Where to Set a 'Meaningful' Bar?

Although it may have been motivated mostly by politics, some Republican lawmakers on Tuesday raised what is a basic question when creating a new policy: How tough do you make requirements to get federal funding? How high should the bar be set?

That was part of the discussion at Tuesday's meeting of the House Ways and Means Health Subcommittee about what doctors and hospitals should do to receive federal funding to buy electronic health records systems. The requirements are part of what's termed "meaningful use" -- as in what should these e-records do to make them useful in a meaningful way?

EHRs will eventually be the foundation for the National Health Information Network, which doctors and hospitals can use to share patient records and policymakers believe will provide the data needed to decrease health spending and improve care. Health care providers can receive up to $63,750 each for installing the systems. The total cost of the incentives: $36 billion, according to Republicans.

That seems a lot for what the federal government has required these records to do, says Rep. Wally Herger, R-Calif. Herger and others say the requirements should include the ability to electronically record lab test results and to exchange data. The Obama administration counters with the fact that the requirements get tougher in the future if the doctors want to keep the finding. But, they said, the initial standards had to be easy enough to meet to get health providers on board.

What's the best approach: Bring the providers along slowly or set a higher bar right at the start?