-Here we come, interoperability and exchange, remarked Farzad Mostashari, MD, at the start of the ONC's unveil of the proposed rule for Meaningful Use Stage 2.

HIMSS 2012 has been eagerly awaiting details of Stage 2, and Farzad along with other officials from ONC and CMS, packed the conference room and even required the opening of a second space to accommodate everyone. The buzz is for good reason. The American Recovery and Reinvestment Act (ARRA) and meaningful use has been huge for the healthcare information technology (IT) market, driving adoption of electronic health records (EHRs) with more than $3 billion dollars in incentive payments being handed out to date.

So what details were announced? Only a cursory overview was given, with subsequent deep dives into the details over the coming days. The actual proposed rule will be posted online on Thursday February 23rd and a 60 day public commenting period will ensue. What has been revealed is that Stage 2 will take great steps towards advancing interoperability with provisions for the use of specific standards. The goal is to move away from testing exchange between health facilities to doing actual exchange.

In terms of measures, decision support will be increased to five quality measures. There will be more emphasis on patient engagement, with a new requirement that more than 50% of all unique patients seen will be required to provide timely health information reports that can be viewed, downloaded, and transmitted within four business days. A new proposed menu item will be the ability to view images in the system. Batch reporting will now be allowed so now each individual physician will no longer be required to submit data.

Certification has now also been changed for Stage 2. The concept revolves around a center core base EHR with defined fundamental technology that every vendor will need to provide. There will then be additional layers of functionality on top of the base EHR. To great applause, it was also said that providers will only need to have technology to demonstrate meaningful use for the stage that they are currently in.

What does this mean in terms of the EHR market. Many hospitals and eligible professionals were waiting on the announcement of stage 2 to understand what will be required to qualify for incentive payments in the coming years. Now with a clearer picture, albeit the final rule will be significantly different, care delivery organizations will likely be more inclined to move forward towards adoption of an EHR.

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