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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).

The 2024 CMS QRDA III IG, Schematron, and Sample Files for Eligible Clinicians for 2024 eCQM reporting is based on the HL7 Implementation Guide for CDA Release 2: QRDA Category III, Release 1 (published September 2021).

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).

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).

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).

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).

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 (measured entity’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 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

Connection 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)  JavaScript Object Notation (JSON) 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 III 

2020 CMS QRDA I 

2020 CMS QRDA III

2019 CMS QRDA I 

2019 CMS QRDA III 

2018 CMS QRDA I

2018 CMS QRDA III

2017 CMS QRDA I

2017 CMS QRDA III

CMS QRDA I (for patient-level data)

  • 2024 CMS QRDA I Implementation Guide (IG), Schematron, and Samples File - CMS Quality Bi-Monthly Forum Slides / YouTube - June 20, 2023
  • Updated 2023 CMS QRDA I IG and Schematron for Hospital Quality Reporting - CMS Quality Bi-Monthly Forum Slides / YouTube - March 28, 2023
  • Updated 2022 CMS QRDA I IG and Hybrid Measure Sample File for Hospital Quality Reporting Slides / YouTube - December 14, 2021
  • CMS QRDA Category I IG Changes for CY 2021 Hospital Quality Reporting Slides / YouTube - 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 Slides / YouTube - January 17, 2023
  • 2023 QRDA III Updates - CMS Quality Bi-Monthly Forum Slides / YouTube - March 1, 2022
  • Final 2022 CMS QRDA III IG Publication - CMS Quality Bi-Monthly Forum Slides / YouTube - July 27, 2021

CMS QRDA I and III 

  • 2023 CMS QRDA I and III Updates - CMS Quality Bi-Monthly Forum Slides / YouTube - August 11, 2022
  • Public Comments on the Draft 2023 CMS QRDA I IG and Updates to the 2023 CMS QRDA III IG and Sample Files - CMS Quality Bi-Monthly Forum Slides / YouTube - May 10, 2022
  • 2022 CMS QRDA I and III Updates - CMS Quality Bi-Monthly Forum Slides / YouTube - May 20, 2021

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.

Last Updated: Feb 21, 2024