I love hoops and acronyms. I jump through them all the time. Now I'm going for PCMH and getting my MIPS in a row with PRIME registry which extracts quality indices directly from the AC SQL database. Unfortunately, a lot of the measures don't work because the registry tries to use the Clinical Decision Support (CDS) rules to denote when a condition has been satisfied, such as a diabetic retinal exam or osteoporosis screening. This can't work because the CDS rules do not match the definitions of the quality indices from Medicare. First of all, the CDS rules have no method of excluding patients from the rule. For example, someone with recognized and treated osteoporosis should be excluded from getting screening for osteoporosis. The CDS rules come up over and over again on patients for whom they don't apply. If AC is planning to use the CDS rules to ever help with MIPS, they need to be dramatically reworked.
