eCQM in DocNow – DocNow

Introduction

DocNow EHR supports electronic Clinical Quality Measure (eCQM) reporting as part of the Merit-Based Incentive Payment System (MIPS). eCQMs use structured data captured within the EHR during clinical workflows to evaluate the quality of care delivered to patients. Unlike registry-based measures, eCQMs are calculated end-to-end within certified EHR technology, meaning the data you document during patient encounters directly drives your quality performance scores.

This article provides a detailed overview of the four eCQM measures currently available in DocNow for the 2025 performance year, including eligibility criteria, numerator options, and denominator exclusions/exceptions. Understanding these measures will help you document effectively and ensure your encounters contribute to accurate quality reporting.

How eCQMs Work in DocNow

When a patient encounter meets the eligibility criteria for an eCQM measure, DocNow will trigger the measure during the provider workflow. At that point, the provider can review the applicable numerator options (such as Performance Met, Denominator Exclusion, or Denominator Exception), select the appropriate response, and submit the eCQM. The submission is transmitted to Patient360 and becomes visible on the MIPS Dashboard for administrative review.

Key Workflow Steps

Patient Eligibility: DocNow automatically identifies patients who meet the initial population criteria (age, diagnosis, qualifying encounter) for each enabled eCQM measure.
Measure Trigger: When a qualifying encounter is opened, the system presents the applicable eCQM to the provider.
Numerator Selection: The provider reviews the available numerator options and selects the one that reflects the clinical outcome or action taken during the encounter.
Submission: The provider submits the eCQM response. The data is transmitted to Patient360.
Dashboard Review: Administrators can monitor submissions on the MIPS Dashboard, including patient details, date of service, provider, measure number, selected numerator, and transmission status.

Admin Tip: The MIPS Dashboard displays encounter-level detail for every submitted eCQM, including patient name, date of service, rendering provider, eCQM measure number, selected numerator, and Patient360 transmission status. Use this view to track compliance and identify documentation gaps early in the reporting period.

MIPS 001 — CMS122v13

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (> 9%)

Identifies patients aged 18–75 with diabetes and at least one qualifying encounter during the measurement period. Evaluates whether their most recent glycemic status assessment (HbA1c or GMI) is greater than 9% or is missing.

Element	Description
Eligible Population	18–75 years at the end of the measurement period with at least one qualifying encounter (CPT) during the measurement period.
Measurement Period	January 1 – December 31, 2025
Performance Met (Numerator)	Patient’s most recent glycemic status assessment (HbA1c or GMI) performed during the measurement period is >9.0%, is missing, or was not performed during the measurement period.
Denominator Exclusions	Patients in hospice care for any part of the measurement period. Patients 66 and older living long-term in a nursing home on or before the end of the measurement period. Patients 66 and older with frailty who also have an advanced illness diagnosis during the measurement period or the year prior, or are taking dementia medications during the measurement period or the year prior. Patients receiving palliative care for any part of the measurement period.

MIPS 112 — CMS125v13

Breast Cancer Screening

Identifies female patients aged 42–74 with at least one qualifying encounter and evaluates whether they had one or more mammograms between October 1 (two years prior to the measurement period) and the end of the measurement period.

Element	Description
Eligible Population	42–74 years (female patients) at the end of the measurement period with at least one qualifying encounter (CPT) during the measurement period.
Measurement Period	January 1 – December 31, 2025
Performance Met (Numerator)	Women with one or more mammograms any time on or between October 1, two years prior to the measurement period, and the end of the measurement period.
Denominator Exclusions	Patients in hospice care for any part of the measurement period. Women who had a bilateral mastectomy, have a history of a bilateral mastectomy, or have evidence of both a right and left unilateral mastectomy on or before the end of the measurement period. Patients 66 and older with frailty who also have an advanced illness diagnosis during the measurement period or the year prior, or are taking dementia medications during the measurement period or the year prior. Patients 66 and older living long-term in a nursing home on or before the end of the measurement period. Patients receiving palliative care for any part of the measurement period.
Stratification	Stratification 1: Patients aged 42–51 at the end of the measurement period. Stratification 2: Patients aged 52–74 at the end of the measurement period.

MIPS 134 — CMS2v14

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

Identifies patients aged 12 and older who were screened for depression on the date of the encounter (or up to 14 days prior) using an age-appropriate standardized tool, and if the screening was positive, evaluates whether a follow-up plan was documented on the date of, or up to two days after, the qualifying encounter.

Element	Description
Eligible Population	12 years and older at the end of the measurement period with at least one qualifying encounter (CPT) during the measurement period.
Measurement Period	January 1 – December 31, 2025
Performance Met (Numerator)	Patients aged 12 and older screened for depression on the date of the encounter or up to 14 days prior using an age-appropriate standardized depression screening tool, AND if positive, a follow-up plan is documented on the date of or up to two days after the date of the qualifying encounter.
Denominator Exclusions	• Patients who have ever been diagnosed with bipolar disorder at any time prior to the qualifying encounter.
Denominator Exceptions	Patient refuses to participate in or complete the depression screening. Documentation of a medical reason for not screening the patient for depression.

MIPS 236 — CMS165v13

Controlling High Blood Pressure

Identifies patients aged 18–85 with a diagnosis of essential hypertension starting before and continuing into, or starting during, the first six months of the measurement period. Evaluates whether the patient’s most recent blood pressure is adequately controlled (systolic < 140 mmHg and diastolic < 90 mmHg).

Element	Description
Eligible Population	18–85 years at the end of the measurement period with at least one qualifying encounter (CPT) during the measurement period.
Measurement Period	January 1 – December 31, 2025
Performance Met (Numerator)	Patient’s most recent blood pressure is adequately controlled (systolic blood pressure < 140 mmHg and diastolic blood pressure < 90 mmHg) during the measurement period.
Denominator Exclusions	Patients in hospice care for any part of the measurement period. Patients with evidence of end-stage renal disease (ESRD), dialysis, or renal transplant before or during the measurement period; also patients with a diagnosis of pregnancy during the measurement period. Patients aged 66–80 with frailty who also have an advanced illness diagnosis during the measurement period or the year prior, or are taking dementia medications during the measurement period or the year prior. Patients 81 and older with frailty for any part of the measurement period. Patients 66 and older living long-term in a nursing home on or before the end of the measurement period. Patients receiving palliative care for any part of the measurement period.