Measure at a Glance
Type: calculated percentage
Denominator: unique patients fitting the age limitations, which may be limited to patients maintained by CEHRT
Duration: calculated over the entire EHR reporting period
Objective: Objective: Record the chart changes in the following vital signs:
- Blood pressure
- Calculate and display body mass index (BMI)
- Plot and display growth charts for children 2-20 years, including BMI/Plot and display growth charts for children 0-20 years, including BMI*
*Part (E) of the objective was changed in 2013 as an alternative to the previous objective. In 2014, the alternative wording for part (E) will replace the current wording.
For more than 50 percent of all unique patients age 2 and over seen by the EP, height, weight, and blood pressure are recorded as structured data.
Replacement Measure (Optional for 2013, Mandatory beginning in 2014): More than 50 percent of all unique patients seen by the EP during the EHR reporting period have blood pressure (for patients age 3 and over) and height and weight (for all ages) recorded as structured data.
Any EP who either sees no patients 2 years or older, or who believes that all three vital signs of height, weight, and blood pressure of their patients have no relevance to their scope of practice.
Replacement Exclusion (Optional for 2013, Mandatory beginning in 2014): Any EP who
- Sees no patients 3 years or older is excluded from recording blood pressure
- Believes that all three vital signs of height, weight, and blood pressure have no relevance to their scope of practice is excluded from recording them.
- Believes that height and weight are relevant to their scope of practice, but blood pressure is not, is excluded from recording blood pressure.
- Believes that blood pressure is relevant to their scope of practice, but height and weight are not, is excluded from recording height and weight.
CMS Technical Specification
The fourth bullet under "Additional Information" on the technical specification is very helpful for practices planning how to achieve this objective. CMS additionally notes in the 2012 rule: "We believe that most providers who provide ancillary services can meet the measures of this objective by obtaining this information from a referring provider and recording the necessary data in their CEHRT."
The attestation portal will require the EP to enter the numerator and denominator of the measure as defined in the technical specification. For 2012, the exclusion question does differentiate between the two exclusion reasons: either the EP sees no patients two years or older, or the three vital signs have no relevance to the EP’s scope of practice.
Please note that this measure requires more than 50% of all unique patients. The attestation numerators and denominators are calculated to the hundredths place in the attestation portal, so while a proportion of 50.01% will be evaluated as a successful attestation, 50.00% will not.
Relevant CMS FAQs
- 10593: clarifying reasons for exclusions
- 10156: allowing self-reported or estimated height in certain circumstances
None at this time.
CMS' Final Rule
§ 495.6(d)(8) see objective, measure, and exclusion above
Standards and Certification Final Rule
§ 170.302(f) Record and chart vital signs
- Vital signs. Enable a user to electronically record, modify, and retrieve a patient's vital signs including, at a minimum, height, weight, and blood pressure.
- Calculate body mass index. Automatically calculate and display body mass index (BMI) based on a patient's height and weight.
- Plot and display growth charts. Plot and electronically display, upon request, growth charts for patients 2-20 years old.