Data Usability Workgroup's

Implementation Guide, Version 1

Executive Summary

The Sequoia Project Interoperability Matters Initiative is a public-private cooperative solving discrete health information exchange challenges. Launched by The Sequoia Project in 2018, Interoperability Matters engages experts from across the healthcare and health IT communities to identify, prioritize, and collaborate on the most pressing, discrete challenges to nationwide health information sharing.

In October 2020, the Interoperability Matters: Data Usability Workgroup was launched by the Sequoia Project to develop specific and pragmatic implementation guidance on clinical content for healthcare stakeholders in order to facilitate health information exchange. This workgroup is open to all industry stakeholders and the roster includes over 200 organizations and over 300 participants following this work effort through 2022. The industry stakeholders engaged represent:

  • healthcare providers,
  • health IT developers,
  • health information networks and exchanges,
  • federal, state, and local governments
  • health plans and payers,
  • consumers and patients,
  • standards developers, public health and others.


This implementation guide covers the identified priority use cases that can be readily adopted within health information exchange vendors, implementers, networks, governance frameworks (i.e., TEFCA, Carequality, eHealth Exchange, Commonwell, etc.), and testing programs. Our primary charge as a workgroup is to improve the usability of data received by end users within their workflows. In this setting, data usability may include timeliness, completeness, clinical context, provenance, and semantics. These and many other dimensions can enable receiving systems to more directly incorporate shared data into the workflow of a clinician and make it more computable (e.g., for clinical decision support) and actionable. This Implementation Guide will build on existing work, including, but not limited to, C-CDA Implementation Guides, C-CDA Templates, ONC and other standards such as USCDI V1 and V2, and the recommendations of the joint Carequality-CommonWell Document Content Workgroup and in coordination with related standards development organizations and industry initiatives. Our intent is not to create new standards, but to serve as a point of convergence and community for existing and future standards and methods. From this, our task is to identify priority areas of focus for vendors and implementers alike that will be most valuable in improving data usability. Future work efforts will incorporate guidance for Electronic Health Information Exchange of data leveraging USCDI V2, FHIR Implementation Guides and other industry publications.

DUWG Implementation Guide Feedback Form

The Data Usability Workgroup is seeking public feedback on the Implementation Guide, Version 1 through October 14, 2022. Please include the page number and line number for all comments.

DUWG Implementation Guide Feedback

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