Hydrogen–deuterium exchange of fast-exchanging species (e.g. hydroxyl groups) can be measured at atomic resolution quantitatively by neutron crystallography, and in real time if exchange is conducted during the diffraction experiment.
High intensity neutron beams are generally generated by spallation at linac particle accelerators such as the Spallation Neutron Source.  Neutrons diffract crystals similarly to X-rays and can be used for structural determination. Hydrogen atoms, with between one and zero electrons in a biological setting, diffract X-rays poorly and are effectively invisible under normal experimental conditions. Neutrons scatter from atomic nuclei, and are therefore capable of detecting hydrogen and deuterium atoms.
Hydrogen atoms are routinely replaced with deuterium, which introduce a strong and positive scattering factor. It is often sufficient to replace only the solvent and labile hydrogen atoms in a protein crystal by vapor diffusion. In such a structure the occupancy of an exchangeable deuterium atom in a crystal will refine from 0-100%, directly quantifying the amount of exchange.