So this is why CDS is messing us up. On this particular patient, he has previous myocardial infarction, with ICD 10 for previous myocardial infarction in the chart, so aspirin primary prophylaxis should not show up. Ditto high blood pressure screening because of his established history of treated high blood pressure. The PHQ-9 has not worked since 9.2. The screening for lipid disorders should also be excluded as he has established E78.5. And of course, he doesn't qualify for lung cancer screening since he quit more than 15 years ago, and had less than a 30 year history. We have computers so that we specifically don't have to wade through this stuff. Now if we use the CDS for practice improvement or to try and measure MIPS all the denominators are way off. It also means that PRIME registry cannot use the CDS for any measurements.
[Linked Image from amazingcharts.com]

Kevin Miller, MD