Civitas Networks for Health® (Civitas) and the Consortium for State and Regional Interoperability (CSRI) have an established, longstanding partnership, with both shared and delineated roles, that, among other things, has been instrumental in advancing the concept of the Health Data Utility (HDU) model. Through both individual and joint educational, knowledge sharing, and advocacy efforts, Civitas and CSRI have worked to align the health data industry and other key stakeholders on what an HDU is and how state-based and local health infrastructure can be used to optimize the collection, analysis, and exchange of health data to improve health care delivery and system efficiency, reduce disparities, and modernize public health data infrastructure.
About Civitas Networks for Health®
Civitas is a national, member- and mission-driven organization that serves as the leading voice and convener for organizations working to use data to improve health in communities across the country. By bringing together local implementers—Health Information Exchanges (HIEs), emerging Health Data Utilities (HDUs), Community Information Exchanges (CIEs), Regional Health Improvement Collaboratives (RHICs), All Payer Claims Databases (APCDs), Quality Improvement Organizations (QIOs), and other multistakeholder groups—Civitas fosters data-driven collaboration that creates national impact while staying rooted in local realities.
About the Consortium for State and Regional Interoperability (CSRI)
CSRI is a coalition focused on HDU advancement comprised of some of the nation’s largest and most robust nonprofit health data networks dedicated to fostering health data interoperability, policy development, and enhancing data exchange capabilities that benefit stakeholders in health and health care including providers, payors, public health agencies, and communities. The organization serves as a platform for collaboration, knowledge sharing, and the development of model capabilities to advance CSRI’s vision that every state should have a statewide HDU. Collectively, CSRI organizations connect over 100 million patients across several states and provide a wide range of services to healthcare organizations.
Civitas-CSRI Partnership and Collaborative Efforts
The relationship between Civitas and CSRI is collaborative and has been critical in the effort to evolve and advance the HDU model to better serve communities throughout the country. As a collection of advanced nonprofit data sharing networks, CSRI members play a major role in driving and advising on policies, thought leadership, and approaches for health information exchange, as well as working to define the capabilities of an HDU. As a national organization representative of over 160 member organizations across the health data landscape, Civitas serves as a platform for its members, which includes the members of CSRI, enabling a unified voice to promote best practices and encourage alignment with its broader membership base to influence policy.
The overlapping membership of Civitas and CSRI, along with CSRI’s robust participation in Civitas’ Governance and Government Relations and Advocacy Council as well as the new HDU Steering Council (more below) assures alignment and has helped the two entities further define their unique role in supporting HDU advancement.
Key Resources to Date
Development of the HDU Framework
A milestone in the evolution and creation of the HDU model was Civitas’ publication of the HDU Framework in March 2023, a comprehensive guide that lays the foundation for defining the principles and components necessary to establish effective HDUs. This framework, developed by Civitas in collaboration with the Maryland Health Care Commission (MHCC) and the National HDU Advisory Council, serves as a blueprint for states, regions, HIEs, and community partners in the design and implementation of an HDU that provides deeper integration of health-related data to support public health and care delivery.
CSRI’s Health Data Utility Maturity Model V.1
Another critical resource in bringing clarity to the HDU concept and setting the stage for aspirational HDU model development was the release of CSRI’s HDU Maturity Model V.1 in April 2023. The purpose of the document is:
- To serve as a means of communicating the HDU concept to interested parties, including existing health data organizations and state governments.
- To serve as a source of strategic guidance to existing health data organizations to inform their planning and strategic decision-making
- To give some standardization to the HDU concept and begin the process of building on and refining an agreed-upon industry maturity model for HDUs
HDU Framework Supplement and Public Comment Period
Building on the HDU Framework, Civitas released the HDU Framework Supplement for public comment in December 2024. The Draft Supplement aimed to expand upon the original framework by reflecting recent progress and developments. It identified updated HDU characteristics and capabilities, emphasized the evolving role of HIE/HDU policy and recognition by state and federal authorities, and highlighted current policy levers for advancing HDU adoption. Additionally, the Supplement showcased the emerging value-added services of HDUs, illustrating through example case studies how these services enhance data exchange and benefit stakeholders and the broader industry.
During the public comment period, a range of insights and perspectives emerged, revealing both areas of strong consensus and points of divergence concerning the HDU model’s definition, governance, sustainability, and technical infrastructure. Key themes include the need to clarify core HDU characteristics, define a baseline of use cases and technical capabilities that every HDU must support, emphasize the public good aspect of HDUs to build trust, develop separate technical infrastructure recommendations, and outline clearer strategies for integrating clinical, public health, and social data using established standards. These themes provided valuable guidance, helping shape the collective understanding of industry priorities related to HDUs and informing next steps on behalf of both Civitas and CSRI.
Case Studies
Civitas and CSRI have partnered to develop case studies showcasing real-world examples of how HDUs can provide tangible benefits in enhancing data-driven decision-making and health outcomes. A few of the more recent case studies developed include:
- Statewide Surveillance via Health Data Utility in California: During the COVID-19 pandemic, California’s Department of Public Health created a real-time laboratory test reporting network called SaPHIRE, which integrates data from over 400 labs statewide. The three-year contract for this upgraded network was awarded to Manifest MedEx.
- Building a Social Care Access Network in Nebraska: Over three years, CyncHealth and United Way of the Midlands built Unite Nebraska, a social determinants of health network connecting 466 organizations to meet social needs across the state.
- Empowering Health Care Organizations in Maryland via HDU: In June 2022, Maryland’s CRISP partnered with the State of Maryland’s Health Services Cost Review Commission (HSCRC) and Medisolv to become the first state to successfully collect hospital electronic clinical quality measures (eCQMs) under a new reporting mandate.
- Emergency Backstop: Maintaining Care During a Cybersecurity Outage: In 2024, a major cyberattack disrupted hospital systems nationwide, including in Indiana, cutting off access to critical patient data for over a month. The Indiana Health Information Exchange (IHIE) stepped in as a real-time clinical data partner, helping maintain care continuity.
Model Advancement and Partnership Commitment
Building on the progress made to date and incorporating feedback received on the HDU Framework Supplement, CSRI announced at the 2025 Civitas Annual Conference that it is actively developing a comprehensive version 2 of the HDU Capabilities Model (HDU Capabilities Model V.2). This updated model will clearly define the essential functions, technical requirements, and maturity pathways necessary for effective HDUs. After analyzing the public comments on the HDU Framework Supplement, CSRI and Civitas have decided to prioritize the release of HDU Capabilities Model V.2 over the creation of two additional resources. The new version is scheduled for release in October 2025.
To guide future and related efforts, Civitas and CSRI are establishing an HDU Steering Council chaired by a CSRI Board member that will oversee the development and execution of CSRI’s and Civitas’ generated HDU content, advocacy, and model advancement efforts. In short, CSRI will continue to provide the deep expertise of sophisticated networks that have become HDUs in their states, and Civitas will bring additional experts to the table while supporting convening, dissemination, advocacy, and amplification of the HDU model. As strides are being made to define, implement, and expand HDUs nationwide, the collaboration between Civitas and CSRI remains essential for ensuring that these data infrastructures effectively serve communities, improve health outcomes, and support a more modern, equitable health care system.
Additional Resources and Opportunities to Engage
Explore our comprehensive collection of HIE/HDU resources, including the HDU Framework, Supplement, and related case studies via the Civitas HDU webpage. For more information about CSRI’s work and initiatives, visit their website.
We welcome your feedback and invite you to get involved. If you have any questions or would like to connect, please contact us directly at contact [at] civitasforhealth.org.