Percentage of patients 18-85 years of age who had a diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period, and whose most recent blood pressure was adequately controlled (<140/90mmHg) during the measurement period
– DENOMINATOR
Patients 18-85 years of age by the end of the measurement period who had a visit and diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period.
A qualifying visit in this case includes any of the following:
Office Visit
Annual Wellness Visit
Preventive Care Services Established Office Visit, 18 and Up
Preventive Care Services Initial Office Visit, 18 and Up
Home Healthcare Services
Online Assessments
Telephone Visits
– DENOMINATOR EXCLUSIONS
Patients with evidence of end stage renal disease (ESRD), dialysis or renal transplant before or during the measurement period.
Patients with a diagnosis of pregnancy during the measurement period.
Patients who are in hospice care for any part of the measurement period.
Patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period.
Patients 66-80 by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria:
Advanced illness with two outpatient encounters during the measurement period or the year prior
Advanced illness with one inpatient encounter during the measurement period or the year prior
Taking dementia medications during the measurement period or the year prior.
Patients 81 and older by the end of the measurement period with an indication of frailty for any part of the measurement period.
Patients receiving palliative care or any part of the measurement period.
– NUMERATOR
Patients whose most recent blood pressure is adequately controlled (systolic blood pressure < 140 mmHg and diastolic blood pressure < 90 mmHg) during the measurement period.
Note: This blood pressure reading should not have been taken during an emergency department visit or an inpatient encounter.
– APPLICATION WORKFLOW
For Denominator:
To record an encounter/visit, navigate to Patient > Provider Notes > Create Superbill. Under the ‘Procedure- CPTs’ heading, enter the encounter code.
eSuperbill
For documenting the diagnosis for hypertension, use the workflow Patient > Provider Notes > Diagnoses. Click ‘Add’ and search for the relevant diagnosis. Fill out the details, and once done, click ‘Save’.
Example of Essential Hypertension Diagnosis
For Numerator:
To record a patient’s latest blood pressure, head over to Patient > Clinical > Vitals. Click ‘+ Add’ and locate the field titled ‘Blood Pressure’. Here, input the systolic and diastolic blood pressure values in their respective fields. Once done, click ‘Save’.
Blood Pressure Field in Vitals
For Denominator Exclusions:
To document ESRD, use the workflow Patient > Provider Notes > Diagnoses.
ESRD Diagnosis
Documentation of renal transplant, dialysis and pregnancy can be done through Patient > Provider Notes > Orders > Procedures. Here, click ‘Add’ and search for the relevant procedure. Once done, click ‘Save & Accept’ or ‘Sign & Accept’.
Example of Dialysis Procedure
To document a patient receiving hospice care, navigate to Patient > Provider Notes > Evaluations. Hospice Care can also be recorded by the workflow Patient > Provider Notes > Create Superbill. Under the ‘Procedure-CPTs’ heading, add the relevant hospice care code.
Hospice Care Evaluation
To record an encounter for patients living long term in nursing homes, head over to Patient > Provider Notes > Create Superbill or to Patient > Provider Notes > Evaluations. Here, click ‘Add’ and search for the relevant finding.
Nursing Home Evaluation
To document an outpatient encounter for advanced illness, navigate to Patient > Provider Notes > Create Superbill. The outpatient encounters can include any of the following:
Outpatient
Observation
Emergency Department Visit
Nonacute Inpatient
To document an advanced illness, use the workflow: Patient > Provider Notes > Diagnoses. Click ‘Add’ and search for the relevant advanced illness.
Note: The advanced illness is to be diagnosed during the outpatient encounter.
Example of Advance Illness Diagnosis
To record frailty criteria, the following workflows can be used:
Frailty device ordered/ applied during the measurement period: Patient > Provider Notes > Procedures or through Patient > Provider Notes > Evaluations
Example of Frailty Device Ordered/Applied
Frailty diagnosis during the measurement period: Patient > Provider Notes > Diagnoses
Example of Frailty Diagnosis
Frailty symptoms during the measurement period: Patient > Provider Notes > Diagnoses or Patient > Provider Notes > Evaluations.
Frailty encounter during the measurement period: Patient > Provider Notes > Create Superbill.
Example of Frailty Encounter
To document an inpatient encounter for advanced illness, navigate to Patient > Provider Notes > Create Superbill or document via Patient > Provider Notes > Evaluations.
The dementia medication can be documented using the workflow Patient > Provider Notes > Medications.
Example of Dementia Medication
To record a palliative assessment, head over to Patient > Provider Notes > Evaluations or to Patient > Provider Notes > Assessments.
Example of Palliative Assessment
To record a palliative encounter, navigate to Patient > Provider Notes > Create Superbill or to Patient > Provider Notes > Diagnoses. Here, document a diagnosis for ‘Encounter for palliative care’.
Encounter of Palliative Care Diagnosis
To record a palliative intervention, navigate to Patient > Provider Notes > Evaluations.
