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Design for Care

We Tried to Warn You

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Emerging Contexts of Systemic Design – ISSS 2014

The 2014 ISSS conference held at George Washington U was organized and convened by current president Gerald Midgely, ( U of Hull) who this year hands off the lead to Open University’s Ray Ison, a leading researcher in water ecosystems. Ray will lead next year’s ISSS conference in Berlin and will be looking for inspiring new ideas for this nearly 60-year organization.

Gary Metcalf provides an excellent recap of the ISSS plenary sessions at the Saybrook University blog. Proceedings are not yet published for the current conference, but the prior years are available online.

The theme for this year was appropriately titled “Leading Across Boundaries,” a clear call to engage ideas across the disciplines to which systems theory and thinking contribute.  I opened this year’s new track in Systemic Design at ISSS 2014 with a context presentation of systemic design in the context of systems practice and education (the additional research paper PPT is posted below this piece).  Our session was highlighted by talks from Ray Ison (Systems and Design: Mutually influencing disciplines and practices?) and Tony Hodgson, who presented his latest Three Horizons work in the context of foresight and systemic design.

Our intent was to share the developing relationships of design thinking to systems research and practice and inspire people in the systems community to contribute to this common ground.  Leading researchers in service and social design have formed a durable discourse toward systems-oriented design as a transdisciplinary design discipline, so we hoped to discover shared cause with the systems disciplines.

Graduate design programs have begun seriously integrating systems thinking courses and pedagogies into leading degree programs. Between the continents, AHO’s Systems-Oriented Design and OCAD University’s Strategic Foresight and Innovation have co-evolved curricula, symposia and workshops over recent years toward the development of a shared space of systemic design research for complex services and social and human-centered systems. This collaboration has resulted in an annual symposium, RSD (moving to Canada for 2015 and 2016), and shared research projects.

Recent Reviews for Design for Care

Design for Care has apparently been discovered by the larger design community this year, after a year in print!  With the launch in June 2013, I had thought that between Rosenfeld Media and my own decently-connected network we might find numerous reviews in the first few months – but more reviews have emerged so far this year. Of course I’m appreciative, they’re all insightful pieces, and its so heartening to me to find that readers are getting the message. The late reviews trend also indicates that the book may have several cycles of discovery. Some of the more in-depth reviews include:

These are primarily reviews within design publications – there are only a few in the healthcare field, and I hope to see more uptake in the clinical and educational domains. My hope is that the late appreciation of the work suggests that the book was slightly ahead of its time, and is connecting with thoughtful readers as its discovered, rather than through reviews being pushed by author or publisher.

Design Research Methods for Systemic Design

From the presentation at ISSS 2014, Washington DC

The recent development of systemic design as a research-based practice draws on long-held precedents in the system sciences toward representation of complex social and enterprise systems. A precedent article, published as Systemic Design Principles for Complex Social Systems (Jones, 2014) established an axiomatic and epistemological basis for complementary principles shared between design reasoning and systems theory. The current paper aims to establish a basis for identifying shared methods (techne) and action practice (phronesis). Systemic design is distinguished from user-oriented or industrial design practices in terms of its direct relationship to systems theory and explicit adoption of social system design tenets. Systemic design is concerned with higher-order socially-organized systems that encompass multiple subsystems in a complex policy, organizational or product-service context.

By integrating systems thinking and its methods, systemic design brings human-centered design to complex, multi-stakeholder service systems as those found in industrial networks, transportation, medicine and healthcare. It adapts from known design competencies – form and process reasoning, social and generative research methods, and sketching and visualization practices – to describe, map, propose and reconfigure complex services and systems.

Appetite for Disruption

The goal of a startup is no longer just user engagement or viability. A “preference for disruption” is celebrated, without reservation, whether a small or big business. (Only recently were reservations even fussed over – Jill Lepore’s critique of Disruption culture was published the week after this conference talk, June 23.)  She states (without critical analysis of causation):

“Ever since “The Innovator’s Dilemma,” everyone is either disrupting or being disrupted. There are disruption consultants, disruption conferences, and disruption seminars. This fall, the University of Southern California is opening a new program: “The degree is in disruption,” the university announced. “Disrupt or be disrupted,” the venture capitalist Josh Linkner warns in a new book.”

