Virtually There?

Dr. Laura Esserman leans forward and speaks with conviction, making broad gestures with her hands. "Over the past couple of decades, I've watched industries be transformed by the use of information systems and incredible visual displays," she says. "What we could do is to completely change the way we work -- just by changing the way we collect and share information."

Sounds familiar, right? But Esserman isn't championing yet another overzealous Silicon Valley startup -- she's envisioning how cancer patients will interact with their doctors. If Esserman, a Stanford-trained surgeon and MBA, has her way, patients won't sit passively on an exam table, listening to impenetrable diagnoses and memorizing treatment instructions. Instead, they'll have access to a multimedia treasure chest of real-time diagnosis, treatment, and success-rate data from thousands of cases like their own. Better still, they won't meet with just one doctor. There will be other doctors on the case -- some from the other side of the hospital and some, perhaps, from the other side of the world.

Esserman and her colleagues at the University of California San Francisco's Carol Franc Buck Breast Care Center are pioneers in the new world of virtual teams and virtual tools, a world in which there will be real change in the way highly trained people whose work depends on intense collaboration get things done. After years of grand promises about the power of high-quality videoconferencing, high-speed Internet connections, and well-designed collaboration software, it may finally be time for virtual work to become a business reality.

Part of the good news is, of course, rooted in bad news: In a period of war and recession, fewer people relish a life of nonstop travel, and fewer companies want to pay for it. But there's more to it than that: The tools are better than they used to be. "The technology has really evolved," says Leon Navickas, chairman and CEO of Centra Software, based in suburban Boston, whose Web-enabled collaboration and e-learning platform is used by more than 1.7 million people. "We're capable of a high degree of interactivity, of developing a very rich media environment through an ordinary computer, even with those who are connected to the Internet at low speeds. And we're able to get through proxy servers and firewalls without compromising the security of the Internet or a corporate intranet."

Meanwhile, companies are beginning to understand the uses (and limitations) of the technology. Accenture is a classic power user. The giant consulting firm, long famous for its fanatical commitment to training and development, uses Centra software, along with all kinds of other virtual tools, as part of its strategy to help people collaborate more and travel less. The company's online-learning portal, myLearning.com, has become a major piece of its knowledge infrastructure. (The firm expects that up to 70% of all of its courses will be offered via e-learning rather than in person.) But the goal, says Reinhard Zeigler, global lead partner for Accenture's eLearning and Knowledge Management group, is "blended learning -- a careful mix of virtual and physical learning experiences. We'll never go completely virtual."

What follows, then, is a real-world guide to the promise and perils of electronic collaboration. To answer the most basic questions about virtual work, Fast Company spoke to a broad group of technology suppliers and leading-edge users, from doctors and developers to consultants and engineers. Their conclusion: When it comes to delivering on the real promise of electronic work, we are virtually there.

Doctors: Not Just Cheaper, Smarter

Be honest. Most companies look to virtual technologies to work cheaper -- to save money on airfare and hotels. But that cost-cutting mind-set underestimates the real potential of the tools available. Electronic collaboration can help people work smarter; it can bring more brains to bear more quickly on more-important problems.

That's why Laura Esserman is so passionate about fully collaborative health care. Her goal at the Buck Breast Care Center is to use virtual tools to bring more useful information (and more doctors) into the exam room. Why? Because two heads really are better than one. She explains that when patients see their doctors after a breast-cancer diagnosis, for example, they are handed a recommended course of treatment that involves serious choices and trade-offs. Of course, most patients don't know enough about the merits of, say, a lumpectomy versus a mastectomy to make an informed choice, so they trust their doctors to tell them what to do.

But a single doctor isn't always equipped to make the best decision, especially since different procedures can have very different long-term physical and emotional impacts -- but may not be all that different in their short-term medical outcomes. "Very often," Esserman says, "doctors recommend a particular treatment because they're more familiar with it. But we should be advocates for our patients, rather than our specialties."