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

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 I 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 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.