Providers Experience Difficulty with Problem Lists
Providers participating in the Meaningful Use incentive program must maintain up-to-date problem lists of current and active diagnoses based on ICD-9-CM or SNOMED CT clinical coding standards. At least 80 percent of all unique patients must have at least one entry, or an indication of none, recorded as structured data. Some providers face problems with this measure due to uncertainty about the requirements, limited knowledge about how the EHR system handles problem list data, limited commitment from clinical staff, lack of clarity about staff roles, and inadequate procedures for problem list maintenance.
- Review and understand the requirements for meeting this measure
Providers need to design and implement workflows that support the capture of problem lists.
- Understand how the EHR system manages data for this measure
Limited classification of clinical problems can lead to undercoding or overcoding.
- Explain the value of problem lists and get buy in from clinical staff
- Identify the individuals responsible for problem list maintenance
Practices can encounter problems if it is unclear who is responsible for maintaining the problem list.
- Define procedures and accountability for problem list maintenance
Problem lists are demanding to maintain, and may contain inaccurate information if not maintained properly.
Related CMS FAQs
- #2881 - To meet the Meaningful Use objective "maintain an up-to-date problem list of current and active diagnoses," are providers and hospitals required to use ICD-9 or SNOMED-CT?
- #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?