The proposed rule states that Stage 2 meaningful use criteria expands upon the Stage 1 criteria to "encourage the use of health IT for continuous quality improvement at the point of care and the exchange of information in the most structured format possible, such as the electronic transmission of orders entered using computerized provider order entry (CPOE) and the electronic transmission of diagnostic test results (such as blood tests, microbiology, urinalysis, pathology tests, radiology, cardiac imaging, nuclear medicine tests, pulmonary function tests and other such data needed to diagnose and treat disease)." CMS may consider applying the criteria more broadly to both the inpatient and outpatient hospital settings.

The proposed rule states that Stage 3 meaningful use criteria, consistent with other provisions of Medicare and Medicaid law, will "focus on promoting improvements in quality, safety and efficiency, focusing on decision support for national high priority conditions, patient access to self management tools, access to comprehensive patient data and improving population health."


The ONC's interim final rule (IFR) describes the standards that must be met by certified EHR technology to exchange health care information among providers, and between providers and patients. The standards involve defining a common language for accurate and secure health information exchange across different EHR systems. The ONC says the IFR describes "standard formats for clinical summaries and prescriptions; standard terms to describe clinical problems, procedures, laboratory tests, medications and allergies; and standards for the secure transportation of this information using the Internet."

The IFR is also advocating that the industry standardize how EHR information is exchanged between organizations, and submits criteria required for an EHR technology to be certified.

"Widespread adoption of electronic health records holds great promise for improving health care quality, efficiency, and patient safety," said National Coordinator for Health Information Technology David Blumenthal, M.D., M.P.P. in a CMS press release. "The Recovery Act's financial incentives demonstrate Congress' and the Administration's commitment to help providers adopt and make meaningful use of EHR technology so they can give better care and their patients' experience of care will improve. Over time, we believe the EHR incentive program under Medicare and Medicaid will accelerate and facilitate health information technology adoption by more individual providers and organizations throughout the health care system."

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