Stage 2 Core Measure 4
Objective:Record and chart changes in the following vital signs:
- Blood pressure (ages 3 and over).
- Calculate and display body mass index (BMI).
- Plot and display growth charts for patients 0 - 20 years, including body mass index.
: More than 80 percent of all unique patients seen by the EP during the EHR reporting period have blood pressure (for patients age 3 and over only) and height/length and weight (for all ages) recorded as structured data.
CMS Specification Sheet
- Any EP who sees no patients 3 years or older is excluded from recording blood pressure;
- Any EP who believes that all three vital signs of height/length, weight, and blood pressure have no relevance to their scope of practice is excluded from recording them;
- Any EP who believes that height/length and weight are relevant to their scope of practice, but blood pressure is not, is excluded from recording blood pressure; or
- Any EP who believes that blood pressure is relevant to their scope of practice, but height/length and weight are not, is excluded from recording height/length and weight.
This objective and measure aligns with Core Measure 8 in Stage 1. Corresponding to the 2013 updates to Stage 1, the age range for blood pressure begins at three years instead of two, and the exclusions are expanded. In Stage 2, the threshold has increased to 80 percent from 50 percent.
Federal Regulations Governing This Measure
CMS' Final Rule
§ 495.6(j)(4)(ii) see objective, measure and exclusion above
Standards and Certification Final Rule
§ 170.314(a)(4) Record and chart vital signs
(i) Vital signs. Enable a user to electronically record, change, and access, at a minimum, a patient’s height/length, weight, and blood pressure. Height/length, weight, and blood pressure must be recorded in numerical values only.
(ii) Calculate body mass index. Automatically calculate and electronically display body mass index based on a patient’s height and weight.
(iii) Optional—Plot and display growth charts. Plot and electronically display, upon request, growth charts for patients.
Depending on the type of certification issued to the EHR technology, it will also have been certified to the certification criterion adopted at 45 CFR 170.314 (g)(1), (g)(2), or both, in order to assist in the calculation of this meaningful use measure.