When the federal government signed into law the Health Information Technology for Economic and Clinical Health (“HITECH”) Act as part of ARRA, which was, in part, designed to create incentives for the use of health information technology, it based many of the incentives on “Meaningful Use.”

The requirements are intended to progress through three different stages over several years.

Stage 1, Meaningful Use: Sets a baseline for electronic data capture and medical information sharing. Requires the use of an electronic health record (EHR) as well as a demonstration that it is used to meet objective and measurable requirements. There are 15 required core objectives and a menu of other objectives, several of which must be met in order to meet the thresholds of quality measurements in order to receive the financial incentives referenced in the regulations promulgated by the HITECH Act. For the most part these were implemented in 2011 through 2013.

Stage 2, Meaningful Use: Stage 2 focuses on “increasing the electronic capture of health information in a structured format, as well as increasing the exchange of clinically relevant information between providers of care at care transitions.”

Stage 2 set forth three broad requirements. First was the standardization of data formats, which is intended to simplify how healthcare information is captured and shared across disparate IT systems, i.e., improved interoperability.

Second, it required that patients are able to easily access and download their digital medical records and images for their own use.

Third, it expanded the scope of quality metrics tracking to include specialists and to reflect outcomes, as well as care coordination.

As part of Stage 2, healthcare entities must satisfy a lengthy list of measure criteria.

Stage 3, Meaningful Use: Stage 3 requirements were released in 2015. These criteria focus on the sustainability of the program through improvements in quality, safety and efficiency that improve health outcomes, and include:

• 8 objectives for eligible professionals, eligible hospitals, and CAHs: In Stage 3, more than 60 percent of the proposed measures require interoperability, up from 33 percent in Stage 2
• Public health reporting with flexible options for measure selection
• Meaningful Use clinical quality measures reporting aligned with the CMS quality reporting programs
• Finalize the use of application program interfaces (APIs) that enable the development of new functionalities to build bridges across systems and provide increased data access. This will help patients have unprecedented access to their own health records, empowering individuals to make key health decisions.