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Step 5: Achieve Meaningful Use Stage 1

Record Vital Signs

Objective:

Record and chart changes in the following vital signs:

  1. Height
  2. Weight
  3. Blood pressure
  4. Calculate and display body mass index (BMI)
  5. Plot and display growth charts for children 2-20 years, including BMI

Measure:

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

  1. Sees no patients 3 years or older is excluded from recording blood pressure;
  2. 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;
  3. Believes that height and weight are relevant to their scope of practice, but blood pressure is not, is excluded from recording blood pressure; or
  4. Believes that blood pressure is relevant to their scope of practice, but height and weight are not, is excluded from recording height and weight.

Clinical Importance

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.

CMS Resources

The following resources are available to help you meet the Record Vital Signs meaningful use core measure:

Related CMS EHR Incentive Program Frequently Asked Questions

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

For additional questions around meaningful use, visit the CMS EHR Incentive Program Frequently Asked Questions (FAQs).

 

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