WASHINGTON – "Meaningful use" has become a household term in the healthcare IT world. Some 50,000 eligible providers have signed up to participate so far in the most ambitious U.S. health IT adoption program to date.

Providers striving to collect data for Stage 1 meaningful use incentives are heading into a federal program that is front-loaded to give more bonuses to early adopters.

Now, the debate is in full throttle over what should be included in Stage 2 – to begin in 2013. Comments have been collected and complaints noted, and federal advisory committees are wrestling with how to push EHR adoption along at a pace that is achievable without causing providers to run from participation.

Some members of those committees have indicated they may select requirements for Stage 2 from a new report issued by the President’s Council of Advisors on Science and Technology (PCAST). These could include EHR functions that would build toward expanding health information exchange and include enabling patients to download information to a personal health record, simple searches by providers and sharing immunization data.

A March survey sponsored by the Certification Commission for Health Information Technology found significant concerns about the preliminary measures proposed for Stages 2 and 3 criteria.

CCHIT Chairwoman Karen Bell, MD, said a number of Stage 2 measures and objectives “were considered to be too aggressive by at least one third of the respondents. Several were considered too aggressive by most of the respondents.”

The HIMSS Electronic Health Record Association, along with most other major trade associations in the health IT sector, want to delay Stage 2 to allow more time for providers and vendors to get ready.

The College of Healthcare Information Management Executives has asked that Stage 2 include flexibility through a menu of measures that would allow providers to focus on their operational goals. CHIME is also calling for a delay of Stage 2.

At the recent HIMSS conference in Orlando, I attended a Town Hall meeting scheduled by the Office of the National Coordinator for Health IT, where one of the first questions fielded from the audience was whether Stage 2 would be delayed.

Tony Trenkle, the federal official in charge of such things, answered without hesitation: "no."