E-mail overload (or status emailicus)

My day is spent running meetings -- staff meetings, steering committee meetings and meetings of various kinds of national/regional/local governance bodies.

Over the past year, I have noticed a trend of continuous partial attention in all these meetings. The number of e-mails that people receive each day exceeds their ability to respond to them, so they develop "status emailicus" -- a bit like status epilepticus (persistent seizures), but it involves retrieving a BlackBerry, iPhone or other mobile device from its holster every 15 seconds throughout the meeting. They're spurred to this sort of constant monitoring because their colleagues have grown to wonder what's wrong when they don't e-mail back within a few minutes. Asynchronous e-mail has become more like synchronous instant messaging.

When you're running a meeting, you'd like to believe that everyone is participating in the discussion, especially when complex issues are being debated. Ideally, when consensus is achieved, everyone will leave the meeting marching to the same tune. But people who multitask in meetings are seeing only every other frame of the movie. They miss the subtleties of conversation and critical details that may later turn into deal breakers. How do we solve this problem?

We could throw away our mobile devices, but that ignores their positive aspects. My own Washington health care IT activities are possible because I can use my mobile device for command and control of all the projects I'm running, even while in planes, trains and automobiles.

One option is to reset expectations. E-mail is not the same as instant messaging, and we shouldn't expect responses the same way. A five-minute response time only works if there are no meetings to attend or any work that requires real concentration.

Another option is to realize that we all spend eight hours a day on meetings and calls and another eight hours on e-mail. We could limit meetings to 30 minutes in duration -- enough time for efficient discussion, but not too long to result in overwhelming e-mail backlog. Following each 30-minute meeting, we could get a 30-minute recess to act on decisions made and catch up on e-mails.

The idea of reserving 50% of your day to address issues of that day has its merits. Each day there are challenges created by customers, employees and the external world. If we left 50% of our calendars open each day for solving today's problems today, we would reduce stress, enhance communication and improve efficiency. We could even develop metrics for senior executives that measure "time to problem resolution" as a means to drive incentive compensation.

Another option is to implement "relevance filters," so that only the messages that get through are the ones deemed important based on personal business rules (Who is the sender? What is the topic? Are you the single recipient or just one of the cc's?). We could also considering charging "postage" -- a micropayment -- for each e-mail sent, but that is likely too extreme.

The bottom line is that e-mail overload exists in our daily lives and we can

  • a. Ignore it and hope it goes away.
  • b. Continue to let e-mail run our lives and distract our every waking moment.
  • c. Take control and organize our e-mail responses by reserving a part of each day, outside of meetings, for timely e-mail responses. A few e-mails are complex problems that require multi-stakeholder coordination. Although I can try to solve such problems via e-mail, my rule is that if more than three rounds of e-mails go back and forth about an issue, it's time to pick up the phone.

I already sense that people are beginning to rethink the way they manage connectedness. Twitter's popularity is decreasing, instant messaging is on the wane, and social networks seem less of an obsession.

I welcome your thoughts -- just don't e-mail me.

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 jhalamka@caregroup.harvard.edu.

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