Recommendations on QRDA Category-III Aggregate Report for Query Health Results Format Srinivas Velamuri, Software Architect, Telligen

 QRDA Header  QRDA Body  Reporting Parameters Section  MeasureSet Section  Measure Section  MeasureSet Section  Measure Section  QRDA Header  QRDA Body – Reporting Parameters Section – Measure Section Edits to QRDA Cat-III structure As per draft standard 2 For Query Health

 CONF-QRDA-III-20: A QRDA Category III report SHALL contain at least one and MAY contain more than one Measure Set section containing information about the measure set.  CONF-QRDA-III-20: A QRDA Category III report MAY contain one or more Measure Set sections containing information about the measure sets. Edits to QRDA Cat-III draft standard As per draft standard 3 For Query Health Rationale: The HQMF query addresses only a single measure, not a Measure Set, so it is recommended to make Measure Sets optional in the response.

 CONF-QRDA-III-21: A QRDA Category III report SHALL contain at least one and MAY contain more than one Measure section, each containing information about a single measure.  CONF-QRDA-III-21: A QRDA Category III report SHALL contain exactly one Measure section, containing information about a single measure. Additional constraint for Query Health As per draft standard 4 For Query Health Rationale: The HQMF query addresses only a single measure, so it is recommended to remove results for multiple measures in the response. However a Query envelope may contain multiple QRDA cat-III responses

Using business names …  While compared to HQMF queries (which may run into several pages), the QRDA Cat-III responses are very simple  Further in QRDA cat-III response, unlike HQMF queries, one can’t find so many sections, entries etc., which may warrant the usage of business names for the sections, entries, etc.  Also unlike HQMF queries, the QRDA Cat-III response is built on top of HL7 CDA R2 standard and is a peer to HL7 CCD standard, which is more widely used by healthcare organizations and a change in this area would call from participation from a broader community  Recommendation: Do not use business names in QRDA cat-III (at least in the short-term) 5

Using CLASSIFIERS …  In HQMF standard proposed edits, there is a mention of CLASSIFIERS to enable Measure (Query) results to be broken down by population subgroups: e.g., age range, gender, race/ethnicity. But this may call for addition of a new SECTION in HQMF other than Data Criteria and Population Criteria, such as “Stratification Criteria Section”. This is a recommendation for the HQMF standards team  However CLASSIFIERS are supported by the way of “measure- specific grouping data elements” of Measure Section in the QRDA Cat-III response 6

Referencing HQMF query in QRDA Cat-III  Need: QRDA Cat-III response needs to contain the reference to HQMF query that is being used to create this response  Recommendation: Use the “inFulfillmentOf” element in QRDA Header to capture the HQMF query information in the QRDA cat-III response 7