Header section of QRDA 1

The QRDA-1 is driven specific to patient information. Please consider the QRDA Incidence Report provided below. This specific QRDA-1 is provided for one particular patient with the name xxxx qqqq, the below sections will describe how and what information the header section of QRDA 1 will contain.

The specification of QRDA 1 and QRDA 3 are available in opensource under CMS provided sheets. please refer this link – CMS standards and specifications for QRDA1 and QRDA3

The below details are essential for the header start data. Since QRDA is built on top of CDA architecture, based on which it is essential to have the tag <ClinicalDocument>, the following tags becomes necessary.

<ClinicalDocument xmlns=”urn:hl7-org:v3″ xmlns:sdtc=”urn:hl7-org:sdtc” xmlns:voc=”urn:hl7-org:v3/voc” xmlns:xsi=”http://www.w3.org/2001/XMLSchema-instance”&gt;
<realmCode code=”US”/>
<typeId extension=”POCD_HD000040″ root=”2.16.840.1.113883.1.3″/>
<templateId extension=”2014-06-09″ root=”2.16.840.1.113883.10.20.22.1.1″/>
<templateId extension=”2014-12-01″ root=”2.16.840.1.113883.10.20.24.1.1″/>
<templateId extension=”2014-12-01″ root=”2.16.840.1.113883.10.20.24.1.2″/>
<templateId extension=”2015-07-01″ root=”2.16.840.1.113883.10.20.24.1.3″/>
<id extension=”1939″ root=”2.16.840.1.113883.3.2710.1.1.1″/>
<code code=”55182-0″ codeSystem=”2.16.840.1.113883.6.1″ codeSystemName=”LOINC” displayName=”Quality Measure Report”/>
<title>QRDA Incidence Report</title>
<effectiveTime value=”20161226034201″/>
<confidentialityCode code=”N” codeSystem=”2.16.840.1.113883.5.25″/>
<languageCode code=”en”/>

The individual patient details are available in the following section. This section is called <recordTarget>

<recordTarget>
<patientRole>
<id extension=”2035b4ac-e241-45a0-afcf-f015c7ff3cdf_1″ root=”2.16.840.1.113883.4.572″/>
<id extension=”2035b4ac-e241-45a0-afcf-f015c7ff3cdf_1″ root=”1.3.6.1.4.1.115″/>
<addr use=”HP”>
<streetAddressLine>874 Schuster Springs Oval, Suite 196</streetAddressLine>
<city>Lake Ladariustown</city>
<state>NH</state>
<postalCode>03689</postalCode>
<country>US</country>
</addr>
<telecom use=”WP” value=”tel:+1-781-271-3000″/>
<patient>
<name>
<given>xxxx</given>
<family>qqqqq</family>
</name>
<administrativeGenderCode code=”M” codeSystem=”2.16.840.1.113883.5.1″ codeSystemName=”HL7 AdministrativeGender”/>
<birthTime value=”19400306153000″/>
<raceCode code=”2131-1″ codeSystem=”2.16.840.1.113883.6.238″ codeSystemName=”CDC Race and Ethnicity” displayName=”otherRace”/>
<ethnicGroupCode code=”2135-2″ codeSystem=”2.16.840.1.113883.6.238″ codeSystemName=”CDC Race and Ethnicity” displayName=”Hispanic or Latino”/>
<languageCommunication>
<templateId assigningAuthorityName=”HITSP/C83″ root=”2.16.840.1.113883.3.88.11.83.2″/>
<templateId assigningAuthorityName=”IHE/PCC” root=”1.3.6.1.4.1.19376.1.5.3.1.2.1″/>
<languageCode code=”eng”/>
</languageCommunication>
</patient>
</patientRole>
</recordTarget>

In the above code structure id extension=”2035b4ac-e241-45a0-afcf-f015c7ff3cdf_1″ refers to the Patient ID. It is the unique identification of a patient.While the root values root=”2.16.840.1.113883.4.572″ and root=”1.3.6.1.4.1.115″ should not differ.

The Gender, ethnicity, race were determined by their corresponding LOINC codes.

The Gender codes are as follows :

  • M – Male
  • F – Female
  • U – Unknown

The Ethnicity codes will be as follows :

  • 2186-5 -> Non-Hispanic or Latino
  • 2135-2 -> Hispanic or Latino

The Race codes will be as follows :

  • 2054-5 -> Black
  • 2106-3 -> White
  • 1002-5 -> American Alaskan
  • 2028-9 -> Asian
  • 2076-8 -> Native Hawaii
  • 2131-1 -> other Race

The language code can be hard-coded and it will not change <languageCode code=”eng”/> it will be the static value.

What is QRDA ?

What is QRDA :

It is a document, which is basically an XML. This document forms a specific document architectural type by itself. More Over, this architecture is built on top of CDA document architecture. Those who are familiar with CDA document architecture can easily de-cipher this too.

Just  like CCDA, proposed by HL7. The QRDA comes with the same kind of conclusion.For CCDA it can be Progress notes CCDA, continuity of care CCDA or procedure notes CCDA and etc. In general  CCDA is a document built with CDA architecture, but this document may vary into number of ways based its need.

Now QRDA, comes with the same confusing flavor of CCDA, except the fact that QRDA itself is a separate document architecture similar to CDA. But QRDA is built by using CDA architecture as its base.

Again, QRDA is a very generalized term of defining its usage. QRDA varies with its own flavors, depending on the need and use. Before getting in to specifics of this works, now let’s understand what QRDA is.

QRDA – stands for Quality Reporting Document Architecture. Developed primarily by HL7 to generate consolidated reports containing details for treatment given for patients.

There are multiple reasons why  QRDA is proposed. US federal initiative proposed QRDA as a quality authority procedure, there by they give additional importance, acknowledging good physicians, empowering care given to the citizen of US by initiating incentives based on good performances for the EHR etc.

Now coming to the previously discussed topic. how QRDA is distinguished. This answer is provided based on the QRDA validating tool. There is a online QRDA validating tool called cypress which can address this solution. visit this site cypress.

In the link you can see that there are various radio buttons available. leave out the reporting parameter section. concentrate on the next block.

  1. None (Base IG Only)
  2. PQRS – Individual
  3. PQRS – Group
  4. HQR – EHR
  5. HQR – IQR
  6. HQR – CDAC

This QRDA is widely classified to 2 types as far the recent meaningful use’s preference. They are QRDA  – 1 and QRDA – 3. QRDA – 1 are those which are specific to patient, QRDA – 3 are those which are specific to group of people a population count.

QRDA – 1 includes the following sections :

  • Header Section
  • Measure Section
  • Reporting Parameters and
  • Patient Data

QRDA – 3 includes the following sections :

  • Header Section
  • Reporting Parameters and 
  • Measure Section

The way of reading these two documents were not the same. QRDA 1 and 3 have very few  things in common. They differ in numerous aspects as much as the information one document can offer.

The content available on these QRDA documents are difficult to interpret and people often face a big difficulty in understanding it. Here is a hierarchy of how the information is organized in the QRDA documents and how good  they will be communicating information for people.

Information Hierarchy in QRDA 3 and QRDA 1 document is provided below :

qrdainformation

 

 

 

 

 

 

 

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