QRDA - Quality Reporting Document Architecture

The Quality Reporting Document Architecture (QRDA) is the data submission standard used for a variety of quality measurement and reporting initiatives. It is based on the Health Level Seven International® (HL7®) Clinical Document Architecture (CDA). QRDA creates a standard method to report quality measure results in a structured, consistent format and can be used to exchange eCQM data between systems.

Current QRDA Reference and Implementation Guides:

Find QRDA Known Issues in the ONC QRDA Known Issues Project.

2024 Reporting and Performance Period

The 2024 CMS QRDA I Implementation Guide for Hospital Quality Reporting for 2024 eCQM reporting is based on the HL7 CDA Release 2: QRDA Category I, Release 1, Standard for Trial Use Release 5.3 with errata (published December 2022).

• 2024 CMS QRDA I Implementation Guide for Hospital Quality Reporting (published May 2023)
• 2024 CMS QRDA I Schematron and Sample Files for Hospital Quality Reporting (published May 2023)

The 2024 CMS QRDA III IG, Schematron, and Sample Files are coming in July 2023.

2023 Reporting and Performance Period

The 2023 CMS QRDA I Implementation Guide for Hospital Quality Reporting for 2023 eCQM reporting is based on the HL7 CDA Release 2: QRDA Category I, Release 1, Standard for Trial Use Release 5.3 with errata (published December 2022).

• 2023 CMS QRDA I Implementation Guide for Hospital Quality Reporting (Updated March 2023)
• 2023 CMS QRDA I Schematrons and Sample Files for Hospital Quality Reporting (Updated March 2023)

The 2023 CMS QRDA III Implementation Guide for Eligible Clinicians for 2023 eCQM reporting is based on the HL7 Implementation Guide for CDA Release 2: QRDA Category III, Release 1 (published July 2022).

• 2023 CMS QRDA III Implementation Guide for Eligible Clinicians (Updated December 2022)
• 2023 CMS QRDA III Schematrons and Sample Files for Eligible Clinicians (Updated December 2022)

2022 Reporting and Performance Period

The 2022 CMS QRDA I Implementation Guide for Hospital Quality Reporting for 2022 eCQM reporting is based on the HL7 CDA Release 2: QRDA Category I, Release 1, Standard for Trial Use Release 5.2 with errata (published June 2020).

• 2022 CMS QRDA I Implementation Guide for Hospital Quality Reporting (Updated November 2021)
• 2022 CMS QRDA I Schematrons and Sample Files for Hospital Quality Reporting (Updated November 2021)

The 2022 CMS QRDA III Implementation Guide for Eligible Clinicians and Eligible Professionals for 2022 eCQM reporting is based on the HL7 Implementation Guide for CDA Release 2: QRDA Category III, Release 2.1, Standard for Trial Use Release 2.1 (published June 2017).

• 2022 CMS QRDA III Implementation Guide for Eligible Clinicians and Eligible Professionals (Updated December 2021)
• 2022 CMS QRDA III Schematrons and Sample Files for Eligible Clinicians and Eligible Professionals (Updated December 2021)

Overview

QRDA is a CDA-based standard. It further constrains CDA Release 2 for exchange of eCQM data. QRDA was adopted by the Office of the National Coordinator for Health Information Technology (ONC) as the standard to support both QRDA I (individual patient) and QRDA III (provider’s aggregate) data submission approaches for quality reporting.  

• QRDA I is an individual patient-level report. It contains quality data for one patient for one or more eCQMs.
• QRDA III is an aggregate quality report. It has been expanded to support the exchange of Promoting Interoperability measures and improvement activities for the CMS Quality Payment Program. A QRDA III report contains quality data for a set of patients for one or more eCQMs, Promoting Interoperability measures, and/or improvement activities.

The HL7 Clinical Quality Information (CQI) Workgroup maintains and updates both HL7 QRDA I and III standards to ensure alignment with other quality-related standards.

CMS publishes QRDA implementation guides (IGs), schematrons, and sample files annually to provide technical guidance for implementing the HL7 QRDA I and III standards for reporting to CMS quality reporting programs. The CMS IGs further constrain the HL7 QRDA standards to support CMS specific requirements, such as requiring CMS program names. The CMS IGs also provide submission guidance for a specific performance/reporting period. Schematron files contain a list of assertion rules used to validate that the generated QRDA reports conform to the requirements specified in the IGs.

Note: IGs, schematrons, and sample files may be updated after initial publication to address stakeholder or policy requirements. Revisit this page for updated resources prior to use.