ISA Timeline and Comment Process


USCDI Data Element to Level 2: Veteran Status

Based on our recent work completed by the VHA Knowledge Based Systems (KBS), Clinical Informatics and Data Management Office (CIDMO) in collaboration with the Department of Defense, the Federal EHR Modernization, CDC NIOSH, and HL7 it is timely to promote the Veteran Status  ( to Level 2. Veteran Status as well as combat history are relevant to assessing certain health risks. The  proposed change is supported  by approved HL7 FHIR Implementation Guide and Connectathon activities illustrating the use of this data element to support Social Determinants of Health and the Gravity Project HL7 accelerator. Connectathon reference: FHIR IG: USCDI: Veteran Status | Interoperability Standards Advisory (ISA) (

Support including Genomics in USCDI v4

Invitae comments in support of elevating the Genomics Data Class to Level 2 and including in USCDI v4. Please find our comments attached. 


Sharing race/ethnicity data between systems

Is there a requirement that race/ethnicity be shared along with other medical information?         The clinic where I volunteer has an EHR interface with the state's immunization registry that seems to only upload data on the immunization but race/ethnicity have to be entered manually. Is this not an interoperability requirement?       I have also volunteered with our local health department's COVID-19 data quality team for almost two years. Most of the Electronic Health Records for positive COVID-19 PCR tests that labs send to the state's online notifiable disease system do not include race and ethnicity. In addition, about 10 % of the ELRs don't have a valid phone number (no phone or area code repeated etc.) and about 5 % do not have a valid residential address for the person (no address or the address of the testing facility etc.). Is there a way to fix this on the front end? We spend most of our time tracking down this missing data. Thanks.                

Patient Naming Policy

I support AHIMA's Patient Naming Policy to improve patient safety.

AIRA Comments

On behalf of the American Immunization Registry Association (AIRA) we are pleased to submit comments on the Office of the National Coordinator’s (ONC’s) updated Interoperability Standards Advisory. These comments are a compilation of the input of our members which include over 80 organizations representing Public Health Immunization Information Systems (IIS), IIS implementers and vendors, non-profit organizations and partners. Immunization Information Systems interface with a broad range of stakeholders, including providers, pharmacists, schools, child care facilities, health plans and payers, among others. Most of AIRA's comments were uploaded on specific pages, but the comment below likely needs a new page: AIRA proposes the addition of a new HL7-balloted Implementation guide for Immunization Decision Support Forecast ( This emerging FHIR R4 standard has been balloted through HL7, published, and is in use in several pilots and/or proof of concepts. AIRA is happy to discuss in greater detail how to represent this new standard on the ISA. We believe this should fit nicely within Content/Structure or Services/Exchange Standards within their respective Clinical Decision Support sections. Thank you for the opportunity to provide comments, and please let us know if there are any follow up questions. 

DirectTrust's Comments on ISA

Thank you for the opportunity to comment on the Interoperability Standards Advisory.  See attached. 

ISA Updates 2021 0930 v2.xls

Academy of Nutrition and Dietetics Comments on 2021 ISA

On behalf of the Academy of Nutrition and Dietetics, thank you for the opportunity to provide our feedback on the Interoperability Standards Advisory.

Academy Comments on 2021 Interoperability Standards Advisory.pdf

terminologies referenced by ISA

It would be very useful to have an "index," so to speak, of all the terminologies/code sets/vocabularies referenced by ISA and where in ISA they're referenced. Does such a thing already exist?