Tag: system dynamics

behaviour changebusinesspublic healthsocial mediasystems science

Genetic engineering for your brand

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DNA doesn’t predetermine our future as biological beings, but it does powerfully influence it. Some have applied the concept of ‘DNA’ to a company or organization, in the same way, it’s applied to biological organisms. Firms like PWC have been at the forefront of this approach, developing organizational DNA assessments and outlining the principles that shape the DNA of an organization. A good brand is an identity that you communicate with yourself and the world around you. A healthy brand is built on healthy DNA.

Tech entrepreneur and writer Om Malik sees DNA as being comprised of those people that form the organization:

DNA contains the genetic instructions used to build out the cells that make up an organism. I have often argued that companies are very much like living organisms, comprised of the people who work there. What companies make, how they sell and how they invent are merely an outcome of the people who work there. They define the company.

The analogy between the DNA of a company as being that of those who make it up is apt because, as he points out, organizations reflect the values, habits, mindsets, and focus of those who run them. For that reason, understanding your organizations’ DNA structure might be critical to shaping the corporate direction, brand and promoting any type of change, as we see from the case of Facebook.

DNA dilemma: The case of Facebook

Facebook is under fire these days. To anyone paying enough attention to the social media giant the issue with Facebook isn’t that it’s happening now, but why it hasn’t happened sooner? Back when the site was first opened up to allow non-university students to have accounts (signaling what would become the global brand it is today) privacy was a big concern. I still recall listening to a Facebook VP interviewed on a popular tech podcast who basically sloughed off any concerns the interviewer had about privacy saying the usual “we take this seriously” stuff but offering no example of how that was true just as the world was about to jump on the platform. I’ve heard that same kind of interview repeated dozens of times since the mid-2000’s, including just nine months before Mark Zuckerberg’s recent ‘mea culpa’ tour.

Facebook has never been one to show much (real) attention to privacy because its business model is all about ensuring that users’ are as open as possible to collect as much data as possible from them to sell as many services to them, through them, about them, and for others to manipulate. The Cambridge Analytica story simply exposed what’s been happening for years to the world.

Anyone who’s tried to change their privacy settings knows that you need more than a Ph.D. to navigate them* and, even then, you’re unlikely to be successful. Just look at the case of Bobbi Duncan and Katie McCormick who were outed as gay to their families through Facebook even though they had locked down their own individual privacy settings. This is all part of what CEO Mark Zuckerberg and the folks at Facebook refer to as “connecting the social graph.”

The corporate biology of addiction

In a prescient post, Om Malik wrote about Facebook’s addiction to its business model based on sharing, openness, and exploitation of its users’ information mere weeks before the Cambridge Analytica story came out.

Facebook’s DNA is that of a social platform addicted to growth and engagement. At its very core, every policy, every decision, every strategy is based on growth (at any cost) and engagement (at any cost). More growth and more engagement means more data — which means the company can make more advertising dollars, which gives it a nosebleed valuation on the stock market, which in turn allows it to remain competitive and stay ahead of its rivals.

Whether he knew it or not, Malik was describing an epigenetic model of addiction. Much emerging research on addiction has pointed to a relationship between genes and addictive behaviour. This is a two-way street where genes influence behaviour and behaviour influences a person’s genes (something called epigenetics). The more Facebook seeks to connect through its model, the more it reinforces the behaviour, the more it feels a ‘need’ to do it and therefore repeats it.

In systems terms, this is called a reinforcing loop and is part of a larger field of systems science called systems dynamics. Systems dynamics have been applied to public health and show how we can get caught in traps and the means we use to get out of them.  By applying an addiction model and system dynamics to the organization, we might better understand how some organizations change and how some don’t.

Innovation therapy

The first step toward any behaviour change for an addiction is to recognize the addiction in the first place. Without acknowledgment of a problem, there can’t be much in the way of self-support. This acknowledgment has to be authentic, which is why there is still reason to question whether Facebook will change.

There are many paths to addiction treatment, but the lessons from treating some of the most pernicious behaviours like cigarette smoking and alcohol suggest that it is likely to succeed when a series of small, continuous, persistent changes are made and done so in a supportive environment. One needs to learn from each step taken (i.e., evaluate progress and outcomes from each step), to integrate that learning, and continue through the inevitable cycling through stages (non-linear change) that sometimes involves moving backward or not knowing where along the change journey you are.

