Offshoring Heart Surgery?!

Last month I gave a keynote speech to the delegates at the Outsourcing World Summit. It was my fourth keynote to this group over the past few years, so I like to think I know something about the subject (see for example, an article entitled “Offshoring Realities, Onshore Solutions” http://www.harari.com/articles.php?WhichArticle=45). But only a couple days ago I had a profound and emotional “aha!” moment that may have permanently affected my entire perspective on offshoring. After finishing a speech to a corporate group , I was invited to have lunch with the CEO of the company. As we broke bread, he introduced me to the luncheon speaker, who turned out to be Dr. Billy Cohn of the Texas Heart Institute in Houston, who is one of the nation’s premier heart surgeons. Cohn gave a superlative speech on the latest mind-blowing innovations in cardiology and surgery, particularly new non-invasive approaches which will replace many of today’s “open ‘em up and cut ‘em” procedures. But one scenario Cohn described was really wild: a prototype technology in which the surgeon, hunched over a computer screen showing the precise graphic details of the patient’s anatomy, was able to simulate the surgery online, and in the process control robots which did the actual invasive and non-invasive surgeries on the patient's heart. This is a much more precise and accurate intervention, and it will be scalable and common within a decade, if not sooner. Cohn showed a short video in which the surgeon, armed with his desktop computer, worked about 10 feet from the robots and the patient on the operating table. Fascinating. And then Cohn said something that really blew me away: He pointed out that there was no reason for the surgeon to be in the same room as the robots and the patient; in fact, there was no reason for him or her to be in the same country! As long as the computer can be digitally connected with the robots, the patient can be in San Francisco and the doctor can be in New York, Zurich or Delhi. Wow! Suddenly the accelerating velocity of globalized offshoring took on a deeply profound dimension. If I want to have heart surgery (or, for that matter, any type of surgery), I can theoretically choose the best doctor for me from anywhere in the world, and I don’t have to visit him, and he doesn’t have to come here. He can do what's necessary from wherever he or she is: instantly receive whatever medical data he needs from the hospital, talk to me via phone or Web or videoconference, schedule the surgery, and then “do it” to me even if we’re separated by thousands of miles. And, technically, given the amazing precision of the hardware and software, he would do a better job that way than if he was actually doing the surgery by hand on site.I’ve often said that every industry nowadays is being impacted by the “Perfect Storm” collision of globalization, deregulation, and technological advance, all of which relentlessly crush time, distance and physical barriers to the accomplishment of work. Viewed in that context, remote digitalized surgeries are a natural consequence. Is that “offshoring”? I suppose it is, but I predict that in the near future that won’t matter. In fact, I predict that “offshoring” will soon become a non-word, or at least an irrelevant one. “Offshoring” suggests that nearly all the work of the organization occurs within four walls, or within sharply defined borders, and little snippets of work are (reluctantly) parceled out to foreign entities when absolutely necessary. But in the future, the successful “organization” will increasingly be seen as a web of high value-add relationships--an extended global network of optimal talent, knowledge, resources, and assets. Companies as diverse as IBM, GE, and Proctor and Gamble are already beginning to operate as such, in tasks as varied as product development, supply chain management, engineering and design. Proctor and Gamble CEO A.G. Laffley, for example, reckons that by the year 2010, at least 50% of new products in P & G’s pipeline will come from employees and external partners located outside the U.S. That, of course, will generate new growth for the company, which will then contract with more talent both in the U.S. and abroad.Think about it: A hospital in the U.S. that views itself as a web of high-value global relationships will be able to seek the best medical staff in the world. The difference is that those talented MD’s may be scattered around multiple continents and will not have to move to the U.S. to deal with that hospital’s patients.