Thursday, November 15, 2007

Halamka's Health Care CIO Blog: essential reading

John Halamka has just launched a personal blog: Life as a Healthcare CIO. Here's his bio:

John D. Halamka, MD, MS, is Chief Information Officer of the CareGroup Health System, Chief Information Officer and Dean for Technology at Harvard Medical School, Chairman of the New England Health Electronic Data Interchange Network (NEHEN), CEO of MA-SHARE (the Regional Health Information Organization), Chair of the US Healthcare Information Technology Standards Panel (HITSP), and a practicing Emergency Physician.

The "practicing emergency physician" part is where he passes the bounds of reality. (I gave up the practice part years ago.) Just when you think you've met the most hyper-manic person possible, another one comes along.

Now he has a blog. God knows how long it can possibly last. Even he must have some limits, though it is possible he's a visitor from the post-Singular future.

So is the blog any good? Maybe it's just marketing material?

Um, no.

It's not good. It's really, really, good.

I'm going to call out a recent post on email and then reference a few more. Emphases and [inline comments] are mine. Note he uses a BB [1]:

...I receive over 600 email messages each day (with virtually no Spam, so they are all legitimate) and respond to most via Blackberry. How do I triage 600 messages? I use these 10 rules to mentally score each email:

1. E-mail marked with a “high importance” exclamation point must pass the “cry wolf” test. Is the sender a habitual “high importance” e-mailer? Are these e-mails actually important? If not, the sender's emails lose points.
[I use "low importance" markers much more often than "high importance".]

2. I give points to high-priority people: my senior management, my direct reports, my family members and my key customers. [I use an Outlook rule that assigns email a colored flag based on similar criteria]

3. I do the same for high-priority subjects: critical staff issues, health issues and major financial issues.
[Halamka is using a BB, I don't think he emphasizes clear subject lines enough. The subject line should describe the topic, justify the email, and (if applicable) state the action requested.]

4. I rate email based on the contents of the “To,” “cc” and “bcc” fields. If I am the only person in the To field, the e-mail gets points. If I am in the To field with a dozen other people, it’s neutral. If I'm only cc’d, it loses points. A bcc loses a lot of points, since I believe email should always be transparent. E-mail should not be used as a weapon.
[Only BCC yourself. Never BCC anyone else. When you want to BCC use Forward a copy instead. My Outlook flagging rules put any email where I'm not on the To Line into a "read later" bin.]

6. I downgrade email messages longer than five BlackBerry screens. Issues that complex require a phone call.
[Most BB users won't tolerate more than two screens. Halamka is unusual. I aim to keep my emails under 500 vertical pixels in Outlook, and the first two lines are for BB users: they contain the key information. The rest is reference and it's minimal. Longer stuff is a blog post.]

7. Email responses that say only “Thanks,” “OK” or “Have a nice day” are social pleasantries that I appreciate, but move to the bottom of my queue.
[He's being polite.]

8. Email with colorful backgrounds, embedded graphics or mixed font sizes lose points.
[I like to use indentation to structure my email. I need to see how that renders on a BB.]

9. I separate email into three categories - that which is just informational (an FYI), that which requires a short response and that which requires a lengthy, thoughtful response. I leave the lengthy responses to the end of the day.
[I put the words FYI in the title and I set message priority to "low".]

10. More than 3 emails about a topic requires a phone call or meeting. Trying to resolve complex issues via and endless ping pong of emails is inappropriate...

Some other essential-reading Halamka topics include:


Where do I get a Halamka fan club t-shirt?

[1] There are significant differences between Blackberry (or iPhone for that matter) email and email with a full keyboard and display. My hunch is that five years from now we'll decide that BB-email was a significant step backwards for business communication, but it does enforce brevity.

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