Opinion: My wired world

I'm often asked how I maintain several jobs -- CIO at Harvard Medical School, CIO at Beth Israel Deaconess Medical Center, CEO of MA-Share, emergency physician and father. The answer is simple: highly efficient use of technology. Here's a typical day:

At 5 a.m., I open my eyes and glance at my BlackBerry 7290 GSM/GPRS/Bluetooth phone/e-mail device and read through the 50 e-mails I have received since 2 a.m. Overnight, there are generally a few major server upgrades, security patches and network enhancements.

By 6 a.m., I'm out the door, heading for my 2005 Prius. It has no ignition key but senses the approach of my Bluetooth signal and unlocks the door as I touch the handle. I sit down and press the power button. The car starts and announces that it has successfully connected to my BlackBerry so that all calls can be handled via the Prius audio system.

I have meetings in five locations, so I type the addresses into the Prius, and it calculates the optimal path. I want to stop for tea, so I ask the Prius' voice-recognition system to identify all coffeehouses along the route.

My first phone call is picked up by the Prius, which automatically mutes the CD I'm playing and pipes the call over the audio system. A child has ingested a mushroom, and the emergency department is requesting a consultation. I recommend that they take a picture with a cellular phone and send it to my BlackBerry.

A few minutes later, I arrive at the site of my first meeting and place a Jabra 250 Bluetooth headset on my ear. While walking, the picture of the mushroom arrives, and I recognize it as a harmless Marasmius. I click on my BlackBerry and finish the consultation via hands-free Bluetooth headset. Then I sit down to my first meeting.

I open my IBM X41 laptop, which automatically recognizes that I am at Beth Israel Deaconess Medical Center and logs me onto the EAP-Fast secured network; it even knows my printer preference for this location.

I run the meeting and take down the minutes on my wireless laptop. As we adjourn, I e-mail the minutes and action items to all of the attendees, then walk to my next meeting, answering 30 e-mails on the way.

I'm meeting a group of reporters to discuss the use of radio frequency identification in health care. In the emergency department, I pass a scanner near my arm. An RFID device, implanted under the skin of my right arm between elbow and shoulder, emits my medical record number and enables a secure Web-based application to display my entire medical history. All 57,000 square feet of the emergency department are wirelessly enabled for data, voice over IP and geolocation via active RFID tracking tags. I clip a PanGo Networks tag to my belt, and a dashboard shows my physical location as I walk through the department, enabling clinicians and patients to rapidly find me.

On to my next meeting, at Harvard Medical School, where my laptop reorients itself. While there, I automatically create a copy of my bio-sketch for a grant, via an automated application that pulls all my publications from the National Library of Medicine.

I have Bluetooth, GSM/GPRS and RFID on my body 24/7. Admittedly, when I travel in remote areas to rock- and ice-climb, I am challenged by lack of signal, so I carry a wide-area text pager as backup. Luckily, I can connect on most summits. This article was composed and sent from the top of Grand Teton, at 13,770 feet.

John D. Halamka is CIO at CareGroup Health System, CIO and associate dean for educational technology at Harvard Medical School, chairman of the New England Health Electronic Data Interchange Network, CIO of the Harvard Clinical Research Institute and a practicing emergency physician. Contact him at jhalamka@caregroup.harvard.edu.

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