Tuesday, February 15, 2011

PQRI XML Testing

Many folks have asked me about the process for testing PQRI XML files, since they are part of Certification and are required to be submitted to CMS in 2012 as part of Meaningful Use Stage 1.   The inspection for Certification is manual (the testing and certification bodies visually examine the files).   To my knowledge, there are not online tools available for self validation of these files (although it would be a great service to the country to create them).

The PQRI resources I do know about are part of the 4 step qualification process for those who want to serve as qualified PQRI registries on behalf of their participants.

Here is the testing process used by the Massachusetts eHealth Collaborative, which acts as the qualified 2011 Physician Quality Reporting System registry for BIDMC's ambulatory submissions.

The Iowa Foundation for Medical Care is the CMS contractor for PQRI testing.

The Massachusetts eHealth Collaborative (MAeHC) worked with the Iowa Foundation for Medical Care (IFMC) as follows:

1.  Self Nomination followed by a phone interview.
2.  Submission of measure calculation process/logic
3.  Submission of data validation strategy/plan
4.  Submission of sample XML

The fourth step required MAeHC to generate sample XML files based on the CMS specification, encrypt the files using CMS approved encryption software, and send them on a DVD-ROM via certified mail to IFMC.

Once this one done, MAeHC sought Individuals Authorized Access to the CMS Computer Services (IACS) accounts to login to the CMS quality data submission site.

In order to get IACS accounts, users must be identity proofed by IFMC/CMS. MAeHC had to submit a list of names with complete contact information of all users who would be authorized to submit registry data to CMS.  Each of them then had to apply for an account via the CMS Application portal and then waited a few days for it to be approved.

Once accounts were approved, each user had to login to the QualityNet portal to ensure the credentials had the proper level of access.  They then were required to submit another set of test files for validation using the online utility to ensure that they complied with any changes that were made in the specifications.

Here's a complete overview of all the CMS requirements for qualification as a PQRI registry.

That's the process.  I hope it helps those organizations seeking to serve as registries submitting PQRI data on behalf of participants to CMS.


Nancy Anthracite said...

You neglected to mention the joys of trying to find tamper evident packaging for the DVD and sending it by Express Mail if you wanted some results within two to three days, all for files that contained no real patient data!

Agencies are not allowed to receive anything that may appear to contain a social security number, fake or not, which can be a real headache for both the senders and receivers. This leads to all of this "over the top" security for getting test files validated.

The validation software really needs to be hosted on a site like NIST has to increase adoption of electronic quality reporting and to reduce the pain for everyone. The NIST validators for CDA and QRDA documents do not report the same results as those from the CMS, so WorldVistA made a FOIA request for it months ago hoping to host it on the Internet like NIST has done, or better yet, to have NIST host it. We do not yet know the outcome of that request.

Paulo Andre said...

I think you could try this unofficial website created by Paul Wehr for validation of PQRI XML files for Registry submission:


I am not sure if it will work for Meaningful use PQRI XML testing.

Akshay Kapur said...

You mentioned "To my knowledge, there are not online tools available for self validation of these files (although it would be a great service to the country to create them)."

Could you elaborate on how the self-validation process might work?

Unknown said...

Paulo mentioned Paul Wehr's validator (nice job :).

Northwestern's EDW has also put up a PQRI XML format validator for public use:


We developed the validator for our own internal testing, but hope it will be helpful to others. If anyone notes issues, please do let us know.

Anonymous said...

Very helpful post, thank you.