implementation+Guidance ![argo_small](https://hackmd.io/_uploads/SyiP7bKrR.png) # Introduction ## New Data Classes and Data Elements ### The following table summarizes the *FINAL* data classes and data elements for *USCDI v6*: ![image](https://hackmd.io/_uploads/BkX-UNtwee.png) ![image](https://hackmd.io/_uploads/Hy7MIEtDxe.png) \* significantly modified data element  ### What has changed between the Draft and Final versions: (Generated by Grok, an xAI AI model, on July 31, 2025) ### Version History and Background - Final (July 2025) Includes a complete version history table with "Version 6 | Publication | July 2025". ### Key themes in differences: - **No major removals**: The core structure remains similar, with expansions rather than reductions. - **Updates for currency**: Standard versions (e.g., LOINC, SNOMED) are updated to reflect the latest available at publication. - :star: **Structural changes**: Some data elements are promoted to new data classes, renamed, or reorganized for clarity. - :star: **Additions and modifications**: usage notes, examples and some definitions. | Data Class | Key Differences in Final vs. Draft | |------------|------------------------------------| | **Care Plan** (Final) / **Patient Summary and Plan** (Draft) | Renamed in final to "Care Plan". Includes Assessment and Plan of Treatment, Care Plan. Final adds usage notes on shared plans across settings (e.g., clinical, condition-specific). Examples expanded (e.g., coordinated care plan). | | **Family Health History** | Promoted to standalone class in final (page 14), with SNOMED/ICD-10-CM standards. In draft, it's a data element under Problems (page 33). | | **Goals and Preferences** |Standards updated (LOINC 2.80 vs. 2.78)/ (SNOMED Clinical Terms (SNOMED CT) U.S.Edition, March 2025 Release). Adds examples for Patient Goals Data Element.| | **Medical Devices** | Unique Device Identifier usage note clarified (contains DI and PI). No major changes. | | **Medications** | Standards updated: RxNorm (July 7, 2025 vs. Jan 6, 2025); NDC optional (July 23 vs. Jan 14, 2025). Changed Data Element, "Fill Status" to "Dispence Status".| | **Observations** | Removed and Advance Directive Observation Data Element moved into Goals/Preferences in Final | | **Problems** | Family Health History removed (promoted to own class). Standards updated (SNOMED March 2025, ICD-10-CM 2025). | |**Other Changes** | Updates to Definitions, Usage Notes, Examples for Patient Goals, Specimen Condition Acceptability  source: [ASTP Standards Bulletin 25-2](https://www.healthit.gov/topic/standardsbulletin_25-2) References:  - [ASTP USCDI website](https://www.healthit.gov/isp/united-states-core-data-interoperability-uscdi#uscdi-v6) - [ASTP USCDI v6 Standard Document (PDF)](https://www.healthit.gov/isp/sites/isp/files/2025-07/USCDI-Version-6-July-2025.pdf) ## Design Principles 1. Our goal is that US Core "defines the **minimum** set of FHIR RESTful interactions for each of the US Core Profiles to access patient data. By establishing **the “floor” of standards** to promote interoperability and adoption through common implementation." 2. Meets the certification requirement and "allows for further standards development evolution for specific uses cases." 3. Use existing FHIR R4 Profiles, Extensions, and Standard Vocabulary when possible. 4. Align with CCDA when possible 6. Link terminology directly to the FHIR® Terminology Service for VSAC Resources,[Value Set Authority Center (VSAC)](https://vsac.nlm.nih.gov/), where applicable and, as a result, align terminology between US Core and HL7 C-CDA. 7. Base our decisions on what is implementable today vs creation of new "aspirational" content. ## US Core Proposals: - [Care Plan](/RDdfbNNsSy-d4IBEX9L4mg) - [Family Health History](/PJg540_xTv6TbJ-b7rUC_A) - [Facility Address](/I0j6EPn6SmGF1vTtp_WR8A#) - [Date of Onset](/0aZXIcJ2SUe2c70L8jyh6A) - [Unique Device Identifier (UDI)](/9wtIE4WlTnGAlY4zPtUZdQ) - [Portable Medical Order](/PbvJwFrkTTqI2CNfBWyOYw) - [Other USCDI V6 Changes](/HI9irNnZSYijIYdDNYl1_A)