Tag Archives: personalized healthcare

Ann Pendleton Julian; Walter H. Kidd Professor, Austin E. Knowlton School of Architecture, The Ohio State University

THE SPIDER
When a spider makes a web the first step is to send out a thread, and then it uses the environment to send out the thread. The entire web sits on some type of construct. Once finished, the web must be strong enough to survive on its own. Some spider webs are able to stretch to 20 times their actual size and can even catch birds without breaking.

Elasticity and Resiliency in a Micro (Nano) Ecosystem:

The spider produces something that uses the environment and allows it to live. The spiders recycle the web each night.

A few important questions:
How do we measure and positively impact resiliency? Is understanding data enough to change behavior?  How do we really effect outcomes for wellness and do it at scale?

REDUCTIONISM
Behavior and perception are integrally linked. Reductionism is how we have been operating. From reductionism, laws that regulate the end universe have been transitioned more to Darwin and evolutionary processes. Small events can change the entire system over night. Causality is an adaptation of the internalized change to the environment.

ECOSYSTEM INTELLIGENCE
Ecosystems are complex emergent systems. Everything you do changes the system and you’re looking for patterns of change.

As a designer working on these complex systems, there are three things you can do:

1. Boundary conditions
2. Probes (things you put in the system to read the system)
3. Create new mechanisms (things to put into the system to create change)

Modulators are microprobes because they read the system backwards. Ambiguity is one of the most effective ways for us to understand the complexity of a system.

We must understand networks to design strategies for change. Networks have structure and function. The size of the network impacts how it functions. The shape relates to the relationships within the network, texture of the network and the function of the network.

Designing for emergence – Movement from low level rules to high level sophistication. The cobweb and snowflakes both emerge. There are 12 different environmental factors that impact these networks.

 WORLD BUILDING
A term that comes from cinema and relates directly to the narrative. We aren’t going to have an entirely new healthcare system, but we can look at ways to improve the complex system that already exists. How do you close the gap?

Systems of action = frameworks for evolution in society

THE TRIANGLE
Reshaping contexts to impact positive change. The change triangle is focused around several things:

1. Vision

2.  Macro-narrative: translating the vision

3. Micro-narrative

Vision is about sight, perception and the imagination. Without imagery you have nothing to engage other people or a way to look ahead or sell a project. Meta-narratives are things that are at the top. Meta-narratives can be myths, political slogans or other stories that we use to make sense of events and are deisgned to evoke the vision of the future. We need to be strategically ambiguous, positive and aspirational. “The American Dream” is ambiguous and can evolve over time and is something we can each adopt in a different way.

We have an entirely new way of looking at meta-narratives. In health it’s about resiliency and creating a wellness ecosystem. Behavior Modification encompasses modification, ability and triggers. The triggers are what begins to change a system. Social networks are at the center of the triangle. The networks have shape, structure and function and these factors determine how they work within the system.

Shape of the triangle – has changed, will change and will be more effective as it changes.

A Cambrian moment: over a very short period time, a large number of things started to appear (species, relationships between species and functions). A large number of things have come about recently in health care and are helping to impact the future of healthcare. How do we create a coherence around all of these new things?

Q & A

Q: In the design triangle and building of ecosystems, a lot of them seem to get back to the functioning of the social networks. Macro narratives lead to micro narratives. When we think about the tipping point of social epidemics, are there ways we can encourage people to change the way they act based on the ecosystem they’re living in?

A: How does it become a part of the persuasive way of understanding what’s going on? We need to begin to sense when there’s an epidemic. Could the micro narratives be the push in the system to change the system?

Q: Are the meta stories and myths the conceptual frames of reference for thinking about one’s relationship with the environment?

A: Yes, and they are the things that begin to bind together. The beauty is when you can see the shape of the triangle changing.

Q: In order for meta and micro narratives to be valuable, someone has to gather them and listen really well. For the mechanisms to be used, somebody has to figure out which one(s) to use. The who and what of social networks is involved in bringing this together and creating the change that we’re directed to do. How do we identify the who and what?

A: Who and what is important. The micro narrative is more about letting the system talk for itself because of the patterns that begin to develop. Who is trying to do what and what is the project of change that someone is involved in? OSU is taking a large role in the “who” of the complex involved and needed within the system. Think about the relationship of boundaries to scale: you need to get something small enough to work on, but large enough to imply a larger scale change.