This presentation based upon the book "No Straight Lines: making sense of our non-linear world" was made at the CareWare conference in healthcare innovation in Aarhus Denmark – The presentation argues that when we design around the needs of humanity, we can create better healthcare systems, which are also more resilient, sustainable, adaptable and in fact less expensive to run. That better much better does not need to cost the earth. We need to be able to hold in play at the same time considerations about how to design for the needs of humanity, to deal with systems thinking and complexity, organisational capability, technology and even data. www.no-straight-lines.com

1. SEEING, CONNECTING TO, AND,
DESIGNING FOR OUR BEST POSSIBLE
FUTURE IN HEALTHCARE
aarhus denmark 2012

2. This presentation is based upon the book
No Straight Lines: making sense of our non-linear world.
Available as:
Open Access Participatory version via this link:
http://read.publification.com/b/no-straight-lines
Paperback and Kindle versions:
http://ht.ly/7OAod

3. alan moore | www.smlxtralarge.com | no straight lines introduction 2012
The challenge:
Be realistic imagine the
impossible
paris 1968

4. Why? do we
experience such difficulty even imaging a
different sort of society?
Why is it beyond us to conceive a different set
of arrangements to our common
advantage?
tony judt
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

5. Why? are we
not able in the 21st Century
to design
more adaptive and
sustainable intelligent systems
for health?
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

6. n o t ‘ w h at i f ’ b u t …
HOW?
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

7. How do we create a service to
better manage people’s chronic
health care. Reducing; wrong
diagnosis, over prescription of
drugs, clogging up hospitals and
specialist time?
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

8. | www.no-straight-lines.com | making sense of our non-linear world | 2012 |

9. It is because of specialization: the power of
modern medicine is also the powerlessness of
professionals
Only the patient has enough information to
co-ordinate care across specialists
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

10. Markle Foundation’s ideal PHR:
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

11. Markle Foundation’s ideal PHR:
1. Access controlled by patient
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

12. Markle Foundation’s ideal PHR:
1. Access controlled by patient
2. Lifelong records
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

13. Markle Foundation’s ideal PHR:
1. Access controlled by patient
2. Lifelong records
3. Information from all
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

14. Markle Foundation’s ideal PHR:
4. Universal access 1. Access controlled by patient
2. Lifelong records
3. Information from all
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

15. Markle Foundation’s ideal PHR:
4. Universal access 1. Access controlled by patient
5. Private and secure 2. Lifelong records
3. Information from all
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

16. Markle Foundation’s ideal PHR:
4. Universal access 1. Access controlled by patient
5. Private and secure 2. Lifelong records
6. Transparent 3. Information from all
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

17. Markle Foundation’s ideal PHR:
4. Universal access 1. Access controlled by patient
5. Private and secure 2. Lifelong records
6. Transparent 3. Information from all
7. Easy exchange
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

18. Who wants to build a barn in a day?

19. The economics, efficiency and effectiveness of sharing

20. 3
types of sharing

21. Sharing data increases safety
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

22. Sharing data increases safety
Clinicians need patients to know what is happening
Patients tell other clinicians what they have learned
Patients cannot self-manage if they do not have the information
Only small number of tests, only at diagnosis, require seeing clinician before
seeing result
Knowledge of the safe ways to give patients their data
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

23. Sharing data saves clinical time
Focus appointment time on explanations and
treatment
Clinicians rarely have time to go through all the test results
Patients often schedule follow-up to ask questions they only think of outside the
room
Relatives call to ask what the patients had been told
Patient will save other clinicians’ time with their
knowledge
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

24. Sharing data is a process
Commit to to everything long-term, but start with test
results
Test results are structured data with crucial benefits to patient with long-term
conditions
Add on prescriptions, letters, and patient-submitted data
Medical notes require retraining of clinicians, but they already know this is
happening
Increase sharing as generate benefits and confidence
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

