There are several cases where a QRDA template, having been derived from a C-CDA template, has vocabulary constraints that conflict with the value sets used in eMeasures: gender, discharge disposition, route code, etc. Below are the resolutions for resolving this issue of conflicting vocabulary constraints: 1) Short-term: relax the validation to allow for SNOMED route codes; provide guidance to implementers that SNOMED route codes will be accepted. 2) Intermediate-term: work with NLM/VSAC to support measure developers creating value sets that align with approved vocabulary recommendations. 3) Longer-term: QRDA templates inherit from C-CDA templates, and therefore adhere to C-CDA vocabulary recommendations. eCQMs adhere to HITSC vocabulary recommendations. In a few cases, the recommendations haven’t aligned. The longer-term suggestion was to invite HL7 into the LEAN process to help identify the reason for these mismatches and to collaborate on a “single source of truth” solution. We are currently working to create a stakeholder group that would respond to and follow HL7 errata and DSTU, update Implementation Guides, and unite all of these related issues in one location.