• Print

Rural Implementation Steps

Step 5: Achieve Meaningful Use

To achieve meaningful use Stage 1, critical access hospitals (CAHs) and rural hospitals must partner with their electronic health record (EHR) vendors to share the responsibility and successfully meet both core and menu objectives. All core objectives are required; hospitals may choose which objectives to meet from the meaningful use menu set.

  • 12 core objectives
  • 5 out of 10 menu set objectives; must include at least one public health objective
  • 15 clinical quality measures (CQMs)

To demonstrate meaningful use Stage 1 successfully, eligible hospitals and CAHs are required to report CQMs. For more information on CQMs, visit the CMS Quality Measures page.

In 2013, there will be two options for CQM reporting:

For 2013 reporting, measures are the same as 2011-2012.

For information on the 2014 CQMs for the EHR Incentive Program, please visit the 2014 CQM Page and download the 2014 Clinical Quality Measures Tipsheet.

To ensure successful reporting of the required CQMs, it is recommended that you:

  • Understand what you are required to collect for each measure.
  • Partner with your vendor to understand how your EHR system will capture the required data and how to produce useful reports.
  • Train staff on documenting and tracking structured data.
  • Train staff to electronically submit measures to CMS.
  • Assess and adjust workflow to make sure you capture the measures consistently and accurately.
  • Establish a policy for meeting CQM requirements.
  • After achieving meaningful use Stage 1, prepare for increased requirements for Stage 2 and adjust resources to meet the new requirements.

The final rule for Stage 2 of the EHR Incentive Programs is now available. Learn more about the final rule.

To position your organization to successfully achieve meaningful use, consider the following steps:

  • Create a meaningful use taskforce/team that includes clinical, administrative and IT personnel
  • Perform a detailed review of all meaningful use objectives (using the CMS meaningful use specification sheet) and identify any meaningful use performance gaps
  • Monitor meaningful use thresholds and enforce documentation requirements as needed
  • Perform non-threshold based meaningful use objectives
  • Prepare for meaningful use attestation by completing the hospital attestation worksheet
  • Perform a test run of meaningful use data using the CMS Meaningful Use Attestation Calculator
  • Attest to meaningful use Stage 1


The following resources are examples of tools that are used in the field today, and are recommended by subject matter experts for the use by others who have made the commitment to implement or upgrade to certified EHR systems.

Namesort descending Details
Computerized Physician Order Entry (CPOE) in Rural and Critical Access Hospitals View
Computerized Physician Order Entry (CPOE): Barriers and Best Practices from the Physician and Provider Perspective View
Computerized Physician Order Entry (CPOE): Best Practices and Recommendation Nurses Perspective View
Meaningful Use Stage 1 Requirements for Medicaid Incentive Program View
Rural Hospitals Achieving Success: An Amazing Journey View
Video: Computerized Physician Order Entry (CPOE): Barriers and Best Practices from the Pharmacist’s Perspective View

The material in these guides and tools represents the collective EHR implementation experiences and knowledge gained directly from the field of ONC’s outreach programs (REC, Beacon, State HIE) and through the Health Information Technology Research Center (HITRC) Communities of Practice (CoPs) in their performance of technical support and EHR implementation assistance to primary care providers. The information contained in these resources is not intended to serve as legal advice nor should it substitute for legal counsel. The resource list is not exhaustive, and readers are encouraged to seek additional detailed technical guidance to supplement the information contained herein.

Reference in this web site to any specific resources, tools, products, process, service, manufacturer, or company does not constitute its endorsement or recommendation by the U.S. Government or the U.S. Department of Health and Human Services.

See Next Step >