Farzad Mostashari, MD, the national coordinator for health IT, summarized the dynamic tension of "keeping our eye on the prize and feet on the ground, being clear about where we want to go but also being cognizant of where we are today. No hospital CIO should feel that they have to make a choice between do I prepare for accountable care or do I go for meaningful use. We should make meaningful use the roadmap of what we need to do to succeed where increasingly care is going to be reimbursed based on quality, efficiency, coordination and safety rather than pure quantity." Among the initial proposals, some measures from stage 1 were moved from the optional menu category to core or required for stage 2, such as incorporating laboratory results as structured data for 40% of test results ordered. In other measures from stage 1, the thresholds were increased to encompass more patients or make the electronic process more pervasive, such as the use of computerized physician order entry for 60% of patients with at least one medication order from 30%.