Guerra On Healthcare: Report EMR Meaningful Use Honestly

For Stage 1 meaningful use, CIOs may be tempted to fudge compliance achievements, but the wise will refrain.

Slideshows: 12 CIOs' 'Career Killer' Pet Peeves
(click for larger image and for full photo gallery)
"For you it will be $7 and, well, there's no charge for children under one," said the gate attendant at the town pool my sister belongs to.

"Well, the young tike is almost there, but not quite," I replied, almost reflexively grasping for the bargain, though my son is almost 13 months.

I then spent the better part of what would have been a relaxing afternoon looking across the pool at the office to see if my crime had been detected, to see if the lifeguards were on my trail. It was terrible. Not to mention, I started to stress about what story I'd use the next time I came.

This little yarn, which illustrates I have some self-improvement to do, made me think about how a little lying can cause a lot of indigestion and, 99% of the time, it's just not worth it.

Integrity, as I've written recently, matters a lot when it comes to CIO leadership, and the slightest lapse can tarnish a hard-earned reputation. In the not-too-distant future, these executives will be faced with what I'll term "The Great Attestation Temptation" -- a moment when, like a CFO signing off on the books, they can claim to have achieved Stage 1 meaningful use. This stage, which is the only one not requiring electronic reporting straight from the electronic medical record, will be unique in the opportunity to err it presents to CIOs.

And also like someone borrowing a little company cash for an "emergency" with the intention of putting it back before anyone notices, CIOs may be tempted to attest they've met the requirements with the full intention of making up lost ground in time for Stage 2's electronic reporting. But will they be able to close the gap in time? And even if they do, will their misrepresentation be obvious to staff? If so, what effect will that have on their standing?

But more than that, what effect will it have on the transgressing CIO? I assure you, the cheapest price that will be paid is a disquieted mind, yet that is an exorbitant fee. The greatest gift in life is to lay one's head down at the end of the day feeling peaceful, tranquil. Deception robs us of that gift and gives little in return. If anything comes back, it is tainted.

But the pressure to say, "We've done it," will be massive. There will, no doubt, be some who succumb to it and send the required documents off to Centers for Medicare & Medicaid Services (CMS), all notarized and official-like. It will be a few years into the HITECH program before, inevitably, CMS audits tag some offenders. At that time, the guilty CIO may have moved to another position or even out of the industry but, like an Olympic medal, one can always have past laurels stripped, perhaps quietly, perhaps publicly.

The bottom line is it's not worth it. Executives should do their best to meet the government's excessive requirements, but no more. They must not relinquish their integrity. I learned a good lesson and it only cost be a peaceful afternoon with family. The choice that lies before CIOs is far starker. Make the wrong decision and they'll lose a thousand peaceful nights. Make the right one and, no matter what happens, they'll sleep soundly.

Anthony Guerra is the founder and editor of, a site dedicated to serving the strategic information needs of healthcare CIOs. He can be reached at [email protected]

Editor's Choice
Sara Peters, Editor-in-Chief, InformationWeek / Network Computing
John Edwards, Technology Journalist & Author
John Edwards, Technology Journalist & Author
James M. Connolly, Contributing Editor and Writer