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. 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:

2019 Reporting and Performance Period

The 2019 CMS QRDA Category I Implementation Guide for Eligible Hospitals for 2019 eCQM reporting is based on the HL7 Implementation Guide for Clinical Document Architecture (CDA) Release 2: Quality Reporting Document Architecture (QRDA) Category I, Release 1, Standard for Trial Use Release 5 (published December 2017).

• 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 III Implementation Guide for Eligible Clinicians and Eligible Professionals 
• 2019 CMS QRDA III Schematrons and Sample Files for Eligible Clinicians and Eligible Professionals

2018 Reporting and Performance Period

For 2018 reporting, there are two CMS QRDA Implementation Guides: one CMS Implementation Guide for Eligible Hospitals and a separate CMS Implementation Guide for Eligible Clinicians.

• 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  
• 2018 CMS QRDA III Implementation Guide for Eligible Professionals and Eligible Clinicians (Updated July 2018)
• 2018 CMS QRDA III Schematrons and Sample Files for Eligible Clinicians and Eligible Professionals Reporting  (Updated October 2018)

Overview

QRDA is a Health Level Seven International (HL7) Clinical Document Architecture (CDA)-based standard. It further constrains CDA Release 2 for exchange of electronic clinical quality measure (eCQM) data. QRDA was 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 quality reporting.  

• QRDA Category I (QRDA I) is an individual-patient-level report. It contains quality data for one patient for one or more eCQMs.
• QRDA Category III (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 generated QRDA reports conform to the requirements specified in the IGs.