25. Design

31. Conduct online
consultations
which are seen
by all clinicians
in team

33. Detailed explanations for patient save
clinician’s time

34. Personal health plans
Teach patient to teach team

35. Why is PATIENTS KNOW BEST
relevant to you?
1. Designed as a platform
2. Designed for sharing: sharing data increases safety, sharing data saves clinical
time, sharing data is a process
3. Truly empowering patients
4. Designing for individual and participatory learning
5. Sustainable, highly effective to an order of magnitude of 2
6. Better much better does not necessarily cost the earth
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

36. The ‘WHAT’S NEXT’ for HEALTHCARE SERVICES
How do we discover our best possible
future for the territory of Ontario’s health
care system – when we are faced with
challenges that are highly complex and
deeply ambiguous? How do we discover
and harness the deep knowledge that
resides in the many people that both run
and use that healthcare system?
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

37. Our best possible future resides in the
minds and hearts of the many not the few
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

38. Participatory Leadership
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

39. Root question: What is happening in the
world/this organization that requires us to
get together to do this work?
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

40. A chaordic process: building shared
awareness, co-creating a shared vision,
harvesting outcomes / perspectives
co-building an action plan,
Execution
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

41. “Cooperation is the
foundation of human
development, in that we learn
how to be together before we
learn how to stand apart”
erik erikson
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

42. designing for cooperation
Faster Alone, Further Together
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

43. Why is the process of the Nova
Scotia story relevant to you?
1. Use of participatory leadership
2. Harnessing of collective intelligence
3. Human technologies that unlock individual knowledge into deep collective insight
that translates into collective action
4. Process of connecting to an emergent best possible future by connecting into deep
human wisdom
5. People embrace what they create
6. Innovation + social cohesiveness
7. A lot less expensive than McKinsey
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

44. The ‘WHAT’S NEXT’ for HOSPITALS
How do we design and build a
hospital which enables patients
to recover from operations at
much greater speeds, with a
reduced need for drugs?
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

45. | www.no-straight-lines.com | making sense of our non-linear world | 2012 |

46. | www.no-straight-lines.com | making sense of our non-linear world | 2012 |

47. | www.no-straight-lines.com | making sense of our non-linear world | 2012 |

48. | www.no-straight-lines.com | making sense of our non-linear world | 2012 |

49. Why is DOWNE HOSPITAL
relevant to you?
1. Designing around the needs of humanity not the needs of utility:
place, space and people
2. Design thinking / systems thinking / complexity
3. Strength of Craftsmanship
| www.no-straight-lines.com | making sense of our non-linear world | 2011 |

50. Summary
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

51. | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
“the limits of our language is the limit to our world
“

52. a design challenge.
I + We = why?
How we make context and meaning, about the webs of relationships and how we derive
value from those relationships and connections are central to human beings.
And all human beings participate in co-creating the complex social networks that
we live in and engage with.
The social environment is a dynamic field that interacts with human consciousness
changes in that environment affect us psychologically.
otto scharmer
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

53. Human nature is not a machine
Successfully designing a medical system requires not just technical and medical
knowledge it requires us to have a deep understanding of human nature.
Image: http://www.flickr.com/photos/camil_t/82015664/

54. designing for human systems
“Me We”
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

55. System Upgrade
alan moore | www.smlxtralarge.com | no straight lines introduction 2012

56. the Human- OS
alan moore | www.smlxtralarge.com | no straight lines introduction 2012

57. WHAT
DOES
THIS
HUMAN OPERATING
SYSTEM
WANT?
ITS WANTS WHAT
WE WANT…
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

58. OPPORTUNITY
FREEDOM
EMPOWERMENT
MUTUALISM
DIVERSITY
EFFICIENCY
INDEPENDENCE
BEAUTY
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

59. designing for:
Knowledge flows
Networks
Organisations as platforms
Adaptive systems
Multiple outcomes
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

60. our epic goal:
strengthen the sources of health
| www.no-straight-lines.com | making sense of our non-linear world | 2012 |

61. www.no-straight-lines.com
@alansmlxl