Clinical Recommendation 2017 Hypertension Clinical Practice Guidelines4 Out-of-office BP measurements are recommended to confirm the diagnosis of hypertension and for titration of BP-lowering medication, in conjunction with telehealth counseling or clinical interventions.47 50 (Class 1, Level of Evidence: ASR ) ACC indicates American College of Cardiology; AHA, American Heart Association; BP, blood pressure; HBP, high blood pressure; HBPM, home blood pressure monitoring; and QCDR, Qualified Clinical Data Registry. 26 Appendix A. Continued Process Quality Measures Short Title: QM-1: Nonpharmacological Interventions for ACC/AHA Stage Elevated BP QM-1: Percentage of Adults 18 to 85 Years of Age Who Had a Diagnosis of ACC/AHA Stage Elevated BP Who Have a Documented Discussion of Intensive Lifestyle Modification in 1 Visits During the Measurement Year Measure Description: Percentage of patients with ACC/AHA stage elevated BP who have a documented discussion of intensive lifestyle modification in 1 visits during the measurement year Numerator Patients who have a documented discussion of intensive lifestyle modification at least once in the performance year and in accordance with ACC/AHA guidelines on nonpharmacological therapy Denominator All patients 18 85 y of age who had at least 1 outpatient encounter with a diagnosis of HBP during the first 6 mo of the measurement year or any time before the measurement period Denominator Exclusions Pregnancy, BP readings taken during an inpatient stay Denominator Exceptions None Measurement Period 12 mo/measurement year Sources of Data Paper medical record/prospective data collection flow sheet, Qualified Electronic Health Record, QCDR, electronic administrative data (claims), expanded (multiple source) administrative data, electronically or telephonically transmitted BP readings Attribution Physician group practice, accountable care organization, clinically integrated network, health plan, integrated delivery system Care Setting Outpatient (office, clinic, home, or ambulatory) Rationale Effective management of elevated BP requires intensive lifestyle modification. 