John Halamka: IT has its own Sports Illustrated effect

Fame for individual accomplishments is fleeting, but the benefits of team efforts build and last

You may have heard about the Sports Illustrated cover jinx, the notion that people who appear on the front of the magazine are likely to experience bad luck, failure or a career spiral.

Over the 30 years of my professional life, I've seen something like the Sports Illustrated effect in IT. I've watched many colleagues become famous, receive significant publicity, then fail to live up to the impossible expectations implied by their fame. They regress to the mean. Nature seems to favor symmetry. Things that rise slowly tend to decline slowly. Things that rise rapidly tend to drop rapidly.

Fame is usually a consequence (good or bad) of invention, innovation and accomplishment. Fame itself is generally not what motivates a person to accomplish great feats. An Olympic athlete is usually driven by a highly competitive spirit. An inventor is usually inspired by a belief that there must be a better way. Fame that is the consequence of a feat can affect future behavior. It can become an intoxicant and motivate someone to strive for accomplishments that keep the fame coming.

I've thought about my own brushes with fame.

When I was 18 and starting at Stanford, I realized that my scholarships would cover only the first year of tuition. I visited the Stanford Law library, read the U.S. tax code and then wrote software for the Kaypro, Osborne 1 and CP/M computers that calculated taxes. The software I shipped from my dorm room generated enough income to start a small company. When the PC was introduced, we were the first to provide such software to small businesses seeking to compute their tax obligations. By the time I was 19, I moved into the home of Frederick Terman, former provost of Stanford and the professor who first encouraged William Hewlett and David Packard to build audio oscillators and form a new company called Hewlett-Packard. The story of a 19-year-old running a software company and living in the basement of a founder of HP was newsworthy at the time. I was interviewed by Dan Rather, Larry King and NHK TV Japan.

The company grew during my medical and graduate school years, but as technology evolved, it didn't innovate to take advantage of new platforms, graphical user interfaces or emerging networks. I sold the company when I began my residency. It eventually closed.

By then, I was learning to build clinical systems, and I worked during my residency to develop a hospitalwide knowledge base for policies, procedures and protocols, an online medical record system, a quality control system, and several systems for medical education. I achieved local fame when the County of Los Angeles named me the County Employee of the Month, the first time it was given to a physician.

I left residency and began practice at Boston's Beth Israel Hospital while doing postdoctoral work at MIT, where I was writing a thesis about using the Web to securely exchange medical records. In 1997, using the Web was considered risky, unreliable and unsecure, but the newly merged Beth Israel and Deaconess hospitals needed a quick win, so "CareWeb" was born. I became CIO.

In 1999, Dr. Tom Delbanco and others had the idea that patients should be able to access their own records electronically. My team created PatientSite. We were credited with inventing one of the first personal health record systems.

And the list goes on -- the backlash from our 2002 network outage, and plaudits for developing an early regional healthcare information exchange, harmonizing standards, creating a private cloud for healthcare records, and achieving hospital certification for demonstrating that we were engaged in "meaningful use" of electronic health record technology.

The interesting conclusion of all of this is that in every case, the fame was temporary, and very soon followed by regression to the mean -- a stellar performance or innovation became typical, average and mundane.

It's nearly impossible to remain at the front of the race forever -- eventually, someone stronger, faster or more nimble will displace you.

In my case, I stopped thinking about my own reputation and fame about 1998, recognizing that every episode of fame is followed by a decline into anonymity -- the Sports Illustrated effect. What's lasting are great organizations and teams that are constantly reinventing themselves -- changing the race they are running.

Steve Jobs said, "We're as good as our last product," and he's right.

If you focus on creating great organizations, which consistently achieve discrete episodes of fame but continuously innovate so that those episodes of rise and fall actually look like a continuous series of peaks, then you can beat regression to the mean.

The organizations in which I work will last for generations. Their reputations transcend anything I will ever do personally. My role is to champion, support and publicize a few key innovations every year that will keep the organizations highly visible. That visibility will attract smart people and retain the best employees who want to work for a place on a rising trajectory. If I can transform the rise of fame and regression to the mean into a trend that feels like one organizational strength after another, I'll declare victory.

John D. Halamka is CIO at CareGroup Healthcare System, CIO and associate dean for educational technology at Harvard Medical School, chairman of the New England Health Electronic Data Interchange Network, chairman of the national Healthcare Information Technology Standards Panel and a practicing emergency physician. You can contact him at

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