Stage 2 Meaningful Use NPRM Moves Toward Patient-Centered Care Through Wider Use of EHRs

Substantial evidence shows that higher adoption of electronic health records (EHR) can save our health care system money, save time for doctors and hospitals, and save lives. Thanks to the Recovery Act and the Medicare and Medicaid EHR Incentive Program, we have seen great success and momentum as we’ve taken the first steps toward adoption of this critical technology: to date, more than 43,000 providers have received $3.1 billion to help make the transition to EHRs; the number of hospitals using EHRs has more than doubled in the last two years from 16 to 35 percent between 2009 and 2011; and 85 percent of hospitals now report that by 2015 they intend to take advantage of the incentive payments.

We have just announced the second stage of the three stage process. This reflects our desire to create ambitious, but achievable, goals that enable eligible professionals and hospitals to make incremental progress in adopting and implementing EHRs. The three stages are:

  • Stage 1 (which began in 2011 and remains the starting point for all providers): “meaningful use” consists of transferring data to EHRs and being able to share information, including electronic copies and visit summaries for patients.
  • Stage 2 (to be implemented in 2014 under the proposed rule): “meaningful use” includes standards such as online access for patients to their health information and electronic health information exchange between providers.
  • Stage 3 (expected to be implemented in 2016): “meaningful use” includes demonstrating that the quality of health care has been improved.

Today’s proposed rules focus on using EHRs to improve health and health care while reducing the burden on physicians and hospitals where possible.

CMS’ proposed rule would specify the Stage 2 criteria that eligible providers must meet in order to qualify for Medicare and/or Medicaid EHR incentive payments. It also would specify Medicare payment adjustments that, beginning in 2015, providers will face if they fail to demonstrate meaningful use of certified EHR technology and to meet other program participation requirements. In addition, as we announced in a November 2011 “We Can’t Wait” announcement, Stage 1 has been extended an additional year for providers who attested in 2011 – meaning that these providers will have to attest to Stage 2 in 2014, instead of in 2013.

The proposed rule announced by ONC identifies standards and criteria for the certification of EHR technology, so eligible professionals and hospitals can be sure that the systems they adopt are capable of performing the required functions to demonstrate either stage of meaningful use that would be in effect starting in 2014.

Together, these rules will encourage even more providers to participate and support more coordinated, patient-centered care.

For details on today’s announcement:

CMS Proposed Rule [967 – KB]

ONC Proposed Rule [485 – KB]

HHS News Release

CMS Fact Sheet

ONC Fact Sheet – Stage 2 Meaningful Use


  1. John Lynn says:

    Some very interesting numbers and I appreciate the overall vision of what each stage will do. The first part of this post reminds me of what I heard at HIMSS, that ONC has become more of a marketing organization. I found that interesting since you could easily see why ONC is considered an EHR marketing organization.

    These first year numbers are interest, but the second year numbers will matter even more. The first year numbers were likely those who already adopted EHR versus those that implemented EHR post-stimulus. Let’s hope the message that providers offer after they’ve implemented is that they love their EHR. If they start telling their colleagues that they hate the EHR that they were “forced” to implement because of the government carrots and sticks, then it will be quite disappointing.

  2. Ben G says:

    The stage 2 “meaningful use” criteria assist HCPs in reducing the amount of medical errors and increase collaborative care practice. However the individuals overseeing the use of EHRs should not be removed from actual advanced practice. EHR incentive programs should apply for all advanced care providers including nurse practitioners as the NP role becomes increasingly prominent in the primary care setting. In addition financial incentives should be rewarded to the advanced care provider who is able to display consistent use of EHR. Respectfully as more duties are expected of all advanced care providers financial compensation should award directly to the provider rather than the institution. This would likely ensure vast EHR use. Lastly, more attention needs to be directed at patient compliance with documented recommended treatment plans. Hence to reduce overall cost to healthcare system the burden of obligation should be equally on provider and patient.

  3. Jeanene Conzales says:

    If they start telling their colleagues that they hate the EHR that they were “forced” to implement because of the government carrots and sticks, then it will be quite disappointing.

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