Discrepancies between "same provider" EP measure logic guidance creates issues with consistent implementation.

We're trying to resolve conflicting guidance on whether eligible providers in a health system should or should not be able to "share" data across patients for the purposes of evaluating clinical quality / care for a patient.

EX: Patient sees provider A for a blood pressure visit at health system. Patient then visits provider B for follow-up blood pressure visit at same system.

Should we be able to evaluate care regardless of the individual provider? If the notion is evaluating the care the patient received, should we be able to bridge providers?

In some cases, guidance has been "yes." In others, "no." The latest formal guidance (which supports the concept of patient-centered health quality measurement), states:

"While the measures in the MU program are targeted towards individual providers, the goal is that the provider demonstrates the correct action was taken for the correct patient, and not that that specific provider necessarily took every action for that patient. In general, if you can demonstrate that the action in question was performed, you receive credit for participating in clinically-appropriate care"

This is the latest guidance from 2014. Does this guidance apply to all EP measures and override any prior conflicting guidance?

"Doesn't need to be the same provider"
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Guidance:
http://jira.oncprojectracking.org/browse/CQM-582

"As mentioned in the comments below, any provider's encounter satisfies the intent of the measure. The intent is that there is follow up for the patient, not that the specific provider in the denominator was the one who provided care at both times. As with many quality measures, this measure looks to see that appropriate care is provided to patients by care teams and not that individual providers are responsible for all care."

Guidance:
http://jira.oncprojectracking.org/browse/CQM-962

"The patient may have visits with different providers - however, a record of the encounters must be in the EHR of the reporting provider."

Guidance:
http://jira.oncprojectracking.org/browse/CQM-1054
http://jira.oncprojectracking.org/browse/CQM-1055
http://jira.oncprojectracking.org/browse/CQM-1056

"While the measures in the MU program are targeted towards individual providers, the goal is that the provider demonstrates the correct action was taken for the correct patient, and not that that specific provider necessarily took every action for that patient. In general, if you can demonstrate that the action in question was performed, you receive credit for participating in clinically-appropriate care."

"Needs to be the same provider"
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Guidance:
http://jira.oncprojectracking.org/browse/CQM-716

"It has to be the same provider at each Occurrence. These measures are reported out at the provider level so only one provider can be accountable."