I've written about the implications of staff bringing their own devices to the office instead of using corporate desktops and the challenges of keeping mobile devices secure.

I own a Blackberry Bold 9700, first released on December 18, 2009. Since I do not read email when I drive, I hand it to my wife who instinctively tries to navigate my email by gesturing on the screen (it does not work). I receive one email every 30 seconds (over 1000 per day), many of which contain web sites and attachments. Reading them on a Blackberry Bold is not a satisfying experience. It's a messaging device, not a comprehensive mobile platform.

In 2007, owning a Blackberry was cool and RIM interviewed me about the my mobile lifestyle.

The iPhone 3GS was released on June 19, 2009 and since then Blackberry has become less cool and RIM has lost $30 billion in market value.

Market changing consumer products are introduced every 6 months. In the same timeframe, I've been working on hundreds of important enterprise initiatives. The average hospital IT project, given limited resources and large scope, takes 18 months.

The consumer IT marketplace moves at such a fast pace, applying thousands of people to create a single device, that the average employee now expects every hospital IT project to proceed in the same manner, even though only one person may be working on a niche project that serves a small number of users.

I sometimes describe the job of the CIO as a quest to minimize negative reinforcement - "I only received 100 challenging emails, it's been a great day". The accelerated pace of consumer IT multiplies impatience, intolerance, and emotion.

It would be great if mobile devices and the Cloud solved all our problems, but unfortunately, the enterprise world has compliance requirements, security constraints, complex business processes, controls, and workflows that are not addressed by consumer technologies.

What's a CIO to do?

1.  Embrace mobile devices and the cloud when they make sense. We do support iPhones and Android devices for email. We do support the cloud for image exchange and a private cloud for hosting community physician electronic health records. BIDMC Information Systems is considered "consumer device friendly", which helps my reputation.

2.  The expectation of new infrastructure and applications every 6 months tempered by the reality of 18 month hospital project plans requires intense communication. This week, I sent my staff a plan to create "IT concierges" for our key stakeholders, ensuring that monthly project updates keep users informed and better align expectations with reality.

3.  Meetings with disgruntled stakeholders are really important to maintain credibility. "Presence" of the CIO can really make a difference when customers perceive the pace of enterprise IT innovation to be slower than the consumer marketplace.

4.  Maintaining agility and flexibility without being dogmatic ensures the CIO is not the rate limiting step to innovation. I've always said that if emerging companies can provide superior service at lower cost to any product we have currently, we should openly evaluate it. Customers will appreciate that IT has a culture of innovation even if product life cycles are longer than the consumer marketplace.

5.  CIOs need to accept that 10% of users will dislike you on a given day because enterprise technologies are unlikely to keep pace with consumer technologies. Rather than get frustrated, realize that by focusing on continuous measured progress, you'll create a trajectory that prudently moves forward, balancing security, innovation, and functionality. As my daughter would say, Ganbatte!

Complexity, unrealistic customer expectations, and resource limitations make the job of CIO increasingly difficult. By focusing on the possible, communicating your plans broadly, and accepting consumer technologies for the use cases that make sense, the CIO can continue to thrive.

John Halamka, MD, blogs regularly at Life as a Healthcare CIO.