Some EHRs have functionality so that providers may document the length of time an intervention should be deferred based on medical reasons or patient preferences.

For example, if a patient declines a flu shot at the beginning of the flu season but says they will think about it, the provider can defer for two months (for the codified reason of “patient refused”) so that when the patient returns for follow-up, the issue can be raised again. If the patient says they don’t want one this season, the length of time can be set to 11 months so that when the patient returns the next flu season, it can be readdressed. If the patient says they are a life-long Christian Scientist and have never received a flu shot and will never accept one, the immunization can be permanently deferred (for the codified reason of patient refused for religious reasons) and the provider need never ask again.

Implementers would like to use the provider designated length of time in reporting logic so that the deferral is valid during the specified timeframe (e.g. 2 months, 11 months, forever).  In the final example of the patient who refused for religious reasons, this prevents the provider from harassing the patient each year and completing unnecessary documentation each year.

Example: CMS 147 Preventive Care and Screening: Influenza Immunization

Patient Declined Influenza Vaccination

• ["Communication: From Patient To Provider": "Influenza Vaccination Declined"] CommunicateFluVaccinationDeclined
•        where CommunicateFluVaccinationDeclined.authorDatetime during "Influenza Season Including August and September of the Prior Year"

The question is relevant for all measures where ‘reason not done’ is an exclusion.