In 2011, CMS established the Medicare and Medicaid EHR Incentive Programs (now known as the Promoting Interoperability Programs) to encourage eligible professionals (EPs), eligible hospitals, and CAHs to adopt, implement, upgrade (AIU), and demonstrate meaningful use of certified electronic health record technology (CEHRT). The program consisted of three stages and by using certified EHR technology, the provider must submit to the Secretary of Health & Human Services (HHS) information on the quality of care and other measures.