Thank you for your question. The measure is written for any clinician to voluntarily report the measure, and not for any specific clinician. The measure does not distinguish who administers the PHQ-9 or PHQ-9M. In an integrated system with a common EHR, a team-based approach should be considered. A PCP may conduct the initial visit (index event), but the patient may also be cared for by a behavioral specialist. All PHQ-9/ PHQ-9Ms administered regardless of location could contribute towards the outcome of remission, and both the PCP and behavioral specialist could report the patient as part of the measure. Alternatively, in an unshared EHR, the same patient being cared for in each separate practice will look like a unique patient because there is no common patient identifier and no common record. However, PHQ-9/PHQ-9Ms that are shared (e.g. electronic transfer of information) between practices and are a part of each practice's record may be used for determinations of index event or in outcome of remission.

Given that patients should only appear in the reports of providers who have met the denominator criteria the quality measure, how do patients diagnosed with depression by their primary care provider get into the report of behavioral health specialists managing their depression to remission? The initial patient population of Depression Remission at Twelve Months specifies the patient must have a depression encounter with a index depression assessment result of > 9? In many instances the patient is screening for depression with the primary care physician, diagnoses with depression and then referred to behavioral health. The patient appears on the primary care physicians’ report but not on the behavior health specialists. Should this measure be written or implemented uniquely to allow behavioral health specialists to utilize this measure to access the quality of care delivered to patients who are referred to their practice?