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:
QRDA Known Issues are found in the ONC QRDA Known Issues Project.
2021 Reporting and Performance Period
The 2021 CMS QRDA I Implementation Guide for Hospital Quality Reporting for 2021 eCQM reporting is based on the HL7 Clinical Document Architecture (CDA) Release 2: Quality Reporting Document Architecture (QRDA) Category I, Release 2, Standard for Trial Use Release 5.2 with errata (published June 2020).
- 2021 CMS QRDA I Implementation Guide for Hospital Quality Reporting (May 2020)
- 2021 CMS QRDA I Schematrons and Sample Files for Hospital Quality Reporting (Updated December 2020)
The 2021 CMS QRDA III Implementation Guide for Eligible Clinicians and Eligible Professionals for 2021 eCQM reporting is based on the HL7 Implementation Guide for Clinical Document Architecture (CDA) Release 2: Quality Reporting Document Architecture (QRDA) Category III, Release 2.1, Standard for Trial Use Release 2.1 (published June 2017).
- 2021 CMS QRDA III Implementation Guide for Eligible Clinicians and Eligible Professionals (Updated January 2021)
- 2021 CMS QRDA III Schematrons and Sample Files for Eligible Clinicians and Eligible Professionals (Updated January 2021)
2020 Reporting and Performance Period
The 2020 CMS QRDA I Implementation Guide for Hospital Quality Reporting for 2020 eCQM reporting is based on the HL7 Clinical Document Architecture (CDA) Release 2: Quality Reporting Document Architecture (QRDA) Category I, Release 1, Standard for Trial Use Release 5.1 with Errata (Errata published October 2019).
- 2020 CMS QRDA I Implementation Guide for Hospital Quality Reporting (Updated December 2019)
- 2020 CMS QRDA I Schematrons and Sample Files for Hospital Quality Reporting (Updated March 2020)
- 2020 QRDA Category I Conformance Statement Resource
The 2020 CMS QRDA III Implementation Guide for Eligible Clinicians and Eligible Professionals for 2020 eCQM reporting is based on the HL7 Implementation Guide for Clinical Document Architecture (CDA) Release 2: Quality Reporting Document Architecture (QRDA) Category III, Release 1, Standard for Trial Use Release 2.1 (published July 2017).
- 2020 CMS QRDA III Implementation Guide for Eligible Clinicians and Eligible Professionals (Updated August 2020)
- 2020 CMS QRDA III Schematrons and Sample Files for Eligible Clinicians and Eligible Professionals (Updated November 2019)
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 I (individual patient) and QRDA III (provider’s aggregate) data submission approaches for quality reporting.
- QRDA I (QRDA I) is an individual-patient-level report. It contains quality data for one patient for one or more eCQMs.
- QRDA 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.
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
Healthcare 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 Guide - Resource which details the different aspects of multiple QRDA validation tools that are available to submitters. It is intended 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 Converter - Converter tool which converts QRDA III files to the QPP JSON (JavaScript Object Notation) format for Quality Payment Program (QPP) data submission. The tool can also be used to test whether QRDA III files can be consumed by QPP and allows you to see whether it complies with the most current QRDA III Implementation Guide and can be successfully submitted to QPP.
Visit the eCQI Tools & Key Resources Library for a complete list of tools and resources used with eCQMs and eCQI.
QRDA Known Issues are found in the ONC QRDA Known Issues Project.
2019 Reporting and Performance Period
The 2019 CMS QRDA I Implementation Guide for Hospital Quality Reporting 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 (Updated November 2019)
- 2019 CMS QRDA I Schematrons and Sample Files for Hospital Quality Reporting (Updated September 2019)
- 2019 CMS QRDA I Conformance Statement Resource
The 2019 CMS QRDA III Implementation Guide for Eligible Clinicians and Eligible Professionals for 2019 eCQM reporting is based on the HL7 Implementation Guide for Clinical Document Architecture (CDA) Release 2: Quality Reporting Document Architecture (QRDA) Category III, Release 1, Standard for Trial Use Release 2.1 (published July 2017).
- 2019 CMS QRDA III Implementation Guide for Eligible Clinicians and Eligible Professionals (October 2018)
- 2019 CMS QRDA III Schematrons and Sample Files for Eligible Clinicians and Eligible Professionals (Updated February 2019)
- Addendum to 2019 CMS QRDA III Implementation Guide for Eligible Clinicians and Eligible Professionals (Updated August 2019)
2018 Reporting Period QRDA Reference and Implementation Guides
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 and Eligible Professionals.
- 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
- Guidance for reporting diagnostic test data in the Diagnostic Study Performed (V3) template of QRDA Category I files
- 2018 CMS QRDA III Implementation Guide for Eligible Clinicians and Eligible Professionals (Updated July 2018)
- 2018 CMS QRDA III Schematrons and Sample Files for Eligible Clinicians and Eligible Professionals (Updated October 2018)
2017 Reporting Period QRDA Reference and Implementation Guides
- 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)
- 2017 CMS QRDA III Implementation Guide for Eligible Clinicians and Eligible Professionals
- 2017 CMS QRDA III Schematrons and Sample Files for Eligible Clinicians and Eligible Professionals
- 2017 CMS QRDA I Conformance Statement Resource
- Technical Guidance for Valid Reporting of Custodian ID using CMS Certification Numbers in QRDA I Files for Hospital Quality Reporting
- Technical Instructions for QRDA I Submissions for CY 2017 eCQM Reporting
General QRDA Education
- QRDA Tutorial - HIMSS 2017 (YouTube)
CMS QRDA I (for patient level data)
- CMS QRDA I Implementation Guide Changes for CY 2020 Hospital Quality Reporting - March 25, 2020
- 2020 CMS QRDA I Implementation Guide, Schematron, and Sample File for Hospital Quality Reporting - June 17, 2019
CMS QRDA III (for aggregate data)
- CMS QRDA III Updates: 2020 CMS QRDA III IG, Schematron, and Sample Files and the Updated 2019 CMS QRDA III IG Addendum - CMS Quality Partner and Vendor Workgroup Calls on August 19 and 22, 2019
QRDA I and III
- CMS QRDA I and III Implementation Guide Updates - January 26, 2021
- 2021 QRDA I and III Implementation Guides Updates and Guidance for Representing Telehealth Encounters in QRDA I Format for Electronic Clinical Quality Measures - CMS Quality Programs Bi-Monthly Forum on October 14, 2020
- 2019 CMS QRDA I Conformance Statement Resource Update and 2020 CMS QRDA I and III Updates - CMS Quality Partner and Vendor Workgroup Calls on February 3 and 6, 2020
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 (CQI) 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.
To participate in the work group, meeting information can also be found on the HL7 CQI Wiki home page.
Seek Help and Provide Feedback
Questions and comments related to the development and implementation of QRDA can be posted to the ONC Jira QRDA Issue Tracker.
QRDA Known Issues are found in the ONC QRDA Known Issues Project.