This document discusses the need for change and resilience in healthcare systems. It notes that hardware, software, and people all have limitations that can lead to problems. The document advocates for taking vigorous and positive action in the present, rather than waiting, as Martin Luther King Jr. advised. It explores concepts like complexity, antifragility, collective intelligence, and overcoming fear to solve big challenges through collaboration. The overall message is that healthcare systems must evolve and adapt in unexpected ways to prepare for an uncertain future.

1. DTX
𝚫
for resilience & better healthcare

2. Healthcare 2022

3. B.C. we had “The Great Big
Digital Staying the Same”

4. A.C. we have a choice

5. But we are in debt

6. Things have evolved in
unexpected ways
2006 2022

7. Just add time and we get…

8. Uno, Dos, Stress & Despair

9. And fear, fear is
the mind-killer

10. What did we learn?

11. 1st Law – Hardware will fail

12. 2nd Law – Software has bugs

13. 3rd Law – People will be people

14. BEGINNING AGAIN
THE URGENCY OF NOW

15. “We are now faced with the
fact that tomorrow is
today. We are confronted
with the fierce urgency of
now. In this unfolding
conundrum of life and
history, there "is" such a
thing as being too late.
This is no time for apathy
or complacency. This is a
time for vigorous and
positive action.”
Dr. Martin Luther King Jnr.

16. ENERGY

17. The problem with our thinking
Cynefin 3 Domain Model

18. VIPARINAMA DUKKHA
“The anxiety or stress
of trying to hold on
to things that are
constantly changing”

19. Where to next…
energy gradients & systems change

20. COMPLEXITY & FRAGILITY

21. Complexity & Constraints
Cynefin 3 Domain Model

22. Complexity is the problem

23. What the hell is
Antifragility?
Credit: N.Taleb AntiFragility

24. Patterns of Antifragility can
help… but it’s not easy

25. DECISIONS

26. “Strong opinions
loosely held”
Marc Andreessen
A16Z

27. Architecture ==
Sum of All The Decisions Made
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28. There’s nothing you can do
about yesterday

29. So stop seeking forgiveness
for crimes against technology

30. Deferring Decisions
& Inspired Laziness

31. Imagination is a must!!!
No Imagination == No Options

32. LEARNING & KNOWLEDGE

33. I know more than I can say
& I can say more
than I can write

34. Knowing the things
you should know
in the way you should
know them

35. Don’t go too far

36. Knowledge Encoding Systems

37. “Thinking is
the new killer
technology”
Dr. Páidí O’Reilly
UCC & Páidí’s Hedge School

38. Build to Learn, Remix & Play

39. PEOPLE

40. Brain Constraints

41. Antagonistic Neural Networks

42. It’s all happening
in our heads

43. More Problems

44. Sync or sink

45. Trust in numbers

46. “In a crew there is always a
pilot, but who is the pilot at
any time can change. If you look
at operating theatres in
hospitals you see something
similar. The professions also
largely develop core concepts
such as trust by collective
practice over time rather than
exhortations and mission/purpose
statements.”
Dave Snowden
Cynefin

47. Build Crews Around
Ritual & Identity

48. Build Human Sensor Networks

49. CLARITY

50. Avoid Drama
Develop a
Drama
Detection &
Avoidance
System

51. Get Clear… Very Clear

52. Fight a common enemy

53. COLLECTIVE INTELLIGENCE

54. for this we need…
collective intelligence

57. So who do we need??

58. CRAIC
NOT
CLEAR
CLEAR
NO CRAIC
It would be great if they were here…

59. Solving Big
Problems Together

60. Digital Tx 4Cs

61. FEAR

62. The Litany Against Fear

63. if you want to find me,
try….
gar.maccriosta@hse.ie
http://ie.linkedin.com/in/garmac
criosta
Hello, my
name is Gar
and I help
with
“The anxiety
or stress of
trying to
hold on to
things that
are
constantly
changing”
Gar Mac Críosta
VIPARINAMA DUKKHA