February 7, 2018
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“The Red Apple” was the elusive prize of medieval conquest for an uninterrupted 800 years.  Secured behind what had proven to be the most formidable combination of building ingenuity and natural defenses was the fortress city of Constantinople.  Dedicated in 330 AD by its namesake Emperor Constantine the Great, it quickly became the center of wealth and commerce of the Middle Ages.  Centered in the city was a stunning 100-foot spire on which suspended a huge equestrian bronzed sculpture of Emperor Justinian; in his hand lay a globe (“the red apple”) and what was to be the rallying cry of would-be-conquers for the centuries to follow.  By the fifteenth century, Constantinople and the Byzantine Empire had been sieged by 23 different invading armies. Only once (briefly by Christians and the Fourth Crusade), had the city’s barriers been breached.  But in the mid-1400’s a new adversary, the Ottomans, were approaching and brought with them not only a creative aggregation of the latest technologies but a collaborative culture that would prove to be truly disruptive.

Although underpinned by their faith in Islam, the Ottoman Empire was a remarkable example of a conglomerate.  An Empire built on serial acquisitions (or conquests), it was renowned for its ability to accommodate and benefit from the capabilities of newly-acquired peoples; offering but seldom demanding conversion and integration into a single faith system. In 1432, Sultan Mehmet II was born and took control of the Ottoman army, after his father’s death. Mehmet quickly set his unrelenting sights on the Red Apple and began to assemble an unprecedented army outside the walls of Constantinople.  A force comprised of tremendous human diversity and armed with creative new uses of warfare technologies (and expertise) acquired from across the globe

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Source: https://commons.wikimedia. org/w/index.php?curid=1323430

– first of their kind massive cannons, sophisticated mining technologies and supply chain capabilities at a remarkable scale.   But beyond their infrastructure and technology, what enabled Mehmet to eventually “take the city” in 1453, was his attention to collaborative logistics and his leadership team’s ability to coordinate and integrate diverse talents against a shared objective.  What gave them their winning edge was their “intrastructure.”

The neologism “intrastructure” was first coined by Locan Dempsey in reference to peer-to-peer communication innovations.  And as all imaginatively-created words it strives to help us conjure an idea.  To link together concepts for which existing vocabulary seem to lack; it intends to spark our imagination. It is clearly a derivative (and a common misspelling!) of the word “infrastructure” – a word that surrounds us today.  We hear it raised in State of the Union addresses along with calls for massive budget allocations to address municipal decline – the urgent need for new roads, bridges, airports, etc.  We hear it in quarterly earnings calls, where management teams speak to their renewed investments in keeping their Company’s R&D and production capabilities well-oiled.   And this all makes sense to us, since the root “infra” means foundation and we can easily appreciate the need to build and maintain the physical world on which society and productivity stand.

But beyond physical capabilities are the interactions and exchange of ideas on which all innovation demands.   This is the dominion of “intrastructure” and the suffix “intra” (meaning “between”).  Our robust commitment to systems and cultures that enable the open exchange of ideas is as critical as any investment in infrastructure may ever be.

In biology, “intra” plays a central role, as complex life depends on the constant coordination between what takes place between the intra- and extra-cellular compartments; between cells and their extracellular matrix (their infrastructure) and as well between the organ systems themselves.  Cellular interdependence demands intracellular cross-talk and collaboration.

But in business “intra” can seem less natural.  All companies hope to encourage collaboration and the type of interactions which capture the synergies between their distinct groups, departments or separate operating units.   It would seem self-evident and inevitable, as they are all part “of one company” but organizational design, misaligned incentive systems, or simple human rivalry all too often impede. With this as a backdrop, mastery of collaborating with individuals outside of the organization can seem impossible.  Yet for those who can and do this well, the consequences are profound.

It is said that two things are shared (and assured) between a successful life as an “individual” and one as a sustainable “enterprise”; our proverbial death and taxes.  As individuals we hope to escape an early death due to disease or misfortune and just expect that taxes will be our toll.  But as enterprises, our longevity is not subject to biological misfortune or calamity but rather death by disruption or obsolescence – and for taxes, we simply hope to have the good fortune to worry about those.  And while all across the world people are living longer and longer lives, the exact opposite is being seen amongst enterprises – their average life span is dropping rapidly.  In the 1950’s, the average life span of a S&P 500 enterprise was ~65 years, by the 1980’s it was down to about 25 and by 2012, it dropped into the teens.  Keeping a company alive is getting harder and harder.

But those businesses that do grow and durably thrive have truly unique features.  Their operational distinction has been coined “absorptive capacity” by Cohen and Levinthal.  Amongst these “survivors and thrivers” organizations you find sustained long-term investment in internal R&D coupled with a substantial emphasis on accessing innovation externally.  Organizations with high absorptive capacity also tend to nurture a humility and recognition of the inherent limits of internal R&D productivity.   And they recognize that diversity and networks are much more powerful than assimilation and homogenization.

Our futures will hopefully be free of siege warfare, but the operational lessons of the Ottomans live on. All futures are built on aspiration; on belief systems that project a better path forward, for the many, not just the few. Futures are built on audacious objectives which are always beyond the grasp of the individual or single enterprise but within the reach of the collective.  In building the future of healthcare, we have many “red apples” that await us, but their harvest will require a renewed commitment to reinvention. In recognizing that breaking down guarded walls is always much harder than building them, we must avoid the false promise of their utility.  Removing barriers and redoubling our aspirations is a must – accepting nothing short of transformation.  Investing in the “intra” structures that connect and inspire us, all.