Trumpets did not sound the first time John Stanley clicked "submit." There were no balloons the second time he did it either. And on the third time? Well, there wasn't a ticker-tape parade.

"At the end, we did a little happy dance," confesses Stanley, chief information officer at Riverside Health System, a four-hospital system in based in Newport News, Va.

The cause for such a raucous celebration? On April 19, three Riverside hospitals became among the first in the nation to attest to being meaningful users of health IT, making them eligible for millions of dollars in incentive funds under the American Recovery and Reinvestment Act. The CMS attestation period for Stage 1 of meaningful use had opened the day before. Stanley would not say exactly how much he expects the hospitals to get, but he calls it "a significant impact to the bottom line."

He's quick to add that it's not about the money. In fact, while his staff was assembled to fill out the attestation forms on the CMS website, Stanley says no one was allowed to say "money" or "incentive."

"We did this because it is the right thing to do," he says of Riverside's aggressive approach to deploying a robust health IT system. "We have been building a system for patient safety and quality for years and were already doing many of the things that meaningful use requires." As a result, Stanley says he was always bullish that Riverside would be able to comply this year, and he calls attestation a recognition of the hard work that it's taken to get to this point.

Riverside certainly isn't the only health system working hard to become a meaningful user, but it very well may be in the minority of those applying for incentive dollars this year. A survey released in late April by the College of Healthcare Information Management Executives reveals that just one-third of respondents expect to qualify for stimulus funding by Sept. 30, the program's one-year anniversary. Roughly 58 percent expect to qualify in fiscal 2012 or fiscal 2013.

But even some hospitals that are ready to attest this year are holding off. Our lead article in InBox this month highlights the dilemma facing CIOs. Karen Thomas, CIO at Main Line Health, told our reporter Alan Joch that the health system originally planned to go through attestation this year, but changed course largely due to the uncertainty around Stage 2. Those rules likely won't be finalized until next summer, leaving hospitals and vendors scrambling.

There's no right answer here. Stanley says that Riverside was ready to apply and wanted to take advantage of the opportunity. He's equally bullish that the system will be ready for Stage 2 come next fall.

CIOs like Thomas seem to be playing it a bit more conservatively, waiting to make 100 percent sure that they—and their vendor partners—will be prepared for the next phase of meaningful use. Both CIOs, however, agree that hospitals can't dally in deploying health IT to improve patient safety and quality of care.