eMeasure specification standards do not provide a method of representing and distinguishing the source of data as either patient-reported or proxy-reported (i.e, reported by a representative of the patient such as family member or caregiver).

There are several eMeasures currently in development that focus on the use of patient-reported assessments that will require this feature:
• Functional Status Assessment and Goal Achievement for Patients with Congestive Heart Failure
• Functional Status Assessment and Improvement for Patients who Received a Total Hip Replacement
• Functional Status Assessment and Improvement for Patients who Received a Total Knee Replacement”

During our MU-2 eMeasure specification process, we used the "source" attribute and planned to reference a "patient" SNOMED concept for three functional status assessment (FSA) measures. However, when the MITRE team ran through their QA processes they flagged the "source: patient-reported" attribute as invalid because the concept of data being "patient-reported" was not something that could be represented in a QRDA-1 file. In order to pass the MITRE QA process, we had to remove the patient-reported attribute from the MAT HQMF specification.

Since we are expanding the above FSA measures for MU-3, how should we approach this issue in our MU-3 specification process? Similarly, is there anything we need to do for the next round of MU-2 annual updates in CY2014 specific to our current MU-2 FSA measures?