In a recent seminar on Meaningful Use, reference was made to HL7 QRDA or, better known as, HL7 Quality Reporting Document Architecture. HL7 QRDA was new to me, so I went on a search to learn more and thought it would be good to share some key information.
First, a definition of HL7 QRDA is required. From the HL7 Wiki on this topic, it is defined as:
“…a standard for communicating health care quality measurement information. The standard will conform to the requirements of the Health Level Seven (HL7) Clinical Document Architecture Release 2.0 (CDA) and will reuse the templates developed for the ASTM/HL7 Continuity of Care Document (CCD) and other CDA implementation guides. The project started in 2007 with a private collaboration supported by the Alliance for Pediatric Quality (Alliance) – a joint effort of the American Academy of Pediatrics, The American Board of Pediatrics, Child Health Corporation of America, and the National Association of Children’s Hospitals and Related Institutions.”
Key points are that this is still a developing standard, and it is using HL7 CDA.
Second, although there are many organizations involved in drafting this healthcare standard, three organizations involved – which are not on the HL7 wiki list mentioned above – include the American Health Information Management Association (AHIMA), the Health Information Technology Standards Panel (HITSP), and Integrating the Healthcare Enterprise (IHE).
Two key resources to review:
- HITSP: HITSP Patient Level Quality Data Document Using HL7 QRDA Component
- AHIMA: A Standard for Quality Reporting
What does this all mean? Although the picture is incomplete, HL7 QRDA may play a role in quality reporting requirements for HITECH & Meaningful Use. From John Halamka’s blog post entitled The Interim Final Rule on Standards (i.e., Meaningful Use proposed rules), point 5 is the important one on this topic:
“The adopted content standard for quality reporting is the CMS PQRI 2008 Registry XML Specification, (note that this means it was suggested by the HIT Standards Committee and not by HITSP, it’s not an SDO product but was produced by CMS). The candidate standards are those to be suggested by the HIT Standards Committee. We debated this at the HIT Standards Committee because QRDA is an emerging standard for quality reporting but not a widely implemented one. This glide path is reasonable, but does require implementers to change course – implementing PQRI XML now and possibly QRDA or other standards later. It will be interesting to follow the comments on this one – maybe PQRI and QRDA should be allowed now to prevent this rework.”
As always, more to come later…

