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:
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 Implementation Guide for Hospital Quality Reporting
- 2018 CMS QRDA I Schematrons, and Sample Files for Hospital Quality Reporting
- 2018 CMS QRDA III Implementation Guide for Eligible Professionals (EPs) and Eligible Clinicians (Updated March 2018)
- 2018 CMS QRDA III Schematrons, and Sample Files for Eligible Professionals (EPs) and Eligible Clinicians
2017 Reporting and Performance Period
The CMS QRDA Category I Implementation Guide for Eligible Hospitals for 2017 eCQM reporting is based on the HL7 QRDA Category I, STU Release 3.1 and further constrains the base HL7 QRDA Category I standard by providing CMS-specific requirements for Eligible Hospitals, such as requiring the CMS Certification Number when submitting QRDA Category I reports.
- 2017 CMS QRDA Implementation Guide for Hospital Quality Reporting
- 2017 CMS QRDA I Schematrons, and Sample Files for Hospital Quality Reporting (Updated July 2017)
The CMS QRDA Category III Implementation Guide for Eligible Clinicians for 2017 eCQM reporting is based on the HL7 QRDA Category III, STU Release 2.1. It further constrains the base HL7 QRDA Category III standard by providing CMS-specific requirements for Eligible Clinicians and incorporates reporting for Advancing Care Information and Improvement Activities using QRDA Category III.
- 2017 CMS QRDA III Implementation Guide for Eligible Clinicians and Eligible Professionals Reporting v1.0
- 2017 CMS QRDA III Schematrons and Sample Files for Eligible Clinicians and Eligible Professionals Reporting v1.0
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 advancing care information 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, advancing care information 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.
Use the following resources when implementing QRDA:
CMS QRDA Pre-Submission Validation Tools Guide
CMS QRDA I Conformance Statement Resource Update
Technical Instructions for QRDA Category I Submissions for CY 2017 eCQM Reporting
2016 Reporting Period QRDA Reference and Implementation Guides
- 2016 CMS QRDA Implementation Guide for Eligible Professional Programs and Hospital Quality Reporting
- 2016 CMS QRDA Implementation Guide Appendix for Eligible Professional Programs and Hospital Quality Reporting (February 2016)
- CMS eCQM EP QRDA Cat III IPP_IPOP Issue Overview
- 2016 CMS QRDA I Schematrons and Sample Files version 2.3 for Hospital Quality Reporting (Updated October 2016)
- 2016 CMS QRDA I Schematrons and Sample Files version 2.3 for Eligible Professional Programs (Updated October 2016)
- 2016 CMS QRDA I Schematron v2.3 Guidance for Hospital Quality Reporting and Eligible Professional Programs (New October 2016)
- 2016 CMS QRDA III Schematrons and Sample Files version 2.2 for Eligible Professional Programs
- HL7 QRDA Category I Specifications
- HL7 QRDA Category III Specifications
- Additional 2016 QRDA Guidance
2015 Reporting Period QRDA Reference and Implementation Guides
- 2015 CMS QRDA Implementation Guide for Eligible Professional Programs and Hospital Quality Reporting
- Addendum to 2015 CMS QRDA Implementation Guide for Eligible Professional and Hospital Quality Reporting
- 2015 CMS/CPC QRDA III Sample File (Updated October 2015)
2014 Reporting Period QRDA Reference and Implementation Guides
- 2014 CMS QRDA Implementation Guide for Eligible Hospital Clinical Quality Measures (Effective July 1, 2014)
- 2014 CMS QRDA Cat 1 Eligible Hospital Sample Files (April 2014)
- 2014 CMS QRDA I Implementation Guides for Eligible Professionals Clinical Quality Measures
- 2014 CMS QRDA III Implementation Guides for Eligible Professionals Clinical Quality Measures
- 2014 CMS Performance Rate Calculation Requirement for Eligible Professionals QRDA-III
- Guide to the Quality Reporting Data Architecture, QRDA, for 2014 eCQMs
- CMS QRDA Category I Implementation Guide Changes for CY 2018 for Hospital Quality Reporting - March 19, 2018
Technical Guidance for Valid Reporting of Custodian ID using CMS Certification Numbers in QRDA Category I Files for Hospital Quality Reporting Programs - August 21, 2017 (pdf)
Technical Instructions for QRDA Category I Submissions for eCQM Reporting to the Hospital IQR and the Medicare EHR Incentive Programs for Eligible Hospitals and Critical Access Hospitals - July 25, 2017 (pdf)
Changes in the 2017 CMS QRDA III Implementation Guide for Eligible Clinicians and Eligible Professionals and the 2018 CMS QRDA I Hospital Quality Reporting Implementation Guide - July 17, 2017 (pdf)
CMS QRDA Implementation Guide Changes for CY 2017 Hospital Quality Reporting - March 28, 2017 (pdf)
How to Correct Common Schema Validation Errors for 2016 QRDA I Submissions - February 17, 2017 (pdf)
- View Webinar (YouTube)
- Qs&As
- QRDA Tutorial - HIMSS 2017 (YouTube)
- Device, Order Not Done Issue Guidance - January 26, 2017 (pdf)
- HIMSS 2016 QRDA Submissions to CMS - March 1, 2016 (pdf)
- 2016 CMS QRDA Implementation Guide Changes for Eligible Hospitals/Critical Access Hospital - December 17, 2015 (pdf)
Get Involved
There is not a formal QRDA user group at this time, although there are active standards communities where QRDA is discussed and reviewed.
The HL7 Clinical Quality Information Work Group wiki serves as a collaborative workspace for the development of technology standards in support of measuring and improving health, health care and health care quality. All users have edit rights to be able to submit edits, add comments and concerns. Items on the Wiki are a work in progress and subject to change.
Seek Help and Provide Feedback
Post questions and comments related to the development and implementation of QRDA can be posted to the ONC JIRA QRDA Issue Tracker.