The Updated 2019 CMS QRDA I IG and Sample File for Hospital Quality Reporting Are Now Available

The Centers for Medicare & Medicaid Services (CMS) has updated and republished the CMS Quality Reporting Document Architecture (QRDA) Category I Implementation Guide to include additional guidance on Reason Template Placement and to emphasize the change to not include value set Object Identifiers (OIDs) when reporting for the 2019 reporting period. The CMS QRDA I IG outlines requirements for eligible hospitals and critical access hospitals (CAHs) reporting electronic clinical quality measures for the:

Hospital Inpatient Quality Reporting (IQR) Program
Medicare and Medicaid Promoting Interoperability Programs for Eligible Hospitals and CAHs

Implementation Guide Update - Reason Template

The 2019 QRDA I IG includes a new appendix in section 9, "Guidance for Reason Template Placement When Specifying ‘Not Done’ with a Reason". It provides detailed guidance for the placement of a Reason template when used with any negated Quality Data Model (QDM) data element, such as “Medication, Not Discharged”.

Guidance on Not Reporting Value Set OIDs

The Health Level Seven (HL7) QRDA I IG Standard for Trial Use (STU) Release 5 - the base standard for the 2019 reporting period - removed the SHALL @sdtc:valueSet requirement for providing value set OID. It is important to implement this change and to ensure value set OID for QDM data element and coded QDM attributes are not included in QRDA I files when reporting for the 2019 reporting period. Including value set OID may lead to unexpected measure results. Note - value set OID should ONLY be used to report negation of QDM data elements.

2019 CMS QRDA I Sample File

The 2019 CMS QRDA I Sample File has also been updated to clarify the Reason Template and Value Set OID guidance.

References and Resources:

The Base HL7 QRDA IG includes a section that describes the change in Volume 1, Section 6 Quality Data Model-Based QRDA, 6.1 Introduction. All conformance statements that require sdtc:valueSet were removed from volume 2 templates.
View the webinar presentation titled “CMS QRDA Category I IG Changes for Calendar Year 2019 HQR” for more details on changes from the 2018 QRDA I IG.

Additional QRDA-Related Resources:

Additional QRDA-related resources, as well as current and past implementation guides, are found on the Electronic Clinical Quality Improvement (eCQI) Resource Center QRDA page. For questions related to this guidance, the QRDA Implementation Guides or Schematrons, visit the ONC Project Tracking System (Jira) QRDA project.