The numerator for this measure is looking at the "most recent" blood pressure results at the "most recent" encounter. For a provider who is in private practice or who may be in a primary care group practice, using the "most recent" blood pressure results at the "most recent" encounter is most likely to give accurate blood pressure results leading to a more accurate reporting measure. However, for multispecialty groups or large academic medical centers who share a patient's medical record across all clinics and specialties, using the "most recent" blood pressure result at the "most recent" encounter does not capture the intent of this measure. It is very likely that a primary care provider could be managing a patient's blood pressure superbly but the patient's most recent blood pressure and encounter could be at a specialty clinic or procedure clinic that caused an elevation in blood pressure due to anxiety of being in a specialist office or having a procedure performed. This one visit with an abnormal blood pressure result would make the provider who is superbly managing this patient's blood pressure fail this measure for this patient.