In the era before Blackberrys, iPhones, instant messaging, social networks, and blogs,  I had a predictable day.

I could look at my week and count the meetings, lectures, phone calls, writing, and commuting I had to do.

Although my schedule was busy, I could schedule exercise time, family time, and creative time.

Today, I would not describe my work day as linear or predictable.   I do as much as I can, attending to every detail I remember, and hope that by the end of the week the trajectory is positive and the urgent issues are resolved.

Here’s what I mean.

Since there are no barriers to communication, everyone can communicate with everyone.   Every issue is escalated instantly.   Processes for decision making no longer involve thoughtful stepsthat enabled many problems to resolve themselves.     We’re working faster, but not necessary working smarter.   We’re doing a greater quantity of work but not necessarily a higher quality of work.

Everyone has a mobile device and their thoughts of the moment can be translated into a message or phone call, creating a work stream of what amounts to hundreds of “mini-meetings” every day.

As issues are raised over the wire, the follow on cc’s result in a volley of messages, thoughts, and more “mini-meetings”.

The linear part of our work streams – face to face meetings, presentations, and travel – interrupt the non-linear work streams running through our digital lives.   Watch how many people use their mobile devices while in meetings and lectures.   Watch how many people need their Blackberry pried from their hands by flight attendants as planes are taking off.    Each day has turned into two work days – the linear one which is scheduled and the non-linear 24 hour flow through our devices and social networking applications.

I do my best to resolve every issue and declare closure on the events of each day.   However, I find myself waking up from my few hours of sleep with a full queue of tasks because our non-linear work stream is no longer is bounded by a work day.

What are the solutions to the overload we are all currently experiencing?

1.  We could eliminate the concept of 1 hour meetings, 1 hour lectures, and airline travel, realizing that much of what we need to do can be accomplished in tweets, emails, instant messages, and calls.   The non-linear work stream becomes our work and we stop trying to schedule a linear workday in the middle of it.

2.  Alternatively, we can realize that the non-linear work stream is ultimately unsustainable, tossing our mobile devices as in theCorona beer commercial.

3.  We could begin to reduce the non-linear work stream by de-enrolling from Twitter, Facebook, Google+, LinkedIn, Plaxo and Instant messaging.  We could maintain just a single email account and triage it well.

I’m not sure which answer is right, but I do believe that the conflict between our linear and non-linear work streams has reached the point where we all have “continuous partial attention”  unable to focus more than a few minutes on any one linear task.

I write my blogs in the middle of the night because that is the only moment when the non-linear work steam dips to a point that I can capture my thoughts in a single burst of uninterrupted writing.

It’s clear to me that our work lives and styles are evolving.  Might there be a day when “work” is plugging into a network and managing the stream of communication, decisions, and  ideas for 9 hours a day, then unplugging and turning the stream over to the next person on shift?  Sounds very Metropolis but I’m not sure any of us can return to the linear work streams of the past.

John D. Halamka, MD, MS, is Chief Information Officer of Beth Israel Deaconess Medical Center, Chief Information Officer at Harvard Medical School, Chairman of the New England Healthcare Exchange Network (NEHEN), Co-Chair of the HIT Standards Committee, a full Professor at Harvard Medical School, and a practicing Emergency Physician. He’s also the author of the popular Life as a Healthcare CIO blog.

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