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U.S. Department of Health and Human Services
Promoting Interoperability (PI)

Promoting Interoperability (PI)

In 2011, CMS established the Medicare and Medicaid EHR Incentive Programs to encourage Eligible Professionals (EP), Eligible Hospitals (EH), and Critical Access Hospitals (CAHs) to adopt, implement, upgrade (AIU), and demonstrate meaningful use of certified EHR technology (CEHRT). 

The PI Programs initially evolved through three stages:

  • Stage 1 set the foundation for the PI Programs by establishing requirements for the electronic capture of clinical data, including providing patients with electronic copies of health information.
  • Stage 2 expanded upon the Stage 1 criteria with a focus on advancing clinical processes and ensuring that the meaningful use of EHRs supported the aims and priorities of the National Quality Strategy. Stage 2 criteria encouraged the use of CEHRT for continuous quality improvement at the point of care and the exchange of information in the most structured format possible.
  • Stage 3, addressing requirements in 2017 and beyond, focused on using CEHRT to improve health outcomes.

In April 2018, CMS renamed the EHR Incentive Programs Promoting Interoperability Programs. CMS instituted changes that moved the programs beyond the initial requirements of Meaningful Use to an increased focus on interoperability and improving patient access to health information.

Medicare eligible professionals previously participating in the Medicare Promoting Interoperability Program were transitioned to the Quality Payment Program. For information please refer to the IHS Quality Payment Program (QPP) website.

Medicare eligible hospitals and CAHs report Promoting Interoperability requirement via the QualityNet system. Eligible Hospitals and CAHs are required to report to the Medicare Promoting Interoperability Program and meet certain measures to avoid a downward payment adjustment. If unable to report due to a significant hardship, hospitals may request a hardship exception (five year maximum).

For more information about the CMS Promoting Interoperability Programs, visit the CMS Promoting Interoperability Programs webpage.