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  1. QRDA Issue Tracker
  2. QRDA-229

eCQM versionNumber mismatch in HQMF and CDA/QRDA

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    • Icon: QRDA-I Standard QRDA-I Standard
    • Resolution: Done
    • Icon: Minor Minor
    • None
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      If a user populates versionNumber with the decimal value that is specified in the latest eCQMs for the four corrected EH 2015 specifications, it will fail the QRDA Cat 1 xsd schema validation, and the file will be rejected by the CMS hospital eCQM receiving system.
      Show
      If a user populates versionNumber with the decimal value that is specified in the latest eCQMs for the four corrected EH 2015 specifications, it will fail the QRDA Cat 1 xsd schema validation, and the file will be rejected by the CMS hospital eCQM receiving system.
    • CMS / DECC HQR
    • Estelle Noone
    • 410-872-7830
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      Per the approved disposition of this DSTU comment regarding the versionNumber mismatch issue (http://www.hl7.org/dstucomments/showdetail_comment.cfm?commentid=730), guidance was added to both the HL7 QRDA-I DSTU R3.1 and QRDA-III DSTU R1.1 to guide the users to only include eCQM Version Specific Measure Identifier when submit QRDA-I and III files.

      In the published 2016 CMS QRDA IG Appendix, similar guidance is also included. The following is the Section 3.1 "Submit eCQM Version Specific Measure Identifier ONLY" from the 2016 CMS QRDA IG Appendix.

      "For the 2016 Reporting Period, only the eCQM Version Specific Measure Identifier is required to uniquely identify the version of an eCQM. The eCQM Version Specific Measure Identifier must be submitted in both QRDA-I and QRDA-III. eCQM Version Neutral Identifier and eCQM Version Number are not used to validate that Update June 2015 eCQMs are being submitted.

      It is recommended that eCQM Version Numbers not be included in the QRDAs. This is due to a known data type mismatch issue between the Health Level Seven (HL7) QRDA and HQMF standards for the versionNumber attribute. Both the QRDA-I and QRDA-III standards are based on HL7 Clinical Document Architecture (CDA) R2, which is derived from the HL7 Reference Information Model (RIM) Version 2.07. In RIM 2.07, the versionNumber attribute is specified as INT data type. HQMF R2.1, however, is derived from HL7 RIM, Version 2.44, where versionNumber is specified as ST data type. Starting from the June 2015 eCQM annual update, eCQM Version Numbers generated by the Measure Authoring Tool (MAT) are now string values such as 4.0.000 and 5.1.000 instead of integers such as 4 or 5. If a version number such as 4.0.000 were submitted, the QRDA files will fail the CDA_SDTC.xsd schema validation and will be rejected by the receiving systems. If the versionNumber attribute is supplied as an INT value, the file will not be rejected, but the value will be ignored."
      Show
      Per the approved disposition of this DSTU comment regarding the versionNumber mismatch issue ( http://www.hl7.org/dstucomments/showdetail_comment.cfm?commentid=730), guidance was added to both the HL7 QRDA-I DSTU R3.1 and QRDA-III DSTU R1.1 to guide the users to only include eCQM Version Specific Measure Identifier when submit QRDA-I and III files. In the published 2016 CMS QRDA IG Appendix, similar guidance is also included. The following is the Section 3.1 "Submit eCQM Version Specific Measure Identifier ONLY" from the 2016 CMS QRDA IG Appendix. "For the 2016 Reporting Period, only the eCQM Version Specific Measure Identifier is required to uniquely identify the version of an eCQM. The eCQM Version Specific Measure Identifier must be submitted in both QRDA-I and QRDA-III. eCQM Version Neutral Identifier and eCQM Version Number are not used to validate that Update June 2015 eCQMs are being submitted. It is recommended that eCQM Version Numbers not be included in the QRDAs. This is due to a known data type mismatch issue between the Health Level Seven (HL7) QRDA and HQMF standards for the versionNumber attribute. Both the QRDA-I and QRDA-III standards are based on HL7 Clinical Document Architecture (CDA) R2, which is derived from the HL7 Reference Information Model (RIM) Version 2.07. In RIM 2.07, the versionNumber attribute is specified as INT data type. HQMF R2.1, however, is derived from HL7 RIM, Version 2.44, where versionNumber is specified as ST data type. Starting from the June 2015 eCQM annual update, eCQM Version Numbers generated by the Measure Authoring Tool (MAT) are now string values such as 4.0.000 and 5.1.000 instead of integers such as 4 or 5. If a version number such as 4.0.000 were submitted, the QRDA files will fail the CDA_SDTC.xsd schema validation and will be rejected by the receiving systems. If the versionNumber attribute is supplied as an INT value, the file will not be rejected, but the value will be ignored."

      CMS issued corrections to four EH (and 12 EP) 2015 eCQM specifications that were posted in May for the annual update for 2016 eReporting. For the four affected EH eCQMs, the version specific identifiers changed and the associated measure versionNumbers were bumped up by a fractional number (e.g., from 5 to 5.1). The four EH eCQMs are:
      • CMS9v4, Exclusive Breast Milk Feeding
      • CMS171v5, Prophylactic Antibiotic Received Within One Hour Prior to Surgical Incision
      • CMS172v5, Prophylactic Antibiotic Selection for Surgical Patients
      • CMS188v5, Initial Antibiotic Selection for Community-Acquired Pneumonia (CAP) in Immunocompetent Patients

      If using the versionNumbers with decimals for any of the four EH eCQMs in test QRDA files, we found that the value in the file did not pass the xsd schema validation. Our understanding is that the versionNumber in HQMF R1 was data type INT (integer), and then in HQMF R2.1, it was changed to data type of ST (string). However, in CDA, and therefore QRDA, versionNumber is INT. So if a user populates versionNumber with the value that is specified in the latest eCQMs, it will fail the schema validation, and the file will be rejected by the CMS hospital eCQM receiving system. Presumably, this same issue would happen with EP submissions for any of the 12 eCQMs that underwent the similar type of corrections.

        1. HR_eMeasures_versions_-_December_April_2013_April_2014_May_2015_JUNE_2015_updates_eMeasure_xref_mapping.xlsx
          26 kB

            yanheras Yan Heras
            enoone Estelle Noone (Inactive)
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              Created:
              Updated:
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