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How do you define a 'unique patient' as it relates to measurements for Meaningful Use?
Posted: December 23, 2010

Per Dr. Jens: The Final Rule for MU has very specific language on this. Essentially, it is defined as a patient who has their first entry into the clinic within the reporting period. Please be careful here — that does not mean that the various EHR MU measured activities have to happen at THAT visit. But the number of unique patient (visits) in a reporting period becomes the denominator for the calculations. The following is detailed explanation of this rule, note that in this definition “we” does not refer to RevolutionEHR but rather to the governing body for meaningful use standards and definitions: In the proposed rule, we state, ”the reason we propose to base the measure on unique patients as opposed to every patient encounter, is that a problem list would not necessarily have to be updated at every visit.”

┬áTo further describe the concept of ”unique patient” we mean that if a patient is seen by an EP or admitted to an eligible hospital’s or CAH’s inpatient or emergency department (POS 21 or 23) more than once during the EHR reporting period then for purposes of measurement they only count once in the denominator for the measure. All the measures relying on the term ”unique patient” relate to what is contained in the patient’s medical record. Not all of this information will need to be updated or even be needed by the provider at every patient encounter. This is especially true for patients whose encounter frequency is such that they would see the same provider multiple times in the same EHR reporting period. Measuring by every patient encounter places an undue burden on the EPs, eligible hospitals and CAHs and may have unintended consequences of affecting the provision of care to patients merely to comply with meaningful use. Given the emphasis placed on the reporting burden by commenters as described in the beginning of this section, we believe that our concerns about the burden of measurement were well founded. We also continue to believe that the use of patient encounters could have unintended consequences on the provision of care by providers.





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