Having regulations or external pressures to change can help, but too much can paralyze action and stymie creativity. And while being motivated to change is important, sometimes it helps to just take action and let the motivation follow.

If this sounds a lot like the process of innovation, you’re right.

Principled for change

Inspiring change in an organization, particularly one where there is a clear addiction to a business model (a way of doing things, seeing things, and acting) requires the kind of therapy that we might see in addiction support programs. Like those programs, there isn’t one way to do it, but there are principles that are common. These include:

  1. Recognize the emotional triggers involved. Most people suffering from addictions can rationalize the reasons to change, but the emotional reasons are a lot harder. Fear, attraction, and the risk of doing things differently can bubble up when you least expect it. You need to understand these triggers, deal with the emotional aspects of them — the baggage we all bring.
  2. Change your mindset. Successful innovation involves a change of practice and a change of mindset. The innovator’s mindset goes from a linear focus on problems, success, and failure to a non-linear focus on opportunities, learning, and developmental design.  This allows you to spot the reinforcing looping behaviour and addiction pathways as well as what other pathways are open to you.
  3. Create better systems, not just different behaviour. Complex systems have path-dependencies — those ruts that shape our actions, often unconsciously and out of habit. Consider ways you organize yourself, your organization’s jobs and roles, the income streams, the system of rewards and recognitions, the feedback and learning you engage with, and composition of your team.  This rethinking and reorganization are what changes DNA, otherwise, it will continue to express itself through your organization in the same way.
  4. Make change visible. Use evaluation as a means to document what you do and what it produces and continue to structure your work to serve the learning from this. Inertia comes from having no direction and nothing to work toward. We are beings geared towards constant motion and making things — it’s what makes us human. Make a change, by design. Make it visible through evaluation and visual thinking – including the ups, downs, sideways. A journey involves knowing where you are — even if that’s lost — and where you’re going (even if that changes).

Change is far more difficult than people often think. Change initiatives that are rooted solely in motivation are unlikely to produce anything sustainable. You need to get to the root, the DNA, of your organization and build the infrastructure around it to enable it to do the work with you, not against you. That, in Facebook terms, is something your brand and its champions will truly ‘Like’.

 

* Seriously. I have a Ph.D. and am reasonably tech literate and have sat down with others with similar educational backgrounds — Ph.D.’s, masters degrees, tech startup founders — and we collectively still couldn’t figure out the privacy settings as a group.

References: For those interested in system dynamics or causal loop modeling, check out this great primer from Nate Osgood at the University of Saskatchewan. His work is top-notch. Daniel Kim has also written some excellent, useful, and practical stuff on applying system dynamics to a variety of issues.

Image credit: Shutterstock used under license.

design thinkingknowledge translationpublic healthsystems thinking

Design (re)Thinking Health Systems

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How might we design health systems to promote health and wellbeing and not just treat illness and disease and manage infirmary and chronic conditions? What if health systems were about health?

If we were to apply design thinking to health systems, what might be do?

In a previous post, I suggested that knowledge translation is too important to be trusted solely to health professionals, partly because they  have largely failed to take up the charge. Taking a step back — a systems thinking perspective — one realizes that to design better knowledge translation, we need to design better health systems.

Julio Frenk, Dean of the School of Public Health at Harvard, believes this too. In a 2010 paper published in PLOS Medicine, Frenk comments on the state of health systems and examines how we might re-think them in light of global health challenges.

Health systems are the main instrumentality to close the knowledge–action gap. To realize this potential, it will be necessary to mobilize the power of evidence to promote change. Yet all too often reform efforts are not evaluated adequately. Each innovation in health systems constitutes a learning opportunity.

Frenk’s article is an invitation to engage in systems and design thinking about health. Both approaches invite pause to consider what the problem is in the first place. For design thinkers, problem scoping is the first step.

For systems thinkers this is akin to setting the boundaries around the problem.

Once we set the boundaries and find the appropriate problem, we then frame it appropriately for design. Problem definition is something often over-looked or under appreciated, but is the core of effective problem solving and design.

