Health Equity by Design Concept Paper
An important piece of HHS' commitment to health equity is advancing data equity. Our work directly supports HHS’s health equity efforts with health equity by design, a focus on including health equity at the outset as a key feature during the design, build, and implementation of health IT policies, programs, and workflows.
Using Standards & Certification of Health IT to Improve Health Equity
Data-driven technologies can help make a positive impact on health equity. Through certified health IT and standards initiatives, ONC is focused on improving the use of data to represent social needs at a granular level. For example, ONC’s United States Core Data for Interoperability (USCDI) helps guide how race, ethnicity, sexual orientation, and gender identity data can be consistently recorded across the health system.
In 2022, ONC added additional health equity-supporting data elements to USCDI, including disability status, mental function, tribal affiliation, and insurance information. The July 2022 Standards Bulletin provides more details about how USCDI v3 promotes equity, reduces disparities, and supports public health data interoperability. For USCDI v4 development processes, we have prioritized behavioral health data, which has disproportionate health equity impacts.
ONC’s Health IT Certification Program ensures that certified health IT supports equity considerations from the start and requires that certified health IT can capture and exchange specific health data in a consistent and standardized way. Using a health equity by design approach, the Health IT Certification program ensures that technology is enabling, rather than limiting, the availability of detailed equity-relevant health information such as race, ethnicity, and language; sexual orientation and gender identity; and social determinants of health (SDOH) data.
Fueling a New Generation of Health IT Development
Since 2018, ONC has funded the Leading Edge Acceleration Projects (LEAP) in Health IT program to invest in future-facing health IT uses and inform the innovative implementation and refinement of standards, methods, and techniques to overcome health IT challenges. The 2021 LEAP in Health IT special emphasis notice helped fund health IT areas to specifically address SDOH aligned with clinical care. We continued investing in equity-focused areas of interest in the LEAP in Health IT 2022 notice of funding opportunity. These include addressing health equity and SDOH through EHRs and equity-enhancing patient-generated health data for clinical care and research.
Social and Environmental Factors’ Effects on Health Care
An integral part of healthcare delivery involves understanding the social and environmental factors that affect patients’ lives outside of the healthcare system. Addressing inequities in these conditions, supported in part through the access and use of social determinants of health data, can help to eliminate health disparities and to improve individual and population health.
Project US@: Establishing the Standard for Patient Matching
Launched in 2021, Project US@ (‘USA’) is focused on standardizing how patient addresses are represented and used across the healthcare ecosystem. This standardization strengthens our ability to measure the social, economic, political, and physical environments that impact health. Standardized patient matching can also improve the accuracy of electronic health information and help providers match patients to their data.
Expanding Minority Representation in Public Health Informatics
ONC funded the Public Health Informatics & Technology Workforce Development Program (PHIT Workforce Program) with $73M in American Rescue Plan funds. This program will help expand minority representation in the public health informatics profession and help close gaps in our public health reporting and data analysis, particularly around race and ethnicity-specific data.
Health Equity Resources
ONC publishes blogs, journal articles, and data briefs on a regular basis to ensure everyone can easily stay current with the latest findings and learnings from our work across the health IT ecosystem.
- Patient Engagement HIT | October 2023
- Journal of AHIMA | October 2023
- EHR Intelligence | August 2023
- GovCIO | July 2023
- HealthLeaders | July 2023
- Healthcare IT News | February 2023
- Healthcare IT News | October 2022
- FedScoop | April 2022