A geek doctor takes a 2.0 approach to healthcare technology

Jessica Lipnack — Thu, 06 Mar 2008 08:02:40 -0800

Wish you could sleep less? Read Colossus, the science fiction classic about a computer that controls the globe's nuclear arsenal. Since absorbing the novel in 1982, John Halamka hasn't really slept. In terms of uptime, his is about 85% -- a lot for a human being.

Halamka was a Stanford undergrad taking 25 credits per quarter when he came across the 1960s book by DF Jones, and cut back on sleep – he says he has averaged 3.5 hours per night since. And no wonder. Following college, the descendent of Czech beer brewers took multitasking to the extreme: He was an editor for Computer Language magazine; wrote three books for technology publisher Sybex, launched a start-up (named Colossus, of course, that developed accounting software and business intelligence tools over its 13-year lifetime), attended medical school while simultaneously getting a masters degree in bioengineering, worked as an emergency room physician, joined the Harvard Medical School faculty, wrote for InfoWorld, and, at age 36, became CIO of a $2.5 billion enterprise responsible for saving lives.

You can get a lot done if you hardly ever sleep but, until 2007, this ice-mountain-climbing/Japanese-flute-playing/Prius-driving/vegan-who-only-wears-black wasn't down with virtual team working. He didn't even blog (imagine!). Like many who've been online since the early days, including me, Halamka was also a bit slow to embrace the Web 2.0 world. We grew up in a different digital universe, one that still depended heavily on print and one-way, online publishing, where users could read but not comment. And though many of us have participated in online conversations for years, we generally held them within private arenas. Our ability to upload "content" was largely limited to pointers to documents on shared drives.

Until recently, Halamka communicated with his large user community via regular emails. As point person for information technology at Harvard Medical School, Beth Israel Deaconess Medical Center, and its parent, CareGroup (under which there are three more hospitals), he addressed his "To:" line to some 14,000 people. The weekly email, a proto-blog of sorts, seemed to work fine. If people had a problem or didn't understand something, they wrote back to him.

Then Halamka's boss, Paul Levy, started blogging. Initially skeptical of executives' willingness to be truly transparent, Halamka took a page from his chief executive's success. The head of one of the largest academic medical centers in the world peeled back the layers of secrecy that typically enshroud the inner workings of such organizations. Advocating "sunshine as the best disinfectant," Levy even started publishing his hospital's clinical data and, before long, his blog, Running a Hospital, was a phenom in the healthcare community. Indeed, it won the MedGadget award in two categories in 2007: Best Medical Blog and Best Health Policies/Ethics Blog.

Around the same time that Levy was being nominated for his awards, Halamka launched Geek Doctor, his own blog, attracting 500 visitors a day, according to StatCounter. And, he tried an experiment. Believing that face-to-face was the best way to work, he stayed home for a week, working "alone." With good technology -- meaning reliable high-bandwidth connections, his trusty Blackberry, and instant messaging, he was able to get a lot more done, he says, without wasting a couple of hours each day commuting.

The experiment proved transformative to his work philosophy. Virtual working, he now says, is not only adequate but in some instances absolutely necessary.

Case in point: Recently, for a few dreaded moments, the hospital's clinical data system went down. In the not-too-distant past, Halamka's inclination would have been to call all the relevant parties together in person to figure out what went wrong. Instead, everyone -- meaning the critical folks in security, network operations, and the like -- remained at their desks, where they had access to key information, and jumped onto a conference call. The system was back up in 20 minutes. It would have taken that long just to get people in the room, Halamka noted.

Virtual meetings and virtual working will only increase in his organization, he says, citing "homesourcing." This hiring trend, whereby employees work principally at home with only rare (if any) trips to the office, is well-suited to New England, where he's based. Competition for resources is intense and the more options available for obtaining talent, the better.

But that's not all Halamka is doing, in terms of technology adoption and experimentation: He is trying out Facebook for rapid application development because of its social networking tools, and extending Web 2.0 technologies across his organizations. He's intensely interested in technologies relating to electronic health records -- he's even had an RFID chip with all his medical records implanted in his arm, in order to explain to patients how it works and the procedures involved.

Sounds like even less sleep is in store for this geek doctor.

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Ian Lamont: The Internet, secrecy, and transparency
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A geek doctor takes a 2.0 approach to healthcare technology