As an ethnographer of innovation practices, I have always appreciated Christensen and his contribution to theories of change. I also observe the trend signified by Lepore, the increasing meta-narrative of “disruption is good.” Disruptive innovation is not always beneficial to a society or even markets.  In Design for Care I fret over the preference for disruption in current business thinking and its unjustified hubris in the healthcare field.  With the mantra of disruption, we can gain attention by claiming the long process of disruptive innovation is occurring, for whatever it is we supposedly want to change. Much of this talk is (technically) bullshit, technology-centric wishful thinking promulgated as a rhetoric of winning, that ignores the realities of institutional practice and the complex forces and demands in healthcare that function differently.

Lepore starts to critique the social effects of disruption rhetoric, but she doesn’t go far enough in critique of cultural effects. However, she’s wrong to blame Clay Christensen for the wave of current disruption talk, as disruption has become a theme of startup and business culture only loosely based on Christensen at this point. She unfairly critiques The Innovator’s Dilemma, the 1997 work based on Christensen’s earlier research on the disk drive industry. But Christensen describes a very real systemic effect within business cycles, that new markets grow around inexpensive but viable alternative products and services, and that these markets can grow under the new cost structure and shift market share to the new provider. I observed the  struggles and barriers to effective innovation practices in my own research of within-organizational innovation, discovering causes resulting from shifts in a company’s values (which of course are influenced by success and a growing customer base, also consistent with Christensen’s Resources-Process-Values theory).  When successful products prevent strategic innovation. Design Management Journal, 2002, 13 (2).

Disruption has become in itself desirable, presumably preferred because of the theory of displacing entrenched regimes. It is the ultimate asymmetric power play, as the algorithmic efficiency of the startup is believed the inevitable winner in a technocentric future. We have culturally created a preference for technological innovation as a “disruptive” force, even in social domains such as education and healthcare. We now expect technology to save us, to provide ready-made “solutions” for supposedly entrenched problems, problems which are often framed as stupidly as “healthcare is broken. Obviously we must fix it.”

Evgeny Morozov eviscerates the Silicon Valley business of solutionism in his recent work, aiming to shift discourses from technological fixes of everything to shore up our collective ability to think and speak well about concerns.  In an interview with Columbia Journalism Review his book To Save Everything Click Here is framed as an attempt

“to integrate the debates about technology into the broader debates about politics, economics, history, and culture—areas of study with much richer traditions and far greater intellectual resources for tackling the many challenges that technology presents. Such a shift in discourse, he feels, would limit the influence of those advocating narrow technological solutions to what are essentially non-technological problems—like spreading democracy—and would rob a word like “disruption” of the positive connotation it has acquired as a force for progress, allowing it to be seen instead as a painful example of neoliberal economics.”

The medium has become the message again, as disruption is not the fix itself but signifies the capacity for innovation, which has become celebrated as a cultural value, not the content of specifically valued developments. Any startup can be disruptive if we merely pivot it enough; any innovation is inherently and perhaps equally desirable to another. The embedded values that accompany technological disruption are rarely questioned, as the headline value of disruption and its promised effects sweeps away the questions that might be asked with a lesser fate. Our own values and social responses are increasingly mediated by technological culture, by apps, by “context”.  As a result, citizens become increasingly unable to imagine effective collective responses to actual shared concerns. Issues deemed too complex for political agreement and deliberation are deferred to the technological solutions of “innovation.”

Critics of Lepore (there were many) come down on her “incompetent” analysis of the Dilemma or her weakly-supported claims of an emerging “faith in disruption.” As she’s a business academic and not a cultural observer, she may have missed the larger system in which disruption fever is happening. We now live in a technogenic culture, a much larger cultural system that has disrupted several generations in society by replacing these “broader debates” with the promises of a frictionless future enabled by an ever-smaller number of ruling figures in Silicon Valley.