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Time Capsule: Certification: Third-Party Validation for People Who Are Lazy, Insecure, or Stupid

I wrote weekly editorials for a boutique industry newsletter for several years, anxious for both audience and income. I learned a lot about coming up with ideas for the weekly grind, trying to be simultaneously opinionated and entertaining in a few hundred words, and not sleeping much because I was working all the time. They’re fun to read as a look back at what was important then (and often still important now).

I wrote this piece in March 2010.


Certification: Third-Party Validation for People Who Are Lazy, Insecure, or Stupid
By Mr. HIStalk

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I admit that I don’t understand why everything and everybody has to be certified these days. EMRs, CIOs, healthcare IT professionals, and nurses all can – for the right price – earn a third party’s validation of their existence (CCHIT, CHCIO, CPHIMS, and RN-BC, respectively).

Even the word itself is comforting. Your new software, IT leader, project manager, or informatics nurse must clearly be less of a risk because they paid someone else to say so. They have become “certified,” and therefore those lesser unwashed options with fewer letters after their name suddenly seem like a fool’s gamble just because they passed a cookie cutter test.

I don’t get it. Who would turf that suitability decision off on someone else, especially when it’s the incumbent themselves who paid for their seal of approval? Does it really help make a better choice?

(Someone told me once that a prospective CIO employer asked them to leave their CPHIMS credential off their application. The reason: HR’s policy was to validate every claimed credential, which would take time and therefore money, but IT didn’t care a bit whether candidates had CPHIMS or not.)

CCHIT certification hasn’t seemed to reduce the risk of adopting EMRs. Or, for that matter, the adoption rate itself. The government likes the comfort of having a third party preventing dangerously rogue EMRs from finding a home in the hands of willing provider customers. CCHIT is from the government and they are here to help. Theoretical benefits aside, nothing seems to have improved from letting prospects themselves evaluate products they might want to buy, other than costs have increased, a new bureaucracy has been introduced, and vendors now develop what CCHIT requires instead of what customers want.

I really don’t get the certified CIO credential. CHIME says an individual so anointed “demonstrates the commitment, knowledge, and experience required to master the core skills inherent to successful CIOs and IT executives.” In other words, the certificate holder has passed some test of theoretical knowledge. The kicker is this: candidates must have already been working as a CIO for three years. Was there a widespread problem where hospitals were hiring dangerously unqualified CIOs, keeping them on the payroll for years, but then suddenly finding that they suffer from incompetence that a simple test would have detected upfront?

My conclusion: certification makes no sense at all unless the decision-maker is too lazy, too insecure, or too stupid to evaluate for themselves.

In fact, I might be skeptical of choosing something “certified.” Is someone trying to hide their unsuitability by waving a rubber stamp seal of approval around instead of standing on their own merits? Aren’t by definition those certified products or job candidates insecure about their track record? I’m thinking those “certified pre-owned cars” at the local buy here, pay here lot. Why not just have your own mechanic check it over?

The main beneficiary of certification is whoever is doing the certifying. In the case of CCHIT, they got to build up a nice grant-fueled bureaucracy doing government work, but still attached to the HIMSS apron strings. For CHIME and HIMSS, their carefully constructed continuing education renewal requirements for certificate holders create a recurring revenue stream of conference and workshop attendance.

I like the business model. Certification thrives on insecurity and everybody is loaded with that. Insecure candidates earn certifications to impress insecure decision-makers. It’s a certified hit.