Record Vital Signs
Record and 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
For more than 50 percent of all unique patients age 2 and over seen by the eligible professional height, weight, and blood pressure are recorded as structured data.
Changes as of August 2012:
Beginning in 2013,CMS changed the measure of the objective for recording and charting changes in vital signs for EPs, eligible hospitals, and CAHs. The original measure specifies that vital signs must be recorded for more than 50 percent of all unique patients ages 2 and over. The new measure amends that age limit to recording blood pressure for patients ages 3 and over and height and weight for patients of all ages.
The exclusions for this objective for EPs also changed. The original exclusions only allowed an EP to claim the exclusion if all three vital signs (height, weight, blood pressure) were not relevant to their scope of practice or if the EP did not see patients 2 years or older. However, under the new Stage 1 changes, an EP can claim an exclusion if the EP sees no patients 3 years or older (the EP would not have to record blood pressure), if all three vital signs are not relevant to their scope of practice (the EP would not record any vital signs), if height and weight are not relevant to their scope of practice (the EP would still record blood pressure), or if blood pressure is not relevant to their scope of practice (the EP would still record height and weight).
This new measure and these new exclusions are optional in 2013 but will be required in 2014 and beyond.
New Measure:More than 50 percent of all unique patients seen by the EP or admitted to the eligible hospital's or CAH's inpatient or emergency department (POS 21 or 23) during the EHR reporting period have blood pressure (for patients age 3 and over only) and height and weight (for all ages) recorded as structured data.
New Exclusion: 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; or
- Believes that blood pressure is relevant to their scope of practice, but height and weight are not, is excluded from recording height and weight.
Accurate, documented vital signs are an important component of patient care. They provide essential, baseline data for treatment decisions and historical trends. This historical information allows for recognition of acute or chronic changes that may prove significant.
The following resources are available to help you meet the Record Vital Signs meaningful use core measure:
- EHR Meaningful Use Specification Sheet for Eligible Professionals - Record Vital Sign [PDF - 170k]
- EHR Meaningful Use Stage 1 Changes Tipsheet [PDF - 285 KB]
Lessons from the Field
"Recording and charting vital signs with specialty practices requires proper training and equipment as well as workflow adjustments."
— Bethany Phillips, Health IT Specialist, Wisconsin Health Information Technology Extension Center (WHITEC)
Many specialty practices do not currently include recording and charting of vital signs in their office workflow. It is important to consider this and make needed adjustments to existing workflows to ensure responsibility and accountability of this data entry. In addition, practices should also assess their need for additional equipment and training. Equipment needs might include things such as blood pressure cuffs or scales, and refresher training on taking blood pressure, calculating BMI as well as entering this information into the EHR might be necessary.
Related CMS EHR Incentive Program Frequently Asked Questions
- #3217 - For the meaningful use objective to “record and chart changes in vital signs”, can an EP claim an exclusion if the EP regularly records only one or two of the required vital signs but not all three?
- #2891 - In recording height as part of the core meaningful use objective "Recording vital signs" for EPs, eligible hospitals, and CAHs, how should providers account for patients who are too sick or otherwise cannot be measured safely?
- #2883 - If an EP is unable to meet the measure of a meaningful use objective because it is outside of the scope of his or her practice, will the EP be excluded from meeting the measure of that objective?
- #2813 - What do the numerators and denominators mean in measures that are required to demonstrate meaningful use?
- #2765 - For EPs who see patients in both inpatient and outpatient settings, and where certified EHR technology is available at each location, should these EPs base their denominators for meaningful use objectives on the number of unique patients in only the outpatient setting or on the total number of unique patients from both settings?
- #3307 - How does an EP determine whether a patient has been "seen by the EP" in cases where the service rendered does not result in an actual interaction between the patient and the EP, but minimal consultative services such as just reading an EKG? Is a patient seen via telemedicine included in the denominator for measures that include patients "seen by the EP"?
- #3309 - When a patient is only seen by a member of the EP's clinical staff during the EHR reporting period and not by the EP themselves, do those patients count in the EP's denominator?
- #3065 - Should patient encounters in an ambulatory surgical center be included in the denominator for calculating that at least 50 percent or more of an EP's patient encounters during the reporting period occurred at practices/locations equipped with certified EHR technology?
- #3077 - If an EP sees a patient in a setting that does not have certified EHR technology but enters all of the patient’s information into certified EHR technology at another practice location, can the patient be counted in the numerators and denominators of meaningful use measures?
For additional questions around meaningful use, visit the CMS EHR Incentive Program Frequently Asked Questions (FAQs).