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.
Connections between Standards
The graphic depicts the flow of quality reporting data between CMS and health care organizations. Health care organizations receive the measure specifications, expressed in HQMF using QDM and CQL and then report results to CMS using QRDA.
Resources for use when implementing QRDA
CMS QRDA Pre-Submission Validation Tools - The intent of the Validation Tools Resource is to give users a single point of reference for these tools and assist them in selecting the most appropriate tool to meet their individual needs.
QRDA III Conversion Tool – An open source tool for converting QRDA III files to the Quality Payment Program (QPP) JSON (JavaScript Object Notation) format for data submission to the QPP. Using this tool measure developers can test their ability to create a QRDA III file for successful conversion to the QPP JSON format.
Find QRDA Known Issues in the ONC QRDA Known Issues Project.
Visit the eCQI Tools & Key Resources Library for a complete list of tools and resources used with eCQMs and eCQI.
Please note - Previous versions are for reference only. Do not use these versions for submissions to CMS. See the About tab for the most current versions of the CMS QRDA Implementation Guides, Schematrons, and Sample Files.
2021 CMS QRDA I
- 2021 CMS QRDA I Implementation Guide for Hospital Quality Reporting (Published May 2020)
- 2021 CMS QRDA I Schematrons and Sample Files for Hospital Quality Reporting (Updated December 2020)
2021 CMS QRDA III
- 2021 CMS QRDA III Implementation Guide for Eligible Clinicians and Eligible Professionals (Updated May 2021)
- 2021 CMS QRDA III Schematrons and Sample Files for Eligible Clinicians and Eligible Professionals (Updated May 2021)
2020 CMS QRDA I
- 2020 CMS QRDA I Implementation Guide for Hospital Quality Reporting
- 2020 CMS QRDA I Schematrons and Sample Files for Hospital Quality Reporting
- 2020 QRDA Category I Conformance Statement Resource
2020 CMS QRDA III
- 2020 CMS QRDA III Implementation Guide for Eligible Clinicians and Eligible Professionals
- 2020 CMS QRDA III Schematrons and Sample Files for Eligible Clinicians and Eligible Professionals
2019 CMS QRDA I
- 2019 CMS QRDA I Implementation Guide for Hospital Quality Reporting
- 2019 CMS QRDA I Schematrons and Sample Files for Hospital Quality Reporting
- 2019 CMS QRDA I Conformance Statement Resource
2019 CMS QRDA III
- 2019 CMS QRDA III Implementation Guide for Eligible Clinicians and Eligible Professionals
- 2019 CMS QRDA III Schematrons and Sample Files for Eligible Clinicians and Eligible Professionals
- Addendum to 2019 CMS QRDA III Implementation Guide for Eligible Clinicians and Eligible Professionals
2018 CMS QRDA I
- 2018 CMS QRDA I Conformance Statement Resource
- 2018 CMS QRDA I Implementation Guide for Hospital Quality Reporting
- 2018 CMS QRDA I Schematrons and Sample Files for Hospital Quality Reporting
- Addendum to 2018 CMS QRDA Category I Implementation Guide for Hospital Quality Reporting
- Sample Hybrid Hospital-Wide Readmission Measure QRDA I file
- Guidance for reporting diagnostic test data in the Diagnostic Study Performed (V3) template of QRDA Category I files
2018 CMS QRDA III
- 2018 CMS QRDA III Implementation Guide for Eligible Clinicians and Eligible Professionals
- 2018 CMS QRDA III Schematrons and Sample Files for Eligible Clinicians and Eligible Professionals
2017 CMS QRDA I
- 2017 CMS QRDA I Implementation Guide for Hospital Quality Reporting
- 2017 CMS QRDA I Schematrons and Sample Files for Hospital Quality Reporting
- 2017 CMS QRDA I Conformance Statement Resource
- Technical Guidance for Valid Reporting of Custodian ID using CMS Certification Numbers in QRDA I Files for Hospital Quality Reporting
- Technical Instructions for QRDA I Submissions for CY 2017 eCQM Reporting
2017 CMS QRDA III
CMS QRDA I (for patient-level data)
- Updated 2023 CMS QRDA I Implementation Guide (IG) and Schematron for Hospital Quality Reporting - CMS Quality Bi-Monthly Forum - March 28, 2023
- Updated 2023 QRDA I IG and Schematron Slides
- Updated 2023 QRDA I IG and Schematron Webinar (YouTube) - starts at 2:50 and ends at 4:27
- Updated 2023 CMS QRDA I IG - CMS Quality Bi-Monthly Forum - May 10, 2022
- Updated 2023 QRDA I IG Slides
- Updated 2023 QRDA I IG Webinar (YouTube) - starts at 15:31 and ends at 18:50
- Updated 2022 CMS QRDA I IG and Hybrid Measure Sample File for Hospital Quality Reporting - December 14, 2021
- Updated 2022 QRDA I IG Slides
- Updated 2022 QRDA I IG Webinar (YouTube) - starts at 10:31 and ends at 13:46
- CMS QRDA Category I IG Changes for CY 2021 Hospital Quality Reporting - April 27, 2021
CMS QRDA III (for aggregate data)
- 2023 QRDA III Updates for the CY 2023 Physician Fee Final Rule - CMS Quality Bi-Monthly Forum - January 17, 2023
- Updated 2023 QRDA III IG - Slides
- Updated 2023 QRDA III IG - Webinar (YouTube) - starts at 1:41 and ends at 6:41
- 2023 QRDA III Updates - CMS Quality Bi-Monthly Forum - March 1, 2022
- 2023 QRDA III IG Updates - Slides
- 2023 QRDA III IG Updates (YouTube) - starts at 30:40 and ends at 33:45
- Final 2022 CMS QRDA III IG Publication - CMS Quality Bi-Monthly Forum - July 27, 2021
CMS QRDA I and III
- CMS QRDA I and III Updates - CMS Quality Bi-Monthly Forum - August 11, 2022
- 2023 QRDA I & III IG Updates Slides
- 2023 QRDA I & III IG Updates Webinar (YouTube) - starts at 8:43 and ends at 12:26
- CMS QRDA I and III Updates - CMS Quality Bi-Monthly Forum - May 20, 2021
- 2022 QRDA I & III IG Updates Slides
- 2022 QRDA I & III IG Updates Webinar (YouTube) - starts at 6:48 and ends at 9:50
- CMS QRDA I and III IG Updates - January 26, 2021
- 2021 QRDA I and III IG Updates and Guidance for Representing Telehealth Encounters in QRDA I Format for Electronic Clinical Quality Measures - CMS Quality Bi-Monthly Forum on October 14, 2020
Get Involved
Participate in an upcoming Health Level Seven International® (HL7®) Clinical Quality Information Workgroup call. This Workgroup creates and maintains HL7 standards supporting quality measurement, evaluation, and reporting.
Seek Help and Provide Feedback
Post questions and comments related to the development and implementation of QRDA to the ONC Jira QRDA Issue Tracker. You must have an account to enter a question or comment.
Find QRDA Known Issues in the ONC QRDA Known Issues Project.