I too am grateful for their efforts. It is nice that you have been successful and are willing to help the rest of us Adam!
In reading about your post and visualizing doing all this with paper, I think the key for AC might to be to visualize how you would make a flow sheet for the CQM with paper - for instance check boxes for DM, HTN, and smoking on one sheet. Then with the patient, there it is all together on one simple page. Prensently there are several routes required to access the various CQM items. Not only do you have to remember to do them each visit, but remember how to get to it in a way that causes the program to remember your actions. The program should do everything it can automatically, for instance excluded child HTN from the data, and the have an efficient system to remind the physician what needs to be checked off at the end of the visit. I would have the physician first pick the parameters they are going to measure, the 3 required and 3 alternate, and then the program would have a box pop up to check items off like smoking cessation counseling and DM foot exam. You could turn this feature off so it does not annoy non-participators, but as it is - the default is to do nothing unless you remember.
