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ACP supports MIPS measure 051: "COPD: Spirometry Evaluation" because current performance does not meet best practices and there is opportunity for improvement through improved diagnostic accuracy. Furthermore, diagnosing or labeling a patient with COPD without performing or reviewing spirometry results may adversely impact future management. In addition, measure specifications include appropriate exclusion criteria for documentation of medical reason for not documenting spirometry results. While we support this measure, we note that spirometry evaluation is only a confirmatory test. A more meaningful measure may assess for COPD misdiagnosis. Additionally, while this measure represents good clinical practice, implementation could promote overuse of pulmonary function tests (PFTs) if clinicians encounter interoperability barriers to data retrieval across incompatible information systems. Performing PFTs in asymptomatic patients is unlikely to benefit clinical outcomes.