If I had an hour to solve a problem I’d spend 55 minutes thinking about the problem and 5 minutes thinking about solutions – Albert Einstein

Health systems are typically defined in light of professional services and policies aimed at making the sick well. They are essentially illness and disease (sick care) systems.  This conceptualization, still dominant in the professional and policy discourse in many Western countries, places medicine at the centre of health services with the allied disciplines working alongside, but rarely ventures its gaze beyond the institutions of care or the conditions such institutions are designed to treat.

Frenk, writing in PLOS Medicine, suggests its time to expand our view of what makes a health system if we are to truly promote and sustain global health and see three key points as provoking such re-thinking:

First, health has been increasingly recognized as a key element of sustainable economic development [1], global security, effective governance, and human rights promotion [2]. Second, due to the growing perceived importance of health, unprecedented—albeit still insufficient—sums of funds are flowing into this sector [3]. Third, there is a burst of new initiatives coming forth to strengthen national health systems as the core of the global health system and a fundamental strategy to achieve the health-related Millennium Development Goals.

In order to realize the opportunities offered by the conjunction of these unique circumstances, it is essential to have a clear conception of national health systems that may guide further progress in global health.

Frenk offers some suggestions:

Part of the problem with the health systems debate is that too often it has adopted a reductionist perspective that ignores important aspects. Developing a more comprehensive view requires that we expand our thinking in four main directions.

First, we should think of the health system not only in terms of its component elements (like human resources, financing, hospitals, clinics, technologies, etc.) but most importantly in terms of their interrelations. Second, we should include not only the institutional or supply side of the health system, but also the population. In a dynamic view, the population is not an external beneficiary of the system; it is an essential part of it.

It’s important to note the mention of the role of the population and its dynamical impact on the system. As populations change dramatically in their composition and form of residency within countries, including a greater movement to urbanization, so too will the myriad factors that influence health systems. The people are the system and thus it will change as populations change. While Frenk lists this as one point of many, it is a radical departure for reductionists or those who see health systems as being about care, not people.

A third expansion of our understanding of systems refers to their goals. Typically, we have limited the discussion to the goal of improving health. This is, indeed, the defining goal of a health system. However, we must look not only at the level of health, but also at its distribution, which gives equity a central place in assessing a health system. In addition, we must also include other goals that are intrinsically valued beyond the improvement of health. One of those goals is to enhance the responsiveness of the health system to the legitimate expectations of the population for care that respects the dignity of persons and promotes their satisfaction. The other goal is fair financing, so that the burden of supporting the system is distributed in an equitable manner and families are protected from the financial consequences of disease.

Frenk’s third challenge is to affirm the very point of health systems at all.

While not explicitly speaking of systems thinking or design thinking, there is much that both fields have in common with Frenk’s argument. Design thinkers might ask: What have we hired our health system to do?

Frenk argues that our health systems must go well beyond just making gains in measured health outcomes towards dignity, respect and social justice.

Finally, we should expand our view with respect to the functions that a health system must perform. Most global initiatives have been concerned mainly with one of those functions, namely, the direct provision of services, whether they are medical or public health services. This is, of course, an essential function, but for it to happen at all, health systems must perform other enabling functions, such as stewardship, financing, and resource generation, including what is probably the most complex of all challenges, the health workforce.

Frenk did not identify specific solutions, but did pose some key questions for health systems design.

If we were to take this challenge up as designers and systems thinkers, what might we do? Here are some suggestions for inquiry:

  • Consider new definitions of health like the one posed in the British Medical Journal that emphasizes looking at the social and environmental influences on health beyond just the absence of physical symptoms. Further inclusion of a psychology of human flourishing might add to this definition.
  • Map out a new system visually with people at the centre, not professionals or institutions. What does that look like? Tools like a Gigamap might provide the kind of multi-media, multi-sensory visual way to conceive of the interrelationships that make up health system. System dynamic models can help this out as well.
  • Engage people across this system to validate this map and co-create possible future models that could serve to shape discussion at multiple levels and  mobilize civil society to support healthy environments.
  • Create small scale, safe-fail / fail-forward, prototypes of small-scale innovations that can be tested, developmentally designed, and rapidly re-developed as needed to start shifting the system as a whole.

Designing health requires designing health systems. Applying new thinking and envisioning a system that is dynamic, comprised of people and just institutions is a start.

