In Stage 3: the criteria 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.

An important part of the CMS meaningful use implementation is the accounting of whether an eligible professional (EP) or eligible hospital is in its first, second, third, fourth, fifth, or sixth payment year when deciding which definition of meaningful use to apply in the beginning years of the program. CMS says it does not want to create additional burdens on EPs and eligible hospitals for becoming a meaningful EHR user before 2015 through creating higher standards for them relative to the EP or eligible hospital that first becomes a meaningful EHR user in 2015.


CMS intends an alignment in the beginning years that brings all EPs and eligible hospitals to the same level of meaningful use by 2015. CMS is only proposing criteria for Stage 1 of meaningful use in NPRM, so Stage 1 will be the criteria for meaningful use for all payment years until updated by future rulemaking. CMS proposes that EPs and eligible hospitals whose first payment year is 2011 or 2012 must satisfy the requirements of the Stage 1 criteria of meaningful use in their first and second payment years to receive the incentive payments. Those EPs and eligible hospitals whose first payment year is 2013 or 2014 must satisfy the Stage 1 criteria for the first year, and then Stage 2 criteria for the second year (if 2014) or Stage 3 criteria for the second year (if 2015).

CMS also outlines the measures necessary for an EP or eligible hospital to demonstrate that it has met the criteria objectives; the measures have been grouped into two categories: Health IT functionality measures and clinical quality measures. As example, computerized physician order entry (CPOE) should be used for at least 80 percent of all orders. CMS defines CPOE as the provider's use of computer assistance to directly enter medical orders (i.e., medications, consultations with other providers, laboratory services, imaging studies, and other auxiliary services) from a computer or mobile device. The order is also documented or captured in a digital, structured, and computable format for use in improving safety and organization. However, for Stage 1 criteria, CMS proposes that CPOE will not include the electronic transmittal of that order to the pharmacy, laboratory, or diagnostic imaging center. CMS goes on to explain in detail how the agency and the Office of the National Coordinator have calculated the percentage used in the measures.

More Industry Headlines