In early 2025, the Office of the National Coordinator for Health Information Technology (ONC) took a significant step in shaping healthcare data exchange by publishing the ONC Standards Bulletin 2025-1 Draft United States Core Data for Interoperability Version 6 (USCDI v6). The draft proposes updates to the standardized minimum dataset used for electronic exchange across health systems, payers, technology vendors, public health entities, and patients.1
Interoperability remains a central technology and policy priority for U.S. healthcare. Persistent friction in electronic data exchange can slow care coordination, increase redundant documentation, and limit patient access to usable information across providers and settings. Against this backdrop, draft USCDI v6 continues ONC’s pattern of expanding the minimum dataset over time to reflect emerging care and reporting needs.1
The USCDI initiative serves as a reference baseline for health IT developers and healthcare organizations when designing and implementing exchange workflows. It is also a practical roadmap for data capture and normalization efforts, since data elements cannot be exchanged consistently unless they are captured consistently, mapped to usable terminologies, and represented in implementation-ready forms.1
The Draft USCDI v6 Bulletin reflects ONC’s intent to push interoperability beyond traditional “core clinical” datasets by proposing additional data elements that support longitudinal care coordination, patient access, and broader exchange use cases. The draft is positioned as a step in the iterative expansion of USCDI, with ONC soliciting feedback on both the proposed content and the practical impact on implementation.1
A notable proposal in the draft is expanded Unique Device Identifier (UDI) representation, including broader consideration of device information beyond certain historical constraints. In operational terms, richer device context helps link device use to outcomes, supports safety surveillance, and improves downstream analytics when device-related complications, recalls, or product performance questions arise over time.1
The draft also signals attention to use cases that benefit from broader context around the patient and care environment, which can include information that supports care coordination across settings. As healthcare organizations lean more heavily on population health programs and proactive care management, “contextual” data becomes more important to exchange reliably and interpret consistently.1
From an implementation standpoint, USCDI expansions create work in multiple layers at once: data capture (front-end workflow and forms), data storage and structure (EHR and ancillary systems), terminology mapping, and exchange packaging (such as FHIR-based representations and implementation guidance). Even when a data element is clinically valuable, the real-world adoption curve depends on how cleanly it can be integrated into clinical workflows and how consistently it can be captured without adding undue burden.1
ONC’s draft acknowledges implementation feasibility as part of the feedback process. That matters because the practical burden is not limited to “adding a field” in one system. It often requires coordinated changes across EHR vendors, interfaces, HIE participants, quality and reporting pipelines, and validation tooling that ensures data arrives in a usable, semantically consistent form on the receiving side.1
These proposals are important beyond standards discussion. Interoperability requirements are frequently downstreamed into certification and operational expectations, and USCDI serves as a common reference point for what data must be exchange-ready as policy and certification cycles progress. For health systems and vendors, draft USCDI v6 should be treated as an early signal of where data normalization and exchange investments are heading later in 2025 and beyond.1
While USCDI v6 aims to broaden the scope of interoperable data, adoption challenges remain. Expanded data elements can require coordinated upgrades across EHR platforms, HIEs, and the ancillary systems used for care coordination, reporting, and analytics. Smaller health systems and ambulatory practices may face disproportionate strain if new elements require workflow changes, terminology mapping, and interface updates without matching operational capacity.1
Consistency is the core technical challenge behind every new data element. If organizations capture the “same” concept in different ways, downstream exchange becomes noisy: receiving systems cannot reliably interpret or operationalize the data. This increases the need for clear definitions, validated value sets, implementation guidance, and testing tools that support consistent adoption under real clinical conditions.1
Interoperability policy also intersects with privacy, governance, and the rules that shape permissible exchange. As USCDI expands, stakeholders must continue balancing broader data availability with patient rights and organizational governance expectations so data exchange remains useful and trustworthy across care contexts.1
ONC’s publication of the draft USCDI v6 opened a formal stakeholder feedback process focused on the proposed elements and the implementation considerations attached to them. Public input at this stage can influence the final shape of the dataset by clarifying definitions, refining boundaries, and identifying feasibility constraints that are difficult to see without frontline implementer experience.1
In practice, stakeholder feedback often centers on questions that determine whether a new element becomes usable at scale: whether the element is defined precisely enough to capture consistently, whether value sets exist or need refinement, and whether the exchange representation supports consistent interpretation. Feedback also commonly highlights unintended workflow consequences, especially where data capture would add steps for clinicians or introduce ambiguity for registration staff and support teams.1
Draft publication does not immediately create certification requirements, but USCDI updates commonly serve as inputs into future certification and regulatory cycles. This is why the draft phase matters operationally for vendors and healthcare organizations: it is the window where planning can begin, internal roadmaps can be aligned, and resource needs can be forecast before requirements become time-bound in downstream programs.1
Implementation readiness should be treated as a sustained operational priority rather than a one-time compliance exercise. Teams can use the draft period to assess where relevant data would be sourced, how it would be captured, which systems would store it, what mappings and terminology normalization would be required, and how exchange workflows would be validated end-to-end. This kind of proactive readiness reduces surprises later, especially in multi-vendor environments where data flows through HIEs, analytics platforms, and patient-facing tools.1
For 2025 planning, the most practical outcome of the draft is clarity: it signals what ONC believes should be part of a minimum interoperable dataset next. Organizations that align data governance, workflow design, and interoperability engineering to these signals are better positioned to adopt the final specification with less disruption and better downstream data quality.1
The draft USCDI v6 release reflects evolving health IT policy that prioritizes data access and utility in a digital care ecosystem increasingly reliant on analytics, coordinated care, and patient engagement. Incremental advances in standardized exchange can improve continuity across telehealth, population health management, and clinical decision support when implementations are consistent and testable.1
Ultimately, the success of USCDI v6 will depend on collective execution by healthcare organizations, technology developers, standards bodies, and policymakers to embed interoperability into operational workflows, not just interfaces. By expanding the draft core dataset and inviting broad stakeholder input, ONC is signaling continued momentum toward a more connected and data-driven health system in 2025 and beyond.1
