Meaningful use requirements will go through three stages over the next several years. Stage 1, focuses on the use of a certified EHR and the demonstration of performance measures to CMS.  Stages 2 and 3 will set higher goals for quality and further encourage the use of electronic health information to improve health care quality. The staged approach was created to give health care providers and EHR technology companies time to gradually build their capacity to meet these requirements. 

Stage 1
Stage 1 sets the baseline for electronic data capture and information sharing.  Stage 1 meaningful use criteria require the use of a certified electronic health record (EHR) and demonstration that the EHR is used to meet objective and measure requirements.  Meaningful use includes a core set and a menu set of objectives that are specific to eligible professionals or eligible hospitals and CAHs.

For eligible professionals, there are a total of 25 meaningful use objectives.  To qualify for an incentive payment, 20 of these 25 objectives must be met.

• There are 15 required core objectives.
• Must choose 5 out of 10 objectives from a menu set of objectives.
• In addition, eligible professionals must report on 6 clinical quality measures:  3 core quality measures and an additional 3 from a set of 38. There are no thresholds for these quality measures; providers only need to submit them to meet the requirement.

For eligible hospitals and CAHs, there are a total of 24 meaningful use objectives. To qualify for an incentive payment, 19 of the 24 objectives must be met.

• There are 14 required core objectives.
• The remaining 5 objectives may be chosen from the list of 10 set of objectives.
• In addition, eligible hospitals and CAHs must report on all 15 of their clinical quality measures.

Stage 2
Stage 2 meaningful use criteria, expected to be implemented in 2013, will continue to expand on this baseline and be developed through future rule making. It is expected that the proposed rule will further encourage the use of health IT for continuous quality improvement; for example, the electronic transmission of orders entered using computerized provider order entry (CPOE) and the electronic transmission of diagnostic test results. 

Stage 3
Stage 3 meaningful use requirements are expected to be implemented in 2015. The proposed rule will focus on sustainability of the program through improvements in quality, safety and efficiency that improve health outcomes. 

Please go to www.mceita.org or www.hhs.gov/healthit/ for more information on meaningful use.