Under the 2009 federal economic stimulus package, health care providers who demonstrate meaningful use of certified EHRs will qualify for incentive payments through Medicaid and Medicare. CMS’ plan proposes phasing in meaningful use requirements over three stages between now and 2013.

The first stage of the meaningful use criteria emphasizes:

Collecting electronic health data in coded formats;
Implementing clinical decision support tools;
Reporting clinical quality measures and public health data; and
Using EHR data to track conditions and coordinate care

The Stage 1 criteria call for physicians to submit at least 80% of their orders electronically. The proposed rules also call for health care providers to use EHRs to check for potential drug interactions. In addition, the rule requires health care providers to provide patients with electronic copies of their medical records within 48 hours of a request. A full list of Stage 1 criteria for physicians is forthcoming (from me). Of course we are tracking a moving governmental target and even what is listed below is subject to change in August when CMS issues final determinations.

Originally the Stages were tied to years (Stage 1 – 2011, Stage 2 – 2012 and Stage 3 – 2013). This has changed and is still under discussion as to when each stage will become enforceable. Also, some of the original deadlines (i.e. Jan 1, 2011) to qualify for full Stimulus money has changed and are still in flux until the final rules come out in August (if they come out in August).

The Stage 2 criteria are expected to focus on structured data exchange and continuous quality improvement. CMS is scheduled to release the second phase criteria by the end of 2011.

The Stage 3 criteria are expected to center on advanced decision support and population health. CMS is scheduled to publish the third phase criteria by the end of 2013.

The HITECH Act offers providers up to $44,000 each if they demonstrate meaningful use as will be defined in phases for 2011, 2012 and 2013 (and beyond).

Future stages will involve Patient Portals, Standardized Interoperability, Disease Management, Health Maintenance, Protocol Management, Pay for performance reporting, migration to ANSI 5010 (in 2012), migration to ICD-10 (in 2013) to name a few. The specific implication of each of these is omitted here lest this document turn to a tome.