Photo: Bartolomeo Eustachi: Peripheral Nervous System, c. 1722 shared by brain_blogger used under Creative Commons Licence

behaviour changecomplexityeducation & learningenvironmenthealth promotion

Complexity and the Information Landscape

 

This morning the newswires are buzzing with a story that alleges Britain’s Climatic Research Unit fudged some of its climate change data and suggesting that a ‘bunker mentality’ took hold in the unit, which led to this kind of skewing of the data and science. One scientist told Doug Saunders from the Globe and Mail that “It wouldn’t be an exaggeration to say that this has set the climate-change debate back 20 years.” Indeed, with the Copenhagen Climate Summit about to start, there is real concern that these allegations – whether proven true or not — will impair the delegates’ ability to reach a deal.

On a different, yet related note, yesterday I went and got my H1N1 shot and was told by the official guiding people through the clinic that about 37 percent of the population of Toronto have had the vaccination. I went to the downtown clinic and waited about 2 minutes to see someone, which is in stark contrast to what we saw a few weeks ago.Why? The threat of H1N1 seems much less in the here and now than it did a few weeks ago when, in the span of one weekend, when U.S. President Obama declared swine flu a national emergency, and two young people in Ottawa died from H1N1. Towards the end of October, H1N1 seemed a lot more scary and that made the issue a lot simpler: get protected or die (or so it seemed)

So what do these two stories have in common? Both illustrate the problem of complexity in the information landscape. H.L. Mencken is quoted as saying: “For every complex problem there is an answer that is clear, simple, and wrong“.

The problem that public health and scientific research faces is that it is in the business of complexity, yet the business of the media is too often in simplicity.  This caused that. That person is bad, this person is a hero and so on. The archetypes and stereotypes come in spades and that is the problem. On the issue of climate change, most scientists worth their salt looking at the data are concerned about what is happening to our climate, not because they know for sure, but because they don’t. In a complex system like the environment, the overlaying causes, consequences and potential confounders of data make it impossible to say for sure that something causes something else in a specific dose. What can be done is that we can observe large scale patterns of behaviour and anticipate changes based on models developed using past, current and possible future (estimated) data and scenario planning.

In public discourse however, this makes for a less compelling story. Many like to think that buying a hybrid car, recycling, and carrying a reusable shopping bag will help solve the problem of climate change, when the truth is an entire system of small changes needs to take place if we really want to make a difference. This speaks to a fundamental lack of understanding of complexity.

With the H1N1 example, complexity is less about the cause and effect relationship of the disease and host and more about the vaccine developed to help prevent it. There are an entire littany of websites, pundits and voices who have turned something that is complicated like a vaccine, with potential complex outcomes in rare events such as allergic reactions, into overly complex issues around patient safety, conspiracy theories and the like. I commented on some of these issues in a previous post. At issue here is a fundamental lack of understanding of statistics and probability.

The problem is that the two are related. For those of us in public health, this is an issue that can lead to sleepless nights. How to both make complex information accessible and interpretable to those without the interest, time or ability to sift through it and make reasoned, informed decisions AND how to enhance people’s understanding of probability? Just yesterday in my course on health behaviour change a student in epidemiology remarked that even something as fundamental as an odds ratio to her field gets debated and misunderstood among her peers. John Sterman at MIT has studied his students — ones that learn about system dynamics — and found that many of them have difficulty grasping the fundamentals of the ‘bathtub problem’ and accumulation, which I discussed in a previous post.

I would argue that this is one of our most fundamental challenges as educators, scientists and members of society.

Think you know about stats and complexity? You might be surprised (and entertained) by how randomness creeps into our lives by listening to the recent podcast on recent episode on stochasticity, or randomness, from WNYC’s Radio Lab.

education & learningpsychologysocial systemssystems sciencesystems thinking

Back to School and the Lesson of Accumulation

For millions of kids and young adults and the many faculty and family members associated with the noble profession of teaching, today is the biggest day of the year. It’s back to school.

School and learning are clearly on the minds of many these days. As I posted last week, there is much to be concerned with how education is (or is not, depending on your point of view) being funded. Yesterday I read an editorial on the CBC’s website from a teacher who pointed to the stress that his profession is under and how it is killing those who choose to remain in it.

