In 2011, CMS established the Medicare and Medicaid EHR Incentive Programs known as Meaningful Use of Electronic Health Records in response to the ARRA HITECH Act of 2009. This incentive program created a foundation for the new Promoting Interoperability Programs to encourage eligible professionals (EPs), eligible hospitals, and CAHs to adopt, implement, upgrade, and demonstrate meaningful use of certified electronic health record technology (CEHRT).

Promoting Interoperability Programs has come to fruition in three stages:

  • Stage 1 established a foundation for Promoting Interoperability Programs by instituting requirements for the electronic capture of clinical data in Electronic Health Record software. An additional benefit was a patient engagement initiative, which required providing patients with electronic copies of health information.
  • Stage 2 centered on advancing clinical processes and ensuring that meaningful use of Electronic Health Records supported the aims and priorities of the National Quality Strategy. These criteria encouraged the use of CEHRT for quality improvement and the exchange of information in the most structured format possible.
  • In October 2015, CMS released a final rule that set forth Stage 3 in 2017 and beyond, which focused on using CEHRT to improve health outcomes. In addition, this rule modified Stage 2 to ease reporting requirements and align with other CMS programs.

Subsequently, the National Coordinator (ONC) Office made changes in the 2015 Health IT Certification Criteria. The 21st Century Cures Act Final Rule made changes to the existing 2015 Edition Health IT Certification Criteria, including:

  • New technical certification criteria to advance interoperability and make it easier for patients to access their electronic health information on their smartphones / mobile devices.
  • New privacy and security certification criteria.
  • Revised standards to 2015 Edition certification criteria were revised, including the United States Core Data for Interoperability updates.

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