The timing precision required for the following QDM elements is not in line with an Ambulatory EP workflow, in addition the Cypress Test Data is setup such that a duration of time needs to be supported for these data elements:

1.Encounter Duration – The EP workflow is different from the EH workflow in that the encounter lasts for a shorter duration and does not span a large period of time and hence the need to document the appointment duration and all associated encounter activities for a given patient within the appointment timeframe results in extra burden for the provider

2.Intervention Performed - e.g. GP_Adult A requires a duration of 15 minutes for a referral to a dental provider which qualifies as an intervention performed

3.Functional Status Result- e.g. GP_Geriatric B requires a duration for the Hip and Knee assessments. In case the patient completes these via a patient portal prior to the encounter or bring in a prefilled assessment how will that be counted toward the measure? Is the intent that the patient complete the assessment in the office?

4.Procedure Performed - e.g. Measure 56 test patient GP_Geriatric A requires a duration for the procedure performed THA which may or may not be available since the procedures are performed outside the providers office and hence the data with timing precision may not be available to record within the EHR

5.Communication From Provider to Provider - e.g. Measure 142 test patient Eye_Adult B requires a duration for the communication of results