QRDA

What is the Quality Reporting Document Architecture (QRDA)?

The Health Level Seven International (HL7) Quality Reporting Document Architecture (QRDA) is a standard document format for the exchange of electronic clinical quality measure (eCQM) data. QRDA reports:

  • Contain data extracted from electronic health records (EHRs) and other health information technology systems.
  • Can be used to exchange eCQM data between systems.
  • Are the data submission standards for a variety of quality measurement and reporting initiatives.
  • Were adopted by the Office of the National Coordinator for Health Information Technology (ONC) as the standard to support both QRDA Category I (individual patient) and QRDA Category III (provider’s aggregate) data submission approaches for Stage 2 of Meaningful Use (MU2).

QRDA Category I and III specifications have and will be used as Draft Standards for Trial Use (DSTUs). HL7 issues DTSUs during the standards development life cycle when many, but not all, of the guiding requirements have been clarified. DSTUs are tested and then formalized in the HL7 ballot process into an American National Standards Institute (ANSI)-accredited normative standard. QRDA Category I and QRDA Category III DSTUs were published in 2015.

CMS has developed and published a combined CMS QRDA Category I and III Implementation Guide for Eligible Professionals and Eligible Hospitals for the 2016 eCQM reporting. This guide:

  • Is based on the HL7 QRDA Category I, DSTU Release 3, and QRDA Category III, DSTU Release 1, and its July 2014 errata update.
  • Provides CMS-specific requirements for the Eligible Professionals and Eligible Hospitals, such as requiring the CMS Certification Number for hospitals when submitting QRDA Category I reports, by further constraining the base HL7 standard.
  • Further constrains the base HL7 QRDA Category III standard to define CMS specific requirements for aggregated reporting by Eligible Professionals.

QRDA Reference and Implementation Guides for eCQM

For eReporting for the 2017 Reporting Period:

For eReporting for the 2016 Reporting Period:

For eReporting for the 2015 Reporting Period:

For eReporting for the 2014 Reporting Period:

Additional Resources

 

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    *Additional QRDA Guidance*
      
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    *How does the PQRS system determine in a QRDA-I file if a patient is a Medicare patient and therefore HIC number is required?*
     
    *How does the PQRS system determine in a QRDA-I file if a patient is a Medicare patient and therefore HIC number is required?*
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    All Medicare beneficiaries are assigned a HIC number.  The PQRS system determines whether a patient is a Medicare patient based on the Source of Payment Typology (SOP) code submitted in the Patient Characteristic Payer template. If any of the Patient Characteristic Payer templates includes any of the SOP code listed below, then the HIC number is required for this patient in a QRDA-I file submission to the PQRS system.
     
    All Medicare beneficiaries are assigned a HIC number.  The PQRS system determines whether a patient is a Medicare patient based on the Source of Payment Typology (SOP) code submitted in the Patient Characteristic Payer template. If any of the Patient Characteristic Payer templates includes any of the SOP code listed below, then the HIC number is required for this patient in a QRDA-I file submission to the PQRS system.
     
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