​​Thank you for your question on the eCQM STK measures. There are several problems with the proposed solution: Non-treatment must be documented in the medical record by the MD/APN/PA or pharmacist. Medical record documentation must be taken at face value without inference. The proposed solution infers that there is a medical record reason documented since it relies on third-party interpretation. STK-5 is time-sensitive and must be documented the day of or day after hospital arrival. The proposed solution may use documentation dated later than that, when the record is reviewed. EPIC and your IT department may be able to help you with a solution. An example might be creating a system-wide list of smart phrases with smart lists that the MD/APN/PA or pharmacist can select from directly and that are then mapped to one of the appropriate value set codes, based on the measure specification.

“I have a question regarding how we meet the eCQM STK measures within our EPIC software. We currently do not have a good process of mapping physician documentation to satisfy this data collection. Our providers currently document the contraindications within their progress notes. My question is if I, as the stroke coordinator, see that the contraindication is in the documentation, can I document in the medical record a smart phrase that states, "This patient has a medical contraindication for not prescribing anticoagulation therapy for Atrial Fibrillation documented in the note by *** on ***" to satisfy the mapping to the data collection?”