Health Data Utilities or HDUs: A Promising New Data Sharing Framework for Advancing Health and Health Equity
January 20, 2026
Overview
HDUs can provide health departments critical information to respond proactively to emergencies, public health risks, and equity focused use cases. They also address many contemporary concerns around data sharing, such as transparency around governance and ensuring the access and use of data serves the public good.
Most public health practitioners are familiar with Health Information Exchanges or HIEs, which enable the secure use and disclosure of electronic health information among health care providers, patients, and other entities. Less familiar to many in the field are health data utilities or HDUs, which have the potential to significantly, and positively, impact public health practice. This article will provide a brief overview of health data utilities, summarize the on-going efforts to define this model of data sharing (including degrees of maturity and capability) and highlight a few states that are moving this work forward.
The Consortium for State and Regional Interoperability (CSRI) defines an HDU as a “not-for-profit organization with information exchange at its core and multi-stakeholder governance which, through its mission and function, seeks to meet the comprehensive health data delivery and analytics needs of a state’s public and private sectors.” CSRI positions HDUs as entities serving the public good, rather than purely market intermediaries. CSRI further explains that health data utilities promote statewide connectivity for health and health-related data. While HDUs may be lightly regulated, they often have rigorous and transparent data governance and seek to provide appropriate and secure access to a range of partners, including the private health care sector, payers, public health and other state agencies, researchers, and patients.
HDUs share some similarities with HIEs in services, governance, privacy and security requirements and other factors. HIEs typically receive and route patient health care information to other health care providers and many times, public health agencies. One frequent example of this would be an HIE that receives an electronic initial case report from a patient electronic health record and routes it to the appropriate public health agency. An HDU may develop in conjunction with an HIE to leverage existing infrastructure or an HIE may evolve into an HDU. For example, in 2022 Maryland passed legislation that directed the state’s designated HIE (known as CRISP) to also operate as a health data utility.
Health data utilities are not interchangeable with HIEs though. They have unique characteristics and may offer services beyond the scope of HIEs. Civitas Networks for Health and the Maryland Healthcare Commission highlight some of these distinctions in two publications; Advancing Implementation of Health Data Utility Models and Health Data Utility Framework: A Guide to Implementation. HDUs have more advanced capability to combine and exchange a variety of data that extend beyond the health care clinical data that is the purview of the HIEs. This can include a broad range of public health data, data from prescription drug monitoring programs, all-payor claims data, and even data on social services. HIEs are primarily focused on the exchange of clinical data to deliver high-quality and efficient care.
The purpose of data exchange for an HDU is broader and may include enhancing care coordination among various sectors, research, advancing health equity, and improving population and community health. Because HDUs work with an expanded set of partners as compared to HIEs, the governance process and legal framework emphasize transparency, a shared approach to decision-making, and may incorporate standards for data privacy and security from sectors other than healthcare. And while HDUs are most commonly discussed in context with HIEs, they also share some similarities with Community Information Exchanges (CIEs), which are community governed networks of health and social service providers that facilitate data sharing among a variety of partners to improve services and coordinated care.
As interest in HDUs grows, there have been additional efforts to formalize both the concept and the functions of the model. CSRI published a model in 2023 to assess the maturity of HDUs as either foundational, intermediate, or advanced. The model looked at a variety of factors including the governance infrastructure, the number of sectors and percentage of each sector that participate in an HDU (network breadth and depth), and the number of services offered across sectors.
Building upon this work, in October 2025 CSRI released a draft of its Health Data Utility Capability Model, which may be revised following a public comment period that closed in December 2025. The expanded model identifies five stakeholder groups: providers, payers, public health agencies, researchers, and patients. It also looks at more than 160 capabilities of an HDU that should be shared across all stakeholders (referred to as shared domain capabilities) and distinct stakeholder domain capabilities. The goal is to have a rigorous model that can quantify the strengths and gaps of an HDU across a variety of domains and subsequently, inform where the HDU should make future investments in its maturation.
Interest in HDUs continues to grow as states recognize the benefits, including their potential to improve population health and health equity. Maryland’s health data utility, CRISP, highlighted some of its early use cases, which included notifying local health departments about recent hospital admissions of children with asthma so the departments knew to offer home visiting services and assisting with the determinations of Medicaid eligibility following the end of the public health emergency.
CRISP also helped lead a program to collect, transmit and report certain electronic clinical quality measures from hospitals, including on opioid use and hyper- and hypoglycemia. Oregon is in the early stages of a community-led approach to build a health data utility to help integrate data from medical providers, community organizations, and public health agencies. And both Michigan and New Mexico introduced bills in the 2025 legislative session to establish health data utilities.
HDUs can provide health departments critical information to respond proactively to emergencies, public health risks, and equity focused use cases. They also address many contemporary concerns around data sharing, such as transparency around governance and ensuring the access and use of data serves the public good.
This article was written by Meghan Mead, Deputy Director, Network for Public Health Law—Mid-States Region.
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