Uniform Data System (UDS) Modernization Frequently Asked Questions (FAQ)

Updated: 12/15/2021

What is the UDS Modernization Initiative?

UDS modernization is a continuous effort to improve data reporting from participants of the Health Center Program. These efforts focus on reducing reporting burden and improving data quality and granularity to better evaluate Health Center Program services and outcomes. The goal is to optimize the use and value of UDS data for health centers and HRSA while improving how health centers prepare and submit UDS data.

(Added: 12/3/2021)

What is the UDS+?

The UDS Patient-Level Submission (UDS+) is an implementation of recent UDS modernization efforts. UDS+ has redesigned parts of the UDS to increase data granularity while simultaneously reducing the annual reporting burden by aligning with interoperability standards and reporting requirements being adopted across the U.S. Department of Health and Human Services and the healthcare industry. These redesigns will replace the existing table data elements aggregated at the health center level, with patient-level data (see question 7 and 12) for the 2023 UDS report.

(Added: 12/3/2021)

What is the purpose of UDS+?

The purpose of UDS+ is to facilitate patient-level reporting data that will better articulate the unique characteristics and needs of health center patients, illustrate the impact, breadth, and depth of health center services and their impact on health outcomes; better inform training, technical assistance, and research and evaluation efforts; and better inform health equity work.

(Added: 12/3/2021)

What is the benefits of UDS+ for health centers?

The primary focus of UDS+ will help reduce reporting burden so health centers can focus on delivering care to patients. Additionally, UDS+ will improve data quality and granularity, improving health centers’ ability to communicate the complexity of the patient populations they serve and provide evidence for reimbursements for care provided. Patient-level data also allows for communities, local, state, and federal agencies to better evaluate the Health Center Program; provide targeted training and technical assistance; and advance quality improvement research to improve equitable access to high-quality, cost-effective care. For example:

  • UDS+ will allow for a better understanding of the Health Center program patient population by including both routine (i.e., patients who received care at least once during the reporting year and at least once during the previous year) and other patients. This information can help health centers better track health outcomes and identify trends or needs that can be used to inform policy and funding on two potentially distinct patient groups.
  • The shift to UDS+ will prepare health centers for reporting their data in accordance with federal interoperability standards. Health centers will be able to electronically report data from their electronic health records with a UDS module and reduce reliance on manual data entry.

(Added: 12/3/2021)

What are some examples of how UDS+ will improve data granularity?

Data granularity is the level of detail in a database. Granular data can be aggregated and disaggregated to meet the needs of different situations. UDS+ will improve data granularity by:

  • Better understanding needs, interventions, and health outcomes of special populations: For example, veterans experiencing homelessness often have unique health needs and might be eligible to receive support from specific programs designed to provide care to this population. Currently, UDS data cannot show the number of patients who are veterans and experiencing homelessness; it can only show the total number of veterans and the total number of individuals experiencing homelessness within a given health center’s patient population. Patient-level data will allow quality improvement staff, researchers, policymakers, and other stakeholders to identify needs of health center patients and allocate resources accordingly.
  • Collecting "routine patient” indicators: For example, health outcomes of routine patients who visit a health center every year for an annual exam could be analyzed separately from patients who only visit a health center once.

(Added: 12/3/2021)

What is the timeline for adopting UDS+?

UDS+ will become part of 2023 UDS reporting requirements. Health centers will need to adopt UDS+ when reporting CY 2023 UDS data (i.e., submission in February 2024).

(Added: 12/3/2021)

How will UDS+ change how health centers report UDS data?

Beginning with the 2023 UDS reporting cycle, HSRA will accept patient-level report data using FHIR (Fast Healthcare Interoperability Resources; see question 14) or alternatively through a manual file upload for the following UDS tables’ data elements:

  • Patients by ZIP Code
  • Table 3A: Patients by Age and by Sex Assigned at Birth
  • Table 3B: Demographic Characteristics
  • Table 4: Selected Patient Characteristics
  • Table 6A: Selected Diagnoses and Services Rendered
  • Table 6B: Quality of Care Measures
  • Table 7: Health Outcomes and Disparities

(Added: 12/3/2021)

What tables will continue to be accepted in the traditional aggregated format?

