Q&A with John Halamka - Online CIO Magazine | Straighttalk

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Dr. John Halamka, CIO at Beth Israel Deaconess Medical Center in Boston and the engaging author of the blog Life as a Healthcare CIO, does it all.

Can a blog help humanize the CIO?

The CIO position used to be one of the most sheltered C-suite roles, hidden from the outside world, especially in non-tech companies. Not anymore. As technology becomes embedded in all business activities in all industries, more and more CIOs are communicating externally, whether speaking at conferences, serving on public service committees, or blogging. Dr. John Halamka, CIO at Beth Israel Deaconess Medical Center, in Boston, and the engaging author of the blog Life as a Healthcare CIO, is one who does it all.

In addition to his CIO role at BIDMC, Halamka is Chairman of the New England Healthcare Exchange Network, Co-Chair of the national Health Information Technology Standards Committee, Co-Chair of the Massachusetts HIT/HIE (Health Information Technology / Health Information Exchange) Advisory Committee, a professor at Harvard Medical School, and a practicing emergency physician. He is also a part-time farmer and an avid rock climber, and he considers Japan his second home.

Halamka writes that he uses his blog to record his experiences “in the world of healthcare IT, supporting 3,000 doctors, 18,000 faculty, and 3 million patients.” The blog also gives him the opportunity to “muse on topics such as reducing our carbon footprint, standardizing data in healthcare, and living life to the fullest.” This description prompted a lively phone interview, as you’ll see in the following edited transcript of Halamka’s conversation with CIO Straight Talk Editor Paul Hemp and Contributing Editor Gil Press.

What are you trying to achieve by blogging?

Generally, the CIO is not the most popular guy. He or she is the person who says no or the person who, apparently, is so under-resourced and over stressed that something simple like, “Oh, we can get it at the Apple store,” becomes a big production for the organization.

CIOs have a bad rap. By blogging, you hope that people see that you are human and that you suffer the same challenges as everybody else. I bring my family and my personal challenges into my blog so that people can relate and say, “Well, maybe I did not get what I wanted from IT, but I believe in the process and I see that the CIO is basically a good guy, a person I can relate to.”

It is somewhat unusual for a CIO to be publicly visible. You also speak at conferences and serve on public service committees, and you write quite a lot about your personal life. Is this something that you think is important for a CIO to do?

Being a CIO is not a job — it is a lifestyle. You would love to believe that you can just check in at nine, leave at five, do the work, and then it is done. That is just not true. In some ways, as you suggest, I do not really separate my work life, my personal life, my international life, and my conference life. It is all part of one life. Engaging in constant communication through social media is truly a part of that combined lifestyle.

What made you decide, when you started writing the blog, to report on all dimensions of your life, not just IT issues?

I guess my role is to try to serve multiple constituencies with multiple purposes. I use the blog as a mechanism for sharing: Here are the experiences of a fifty-one-year-old, who is in the sandwich generation, the kind of person dealing with those you manage above — your parents — and those you manage below — your children. I some- times look at particular incidents in life, even serious ones like my wife’s breast cancer or my father’s death, with an IT perspective. What was it that IT did, or should have done, that it did not? That, in some ways, becomes part of the important information-sharing role as we create policy. The Health IT Standards Committee has been working on end-of-life-care preference standards. I am driving that, in part, based on my experience with my father. Sometimes the personal is just meant as “get to know me,” and sometimes it’s a means to drive policy.

If I am a CIO who is not contributing to the national health care debate but am working for, let’s say, a trucking company, is there a reason for me to blog the way you do?

As I mentioned, CIOs have to say no a lot. Everyone internal to your organization or in the companies associated with your organization — the business partners, the vendors, the customers, and all the rest — may know you as the guy who says no. Your blog may help explain that it is not that you want to say no; it is the nature of the job that forces you to make these kinds of decisions. What I find is that when you communicate, when you get people together in a room, when you take them out to dinner — or when you blog — the tensions and sometimes the animosity just disappear. If there is anything that I have learned from my blog, it is that being extremely public with my professional and personal issues, and sharing my highs and my lows, has really decreased the animosity that people may have toward me, either inside or outside the workplace.

So would you recommend that other CIOs engage in social media?

Absolutely. Of course you have to do it carefully. You will notice in my blog that I do not specifically endorse a vendor. I may say, “I tried this, and it worked,” or, “I had a unique problem to solve, and here is how I approached it,” but I do not say, “Buy this. It’s $49.95.” Or, if I serve on the board of directors of a company, I wouldn’t highlight its products as important or revolutionary. I stay away from things that people might perceive as a conflict of interest.

Speaking about evaluating products, I’m writing a blog post about my experience with Google Glass. The idea is that an emergency physician can walk into the room and immediately see a heads-up display of all relevant documentation, the vital signs, and any diagnostic tests on the patient he is about to see.

And how would this be different from the doctor looking at his cell phone?

The advantage to using Google Glass is that you can actually put eyes on the patient while looking at the data. We will have to experiment with a number of user interfaces, but with Jester and Touch, you could imagine being able to look at the patient and then to instantly inquire about the data on the body part you are looking at. It is an interesting paradigm. Patients do not particularly appreciate when you are staring at a keyboard instead of at them, and I have a feeling that in the emergency department, Google Glass may very well provide the best of both worlds: the ability to interact with the patient while consuming data, and to do it at a very fast pace. Just as the iPad has become the chosen form factor for clinicians today, I can definitely see a day when computing devices are more integrated into the clothing or body of the clinician.

In the current environment, how do you find time to spend on an experimental project like that?

I end up doing a fair amount of the design work myself, and I bring in talented members of my team who do it through pure strength of will. A few hours at night, and a few hours on the weekend, as it can be fit in with operational constraints.

Speaking about finding time, you are now becoming a professional farmer, in addition to everything else you do. You have blogged about “building a brand” for your farm and formulating “a multi-year strategic plan leading to full recognition as an agricultural enterprise.” Is this your new start-up?

Yes. This weekend we harvested honey from eight beehives. We have honey. We have the fiber from the alpaca, and we have the hoop house going in this summer, which means that I will be able to have quite an array of vegetable production for at least about eight months per year. Then we will have about 500 pounds of shiitake mushrooms fruiting this spring. We are getting there.

Originally published in CIO Straight Talk, No. 4 (December 2013). Other featured posts by Dr. John Halamka: Dealing with Difficult PeopleOutcomes as a ServiceMaking Time for Innovation