USCDI v6 and the Future of Interoperability
- EquinoxHIT News
- Nov 17
- 5 min read
Healthcare interoperability continues to evolve with significant momentum. With USCDI v6 released, USCDI v3 becoming a regulatory requirement for certified health IT on January 1, 2026, and major EHR vendors racing to align their platforms, the industry is closer than ever to achieving truly seamless, patient-centered data exchange. For healthcare leaders planning new facilities or system upgrades, understanding these changes isn't optional, it's essential to building future-ready infrastructure.
The federal government's latest interoperability standard offers a roadmap for more connected care, adding new data elements that support clinical precision, public health, and care coordination. At the same time, leading EHR vendors are evolving their platforms to align with these standards, signaling a broader industry shift toward real-time, structured data exchange.
What Is USCDI?
The United States Core Data for Interoperability (USCDI) is a standardized set of health data classes and elements developed by the Office of the National Coordinator for Health IT (ONC). It defines the minimum data that certified health IT systems must be capable of exchanging to support interoperability across care settings. USCDI is updated annually and serves as the foundation for ONC's Health IT Certification Program, Trusted Exchange Framework and Common Agreement (TEFCA) participation, and Fast Healthcare Interoperability Resources (FHIR)-based APIs (application programming interfaces that enable systems to exchange data).
To understand v6's significance, let's look at how we got here.
v1: 2020 — Foundation data classes
v2: 2021 — Health equity focus (SOGI, SDOH)
v3: July 2022 — Equity, disparities, public health (Required for certified health IT by January 1, 2026)
v4: July 2023 — Care planning, medication reconciliation
v5: July 2024 — Health equity & identity focus
Introduced 16 new data elements across 2 new data classes. These additions advance health equity, identity representation, and clinical precision.
New Data Classes:
Observations: Non-lab and non-imaging tests and findings
Orders: Includes medication, lab, imaging, and procedure orders
Notable Data Elements:
Name to Use
Pronouns
Sex Parameter for Clinical Use
Advance Directive Observation
Interpreter Needed
Medication Order
Author and Author Role
v6: July 2025 — Care planning & device tracking
Builds on v5 with a focus on care planning, device tracking, and facility-level data. These updates aim to improve longitudinal care, emergency preparedness, and public health surveillance.
Promoted Data Elements:
Care Plan
Unique Device Identifier
Family Health History
New Data Elements:
Facility Address
Date of Onset
Device Used
Updated Elements:
Vaccine Code (renamed from "Immunizations")
v7: In development — Draft expected January 2026, final July 2026
The ONC has confirmed that USCDI v7 is already in progress, with public submissions for new data elements underway. Early proposals include additions related to protective factors, social programs, and expanded terminology standards.
Vendor Landscape: USCDI Adoption
Standards are only as good as their adoption. Here's how the major EHR vendors are responding:
Epic Systems
Latest innovations: MyChart Central for unified patient access, Bluetooth sensor integration, real-time wayfinding, staff duress alerts, and prior authorization APIs
USCDI alignment: USCDI v3 support available; actively developing v5 support
QHIN status: Epic Nexus, a subsidiary of Epic, obtained Qualified Health Information Network (QHIN) status in 2023
Oracle Health (Formerly Cerner)
Platform evolution: AI-first solutions with FHIR-based interoperability
USCDI alignment: Supports FHIR R4 APIs for standards-based exchange with USCDI compliance QHIN status: Achieved candidate status (working toward full designation)
MEDITECH
Platform focus: Intelligent data usability and clinician-friendly interoperability through Expanse platform
USCDI alignment: Full support of USCDI v4; committed to v5 support in 2025
QHIN connectivity: Partnered with Health Gorilla (designated QHIN) through Traverse Exchange network
Veradigm (Formerly Allscripts)
Platform approach: Provider-payer-life sciences connectivity through the Veradigm Network
USCDI alignment: Supports FHIR R4 APIs with USCDI compliance across TouchWorks and Altera platforms
QHIN connectivity: Partnered with MedAllies (designated QHIN)
Why This Matters: Interoperability vs. Integration
Here's a distinction that matters for every healthcare construction project: integration connects systems; interoperability ensures they actually understand each other. In August, we explored the distinction between interoperability and integration in HIT, a critical nuance for healthcare leaders. USCDI v6 pushes the industry past simple data exchange toward true semantic interoperability. This means a care plan documented in one system is immediately understood and actionable in another, without translation or manual intervention. This isn't just a technical achievement. It's a transformation in how care is delivered across organizational boundaries. Standardized data elements enable seamless, meaningful exchange across platforms and care settings, turning fragmented information into coordinated care.
Ready to Build for Tomorrow's Standards Today? Equinox HIT is Your HIT Construction Partner.
At Equinox HIT, we ensure your healthcare construction project isn't just compliant. It's built to excel as interoperability standards evolve. Whether you're deploying Epic, Oracle Health, MEDITECH, Veradigm, or another platform, we translate federal standards like USCDI v6 into actionable strategies that work in your facility from day one.
Our expertise spans:
Clinical workflow mapping aligned with USCDI data elements
Device deployment strategies for seamless EHR integration
Governance frameworks that support long-term scalability
C-suite technology roadmaps that bridge construction and activation
Don't let your technology infrastructure become obsolete before the ribbon cutting. From device deployment to C-suite alignment, we ensure technology isn't just installed. It's activated with purpose.
Contact us today to learn how we can help you build smarter, more connected spaces, ready for the future of care and compliant with tomorrow's standards.
References:
AHIMA. "What Does the TEFCA Mean for Your Organization?" 2025. Link
Becker's Hospital Review. "EHR vendors step up interoperability efforts." 2024. Link
Becker's Hospital Review. "Epic unveils new interoperability features: 7 things to know." 2025. Link
Becker's Hospital Review. "Hospitals Accelerate EHR Upgrades in 2025." 2025. Link
eCQI Resource Center. "USCDI v6 Available Now." 2025. Link
EHR Association. "Comments on USCDI v6 Draft." 2025. Link
Epic Systems. "Epic's FHIR API Specifications." 2025. Link
Epic Systems. "In latest interoperability expansion, Epic advances personalized care." 2024. Link
Epic Systems. "Open. Epic: USCDI v5 Development." 2025. Link
Equinox HIT. "Interoperability vs. Integration in HIT." 2025. Link
HCI Innovation Group. "ASTP Releases New Version of USCDI." 2025. Link
MEDITECH. "MEDITECH advances interoperability standards with its full support of USCDI v4." 2025. Link
MEDITECH. "The Push and the Pull: An Interoperability Update." 2024. Link
Oracle Health. "2025 Cerner Real World Testing Plan." 2025. Link
TechTarget. "ONC releases USCDI Version 5 to drive interoperability." 2024. Link
U.S. Department of Health and Human Services. "Health Data, Technology, and Interoperability: Certification Program Updates, Algorithm Transparency, and Information Sharing (HTI-1) Final Rule." 2023. Link
Veradigm. "Introduction - Veradigm and Altera FHIR API." 2025. Link
This article was developed by the Equinox HIT Team with editorial assistance from AI tools and re-reviewed by the Equinox HIT Team for accuracy and alignment with our standards.
