Guerra On Healthcare: HITECH Demands Leadership, Then Checklists

Guide instructs healthcare CIOs to move away from their task orientation and adopt a more strategic mindset to thrive in the era of meaningful use, but a blend of both is the better choice.

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Meeting HITECH's requirements for meaningful use, and reporting it electronically to the Centers for Medicare and Medicaid Services, is going to be a huge challenge for CIOs. As such, the key healthcare CIO organization, the College of Healthcare Information Management Executives (CHIME), has been putting out great information to help support its members, and even its members' bosses.

In one of those guides, the organization states that CIOs who are more "task-oriented" will have to move out of their comfort zones and adopt a more strategic mindset. This usually involves a change in outlook from taking orders to giving them, and giving orders means thinking strategically about the direction and needs of the organization.

Doing that also requires that CIOs huddle with key C-suite colleagues, such as the CEO, COO, and CFO, and especially their clinical counterparts, the chief medical officers and chief nursing officers, who will be the real keys to getting adoption of any meaningful use-related technologies.

"Huddling" can be tough for shy tech types who have grown up behind a computer and never looked forward to chatting everyone up at the hospital holiday party, but it's time to mingle. Many top CIOs I've interviewed say 90% of their job is about relationship (consensus) building. The rest is usually about having a great CTO and staff to make sure the trains run on time and the infrastructure doesn't collapse.

CIOs who have a vision for how technology can help their organizations both deliver better patient care and remain financially solvent are now in position to shine. If they can do both of those while qualifying for all the HITECH money they're entitled to, it's continuous employment from here on out. But those lucky executives need to quickly huddle up, position themselves as leaders of the meaningful use project (not executers of others' orders) and run with this ball.

In moving to a more strategic mindset, CIOs might be tempted to altogether shed the "checklist mentality" which gets so much negative press in executive training sessions. I think that would be a big mistake, much like a field goal kicker overcompensating for hooking one. Checklists are a key tool for actually getting things done, and no matter how fantastic a strategic plan is, it won't qualify for a nickel of HITECH money unless someone operationalizes it.

In fact, rather than being demonized in healthcare, checklists have been lionized by the likes of Peter Provonost, MD, who became a veritable celebrity for promoting their use in the ICU to reduce hospital-acquired infections.

There is no doubt that task- or checklist-oriented CIOs need to move out of their comfort zones, give up the solitary corner table in the cafeteria, and sit with the rest of the C-suite, as CHIME suggests. But they also need to "dance with who brung 'em," keep their checklists and never forget that executing is as important as conceptualizing.

This is a once-in-a-lifetime opportunity for CIOs to shine. Trusting that everything that got them here is also critical to getting them there -- with a little bit layered on top -- is the best formula for rising to this historic occasion.

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]

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