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.