“I think that the whole idea of teaching has changed in the last 15 to 20 years,” says Emily Noble, past-president of the Canadian Teachers’ Federation.

“People are dealing with more high-need students, with more multicultural issues and with no-fail policies.

“Teachers want to make a difference, but the supports are just not there.”

It’s not a particularly rosy time for educators of any stripe.

Anyone who’s been at the head of the classroom (myself included) knows that teaching is as much of a vocation or calling as it is a job. It is not something you do from 9-5 or whatever the set hours are. If you ran an education system on ‘work to rule’ where people did just what their job required of them within normal hours, paid them an hourly wage and had them account for every minute they worked, the system would collapse within weeks. I can’t imagine that there has ever been a greater gap between what teachers actually do and what they are perceived to do by those outside of the profession. As a professor, I routinely shock people who think that I have 4 months off each summer and spend the remaining 8 wandering the hallowed halls of academe ‘thinking big thoughts’, reading books and conversing with grad students in between teaching duties. Between ongoing grant writing, doing research, conference presentations, thesis defences, supervising staff, writing, and preparing our courses for the fall (including adding in the H1N1 provisions this year) summers are anything but idyllic times off. There’s a lot of stress in this job and, as a recent double issue of the Journal of Human Behavior in the Social Environment explored, it manifests itself in many (mostly harmful) ways. Still, most of us do it because we believe in our profession and, mostly, enjoy what we do.

Whether at university or primary or secondary school, teaching as a whole is undergoing a major change. As Smol writes:

There is a general understanding that things “are not the same as they once were.”

Teaching has always been a tough, but rewarding job in part because there’s always new things to learn and we, as humans, are wired for learning. Teaching is also a dynamic profession aimed at supporting this learning, but as Smol and others have written, the changes that are happening in education are great and fast and without the structural supports in place to help these changes take place. I wrote of resliency in my last post, arguing that we’re testing the resilience of our education system with this imbalance between demands and resources. Today I want to focus on another important systems concept: accumulation.

It turns out, people are lousy at understanding how things build up over time. A study by John Sterman from MIT, one of the leading scholars in system dynamics, found that even among his students — some of the best, brightest and well-equipped to handle this topic given that it is part of their studies — most have a poor sense of what accumulation really means. So do educational policy makers I suspect. The reason this is important for education is that as accumulation of stress builds the likelihood of something going amiss increases dramatically. A tipping point, that term popularized by Malcolm Gladwell in his book by the same name, is an expression of accumulation.

In our case of education, the tipping point could come when people no longer want to become teachers en masse. Or, it becomes nearly impossible to hire good, quality educators for anything other top salaries, which in an age when even the basics aren’t funded, seems unlikely. Or, teachers begin to amass more sick days than ever before (which is already happening) creating disruptions in the classroom. (Note: Remember those days when the substitute teacher came to class? Were those ever days filled with lots of learning and orderly classrooms? Not often. Imagine that on the rise as teachers start to miss days on the job a little more)

The unintended consequences could see parents fleeing the public system of education for private institutions, leaving a growing gap between the education of the haves and have nots  even more than exists today. Another option is that some other market form of education replaces our current system. Among the many scenarios that could play out, most suggest that the system could break. And when systems break suddenly and quickly, the stress increases, which seems a little counterproductive given that it is one of the problems in the first place.

The Arab proverb about ‘the straw that broke the camel’s back’ comes to mind here. The mistake is thinking that a single straw caused all that damage. It did, but only because of its relationship to all the other straws. Each straw weighs the same and presumably has the same relative impact on the camel. What tipping points show is that, despite this similarity between objects (straws, stressors, whatever…) not all are created equal in terms of their impact. While it is true that each individual object taken on its own is relatively the same, the cumulative impact makes each of them quite different. That ‘last straw’ (which, incidentally, is the name of a great teaching game on the social determinants of health) , has far more influence than any other straw. What we don’t often know is which straw will serve as the ‘last’ one. How resilient is the system? What is its carrying capacity? We don’t know, but by paying attention we can anticipate problems ahead and potentially avoid this last straw scenario and the tipping points that follow.

So as you go back to school, consider bringing something other than just an apple for the teacher.  Perhaps a lesson in accumulation for the principal, school board officials, the public taxpayer, and educational policymakers will do.