​The measure logic intends to capture the education components related to warfarin therapy management that should be included in any materials given to the patient. You may be addressing all the education components in a single pamphlet or handout, which is perfectly acceptable. In QRDA category 1, each education component would need to be included separately to satisfy the measure, since the eCQM logic specifies the components separately. However, you may map a single reference to the educational materials in the EHR to each of the five educational components for reporting purposes, as long as your organization ensures that 1) the materials address each and every one of the warfarin education components specified in the eCQM logic; 2) there is evidence in the EHR that the patient was given a copy of the materials satisfying all the education components. We welcome your suggestions on how to make the eCQM logic and guidance clearer.

Our team is mapping the CMS 110 (VTE-5) Measure requirements and will be utilizing "patient education" and "smart text" based on recommendations provided by the QRDA-1 tracker from our ONC-certified EMR vendor: EPIC. Currently our Education Plan contains the following verbiage: "Description: Compliance; dietary advice; follow-up monitoring, potential for adverse drug reactions and interaction. Written material given." (attached - see yellow area on top) The RN can document if patient was Eager/Accepted/Refused, and/or Demonstrated/Verbalized Understanding. This would also show up in the patient education section. Would the above suffice for the CMS 110 VTE-5 eCQM requirement, or does each criteria [patient received written discharge instructions, received written information on drug interaction compliance, written information on adverse drug reaction education, written information on INR monitoring, written instruction on vitamin K dietary management, written instructions on medication compliance, written instructions not to change diet, and written instructions addressing follow-up monitoring] need to be explicitly stated as the QRDA-I tracker has broken each of the criteria down into distinct value sets for this measure? If the above (attached) education does not qualify, would the below education from the American Heart Association for Warfarin education suffice if added to our education plan verbiage? If discharged on WARFARIN (COUMADIN®): I have been given information about Warfarin (Coumadin®). I understand there are several steps I should take to help keep myself healthy. These steps include: 1. The importance of taking warfarin as instructed. 2. That warfarin therapy requires frequent lab checks to make sure the blood is thinned enough but not too much. It is very important to come to appointments for monitoring warfarin by getting the blood test call PT/INR. 3. I will have follow-up appointments already scheduled for me (see After Visit Summary for details of date/time) to monitor warfarin with PT/INR tests after my discharge. 4. Warfarin increases my risk for bleeding, and I will let my doctor know about anytime I have unusual or excessive bleeding. 5. Warfarin can interact with many other medications. It is important not to discontinue or start any medication, over-the-counter medication or health food supplements except with the advice of the physician or pharmacist who knows you are on warfarin. 6. Foods that you eat which contain Vitamin K can influence how well warfarin thins the blood. It is important to try to continue a “consistent amount” of Vitamin K in the foods you eat while on this medication. If you are planning a major diet change, you need to discuss that with your care provider. 7. I understand that ANY changes to my diet and medications can affect the PT/INR levels in my blood. There are pamphlets available to explain the Vitamin K content of foods and important medication interactions that your nurse, pharmacist or doctor can provide. American Heart Association article about safe use of warfarin is available at: http://circ.ahajournals.org/content/119/8/e220.full.pdf+html Thank you