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Uniform Data System (UDS) Modernization Initiative

The UDS Modernization Initiative aims to reduce reporting burden, improve data quality, and better measure program services and outcomes. The goal is to expand the value and utility of UDS data for the Health Center Program while improving how health centers prepare and submit UDS data by focusing on four main areas:

  • Reporting Modernization. Improve UDS reporting through advances in health information technology. This effort includes the UDS Patient Level Submission (UDS+) Initiative to move from aggregate reporting of UDS patient demographics and clinical quality measures to reporting of de-identified patient-level data.
  • Content Review. Update UDS tables and content to improve data standardization and quality, including clinical quality measure (CQM) alignment with specification updates.
  • Stakeholder Engagement. Get feedback from UDS stakeholders on proposed changes to UDS reporting processes, tables, and measures.
  • Testing. Before implementing changes, testing innovations with health centers and other UDS reporting stakeholders through the UDS Test Cooperative (UTC).

For more detailed information about the initiative, visit UDS Modernization Frequently Asked Questions.

UDS modernization reporting

UDS+ initiative

Once UDS Patient-Level Submission (UDS+) is fully implemented, health centers will submit de-identified patient-level data instead of aggregated data for existing patient-oriented tables. UDS+ aims to increase the utility of UDS report data and to reduce annual reporting burden by aligning with interoperability standards and reporting requirements used across the U.S. Department of Health and Human Services and within the healthcare industry.

HRSA is working toward increased implementation as interoperability of electronic health information continues to improve and wider adoption of Fast Healthcare Interoperability Resources (FHIR®) standards and associated clinical quality reporting architecture occurs. FHIR® is an application programming interface (API) standard used to represent and exchange health information.

The UDS Modernization Initiative is developing a UDS+ FHIR® data receipt and submission process and is closely following advancements in FHIR®-based reporting led by work groups, industry members, and other federal agencies.

View the UDS Modernization FAQ page for additional information.

UDS Modernization Projects 

Historical UDS Modernization projects have focused on creating reporting tools to help health centers submit legacy UDS data via the HRSA Electronic Handbooks (EHBs) system. These tools are currently used by health centers to report aggregate data only and include:

  • Preliminary Reporting Environment (PRE): From October to December, health centers can use the PRE to enter UDS data before the official reporting season starts in January. This helps identify potential data reporting issues earlier and gives health centers additional lead time to prepare their data for submission.
  • Offline Excel files: Health centers can download UDS tables in Excel to local computers, enter data from electronic health records, and then upload to EHBs. More than one person can fill out the tables at the same time. Health centers can use the error report to correct the data in Excel, or in the EHBs. Also, health centers can use the Excel mapping document as a guide to write commands that extract data and populate the Excel file.
  • Hyper Text Markup Language (HTML) files: Health centers can download the UDS tables in a format that looks like what is in the EHBs. The HTML file validates data when information is entered. More than one person can enter data into different tables at the same time. As each staff member completes their part in Excel, health centers can import these data into the offline HTML file. Health center staff can also export certain data to share with colleagues for review before uploading into the EHBs.

UDS modernization testing

UDS+ proof of concept testing

HRSA is seeking volunteers to participate in UDS+ proof of concept and testing activities. The goals of these activities are:

  • Onboarding participants and confirming their ability to connect to HRSA servers and submit appropriate data files.
  • Testing FHIR® server’s ability to receive data from participant sites.
  • Testing EHR vendor’s ability to submit data files that conform with FHIR® standards.

Health centers, PCAs, HCCNs, and HIT vendors that have the capacity to support UDS+ reporting can communicate their interest to HRSA through the BPHC Contact Form by selecting Uniform Data System (UDS) > UDS Modernization > How to Join the UDS Test Cooperative. 

Completed general UDS modernization reporting tests

A variety of UDS reporting innovations have been tested with stakeholders through the UTC.

Completed modernization reporting tests include:

  • Routine patient visits definition: Using electronic standards to improve the accuracy of health center clinical performance by evaluating: 
    • Whether clinical quality measure (CQM) scores reflect the quality of care given to well-established patients who have identified their health center as their medical home.
    • If CQM scores change when non-routine patient data were included in performance calculations.
  • Standardized countable visits reporting: Testing whether health centers can collect and report UDS countable visits by using electronic clinical quality measure (eCQM) standards from the National Library of Medicine. Using electronic standards increases data reliability, reduces inconsistent reporting of visits across health centers, and decreases reporting burden.
  • Streamlined diagnoses and services reporting (UDS Table 6A). Aligning diagnoses and services in Table 6A with national, standard clinical language to improve consistency and accuracy and reduce reporting burden. Before this change, health centers interpreted and aligned diagnoses and services codes with UDS Table 6A and national systems, which created variation in data and additional burden.
  • Financial tables redesign: Analyzing financial information collected in the UDS to find data that is rarely or inconsistently reported, not comparable to financial audits, and not reflective of a health center’s overall wellbeing.

Content review

Enhancements to UDS tables and content ensures consistent quality and value of UDS data to the Health Center Program. This process helps the program better measure health center services, clinical quality improvement, and the patient population.

Each year, changes to UDS tables and content are described in advance through UDS Program Assistance Letters (PALs), Federal Register Notices, and the annual UDS Manual available on the UDS Training and Technical Assistance microsite. They include aligning UDS clinical quality measures with Centers for Medicare and Medicaid Services (CMS) electronic-specified clinical quality measures (eCQMs) and using national value sets and electronic standards for reporting diagnoses and services.

Stakeholder engagement

Stakeholder engagement is key to the success of the UDS Modernization Initiative. Health centers and other UDS stakeholders have many opportunities to share their feedback on UDS Modernization activities.

The UTC consists of a diverse group of representatives from health centers, Primary Care Associations, Health Center Controlled Networks, National Training and Technical Assistance Partners, and health IT vendors who test and offer feedback on proposed UDS changes and enhancements. 

Learn more

  • Contact us through the BPHC Contact Form if your organization is interested in learning more about UDS modernization efforts and joining the UTC. Choose Uniform Data System (UDS) > UDS Modernization > How To Join the UDS Test Cooperative.
  • Subscribe to the Primary Care Digest for updates about UDS modernization efforts.
  • View Health Care Data Interoperability Resources (PDF - 112 KB) for information about general health IT implementation from BPHC and its partners, other federal government agencies, and non-profit organizations.
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