What are HDUs?
A Health Data Utility (HDU) is a not-for-profit organization with multi-stakeholder governance, which seeks to meet the comprehensive health data delivery and analytics needs of a geographical regions or jurisdictions public and private sectors. The HDUs has information exchange at its core, but unlike HIEs, which primarily exchange and integrate data, HDUs build on to this by combining clinical, non-clinical, administrative and public health data to meet comprehensive health data delivery analytics needs across sectors. HDUs leverage existing infrastructure by collaborating with state or regional HIEs and the broadened role of an HDU enables complex use cases while ensuring privacy and security of the data.1
Examples of capabilities an HDU could provide are:
- Master Patient Index (MPI) capabilities
- Provide access to aggregated data to show trends (i.e number of patients with a certain conditions within an area)
- Ability to provide information about a patient’s encounters across systems
- Validation of the data quality of the data going through the HDU
- Maintain summaries of the data available for research use
- Provide access to aggregated data to show trends and identify anomalies
How does an HDU differ from other types of entities?
The idea is that the HDUs operate in the data ecosystem in the following way:
Generated by wpDataTables
It’s important to understand that the evolution from an HIE to an HDU is determined by the additional capabilities an HDU is providing. In almost all cases, HDUs started as traditional HIEs and became HDUs by expanding its capabilities to integrate non-clinical, administrative and public health data; provided advanced analytics for population longitudinal health and operated with strong partnerships with public health. An Issue brief by Civitas, Advancing Implementation of Health Data Utility Models (Jan 2023) outlines the history, current state, and drivers for the emergence and advancements of HDUs. This brief states that many state HIEs are well-positioned to evolve into an HDU model.
The Health Data Utility (HDU) Capability Model
The Consortium for State and Regional Interoperability (CSRI) has a vision that every state in the nation should have an HDU. CSRI and Civitas Networks for Health released on October 28, 2025 a detailed Health Data Utility Capability Model, identifying over 160 capabilities an HDU must have across four tired levels. The organization was recently conducting listening sessions and public comments to gather input before finalizing this complex technical and policy model. The comment period ended on December 12, 2025 and we will continue paying attention to the outcome of this activity.
Why are we talking about this now?
The concept of HDUs has gained momentum in recent years as health information exchanges (HIEs) have advanced and developed more technology and functionality to serve state and other healthcare stakeholders at scale.2 The HDU concept has, over the past years, moved from theory to the implementation phase, necessitating attention to their technical and policy standards.
There are clear indications that CDC and ASTP views Health Data Utilities (HDUs), or entities that perform the HDU function, as a critical partner, essential for fulfilling the goals of CDC’s public health data strategy. The most direct reference to this is found in language describing the new model for public health data flow, where HDUs are identified as a critical partner working through shared standards rather than hierarchical command.
Recommended articles if you want to read more:
- Intermediaries are essential to the public health data ecosystem (ASTHO)
- The CSRI Health Data Utility Capability Model
- HDU framework (CIVITAS)
- What is a Health Data Utility (CSRI)
- CIVITAS MHCC HDU Brief (2022-15-12)
- Civitas HDU Framework Supplement (HLN Blog)
References: