HHS updates interoperability standards to support sexual orientation and gender identity


The U.S. Department of Health and Human Services’ Office of the National Coordinator for Health Information Technology (ONC) recently released an update to the agency’s United States Core Data for Interoperability (USCDI) – a standardized set of health data classes and elements that are utilized for interoperable health information exchange – to support electronic exchange of information regarding patients’ social determinants of health (SDOH), sexual orientation and gender identity (SO/GI).

By updating the standards, health care providers will be able to electronically capture and use SDOH and SO/GI data in clinical settings. Currently, many health care facilities have not developed systems to collect SO/GI data from their patients, which often results in health disparities for lesbian, gay, bisexual and transgender patients whose health care needs are not properly identified. ONC stated that it hopes the update will help “address disparities in health outcomes for minoritized, marginalized, and underrepresented individuals and communities.”     

The update does not require health care providers to record the data or for individuals to share the data, but does create a framework for health information technology developers to build support for exchanging the data in the future. ONC’s release will make the updated version of USCDI available for consideration as part of ONC’s Standards Version Advancement Process (SVAP), which takes place this fall. The SVAP will allow health information technology developers to update their certified health information technology to support the new version of USCDI and to push those updates to their provider and hospital clients. 

As required by ONC's Cures Act Final Rule published in May 2020, health care providers are prohibited from interfering with the access, exchange or use of electronic health information, which – until October 6, 2022 – is limited to the data elements in USCDI. Any update to USCDI approved through SVAP will remain voluntary for health care providers, but could become a new standard through future ONC rulemaking. 

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