  • Table 5: Staffing and Utilization
  • Table 5: Selected Service Detail Addendum
  • Table 8A: Financial Costs
  • Table 9D: Patient Service Revenue
  • Table 9E: Other Revenues
  • Appendix D: Health Center Health Information Technology (HIT) Capabilities
  • Appendix E: Other Data Elements
  • Appendix F: Workforce

(Added: 12/3/2021)

When do health centers need to stop using chart sampling?

Health centers will be required to report on their full universe of patients in the CY2022 UDS reporting cycle. By retiring chart sampling as a method for reporting on any of the CQMs in UDS Tables 6B and 7, the data will provide a more accurate and complete reflection of the quality of care for all patients served.

(Added: 12/3/2021)

How can health centers get more information about UDS+?

(Added: 12/3/2021)

How can health centers provide feedback?

Stakeholder engagement is key to the success of the UDS Modernization Initiative overall, and UDS+ implementation. Health centers and other UDS stakeholders have many opportunities to share their feedback on UDS Modernization activities. The UDS Test Cooperative (UTC) consists of a diverse group of UDS stakeholders who test and offer feedback on proposed UDS changes and enhancements. The UTC includes staff from health centers, Primary Care Associations, Health Center-Controlled Networks, and Health IT Vendors. A Steering Committee of health center representatives from the ten HHS Regions leads the group. Other feedback channels include interactive sessions with health centers, surveys and participation in pilot projects. If your organization is interested in learning more about UTC or becoming a test site, contact us through the BPHC Contact Form HRSA BPHC exit disclaimer. Choose the requestor type, question type (health center), and BPHC subcategory (UDS Modernization Initiative).

(Added: 12/3/2021)

How can health centers prepare for UDS Modernization overall, and UDS+ implementation?

  • Begin discussions with stakeholders (e.g., health IT staff and vendors) to understand UDS+ requirements in anticipation of CY2023 UDS reporting.
  • Visit the UDS Modernization Initiative webpage to learn more.
  • Submit questions about UDS Modernization through the BPHC Contact Form HRSA BPHC exit disclaimer. Choose the requestor type, question type (health center), and BPHC subcategory (UDS Modernization Initiative).

(Added: 12/3/2021)

What is patient-level data reporting referred to in UDS+?

Patient-level data is de-identified data that includes granular information that tells us about the patient without compromising their identity. UDS+ will not contain data copied directly from patients' electronic medical record (EMR) and will not contain patient identifiers to ensure the privacy of the individual.

(Added: 12/3/2021)

How can reporting patient-level reduce reporting burden?

Traditionally, UDS data is generated through health centers’ electronic health records (EHR) by looking through patient records. The information is then aggregated at the health center level. By reporting patient-level data, health centers will be able to leverage technology to bypass the manual aggregation step. Using FHIR standards and aligning to CMS eCQMs allow for standardization of data and reduce the potential for misinterpretation of measures or calculation errors.

(Added: 12/3/2021)

What is FHIR?

FHIR stands for Fast Healthcare Interoperability Resources. Plans are underway to enable UDS+ reporting via FHIR, an application programming interface (API)-focused standard that enables quick and efficient exchange of health data. Interoperability of electronic health information continues to improve with wider adoption of FHIR standards and associated clinical quality reporting architecture. Learn more about the FHIR Fact Sheets.

(Added: 12/3/2021)

Is FHIR required for UDS+?

FHIR is not required for UDS+. FHIR will be one of two options for submitting UDS+ data. HRSA plans to accept UDS+ data through either a manual file upload system (i.e., traditional HL7 format or CSV formatted files) or FHIR interface.

(Added: 12/3/2021)

Related Resources

Date Last Reviewed:  December 2021