2017Weeknotes

Specific Solutions, Broad Impacts

The solution space for systems problems often looks nothing like the problem space. The problem space is often broad, ill-defined, and might even change as time (and research) go on. In this project, we have talked about broad systems problems such as the culture of clinical trials, the issues with data sharing, and misaligned incentives. Although abstract, these are the real problems that need to be resolved. Our past year has been spent defining these problems so that we can understand specifically what the issue is. This has lead us down the path of gold standard RCTs, incentives for data sharing, and creative pricing models. Zooming in and out like this allowed us to look at a broad problem, focus in on the issues and define it, then zoom out again to see if our definition was relevant, zoom back in to see how we could fix it, and so on. The engineering design process is often a circle, but I would like to think of the systems engineering design process as a three dimensional torus with different levels of thickness along the way.

But it is equally as important to look at the solution space and think about the same process. While the problems often start out as broad, the proposed solutions are often specific. These solutions often tackle the specific problems that are seen in the system, but not the broader systems problems that are regularly encountered. While it would be great to work in a linear fashion and solve a problem once we have defined it well, we are losing out on a lot of resources if we don’t take a systems view of the solutions as well. And there are some solutions out there which are amenable to this systems view.

One such example is a live demonstration course for surgery and devices. The course basically gets everyone in a room to demonstrate new techniques live. Experts can comment and critique during the demonstration. Novices can learn not only the new technique, but also its associated nuances. It is a method which solves an incredibly specific problem for specific issues. However, zooming out, we realize it actually goes out and tackles a number of broad systems issues as well. Experts from all areas are encouraged to participate, and critique. A moderator takes questions and comments, making sure the conversation keeps going forward in a constructive direction. This allows the breaking of silos across different ideas. It also disseminates information in a very quick way, allowing not just rules but ideas to transfer as well. Finally, it puts the focus of medical intervention directly where it is relevant: the patient and making them better.

A number of other solutions also exist, including some of our own that we have already talked to a number of stakeholders about. Over the next months, we will be zooming in and out of these question formulations. Lucky for us we have already done this when formulating our problems, so we have practiced extensively. Stay tuned!