Ph.D candidate, Lab Coordinator
Sam Petrie (BKI, Free Range scholar) is an Ph.D candidate in the Department of Health Sciences at the University of Carleton. His research interests include the scalability of pilot projects, the demographics of high-cost health users, and the use of telehealth / eHealth technologies to better serve rural communities. With an interdisciplinary undergraduate background in Knowledge Integration, he approaches complex problems from unique perspectives in a hope to develop impactful solutions.
Background: Implementation rates of e-health initiatives continue to be low despite increased private investment in health technologies and strong interest by healthcare organizations. One of the reasons for this is that most e-health initiatives are not designed for the complex adaptive systems in which they operate, and thus can be overcome by uncertainty and unforeseen events.
Objective: This debate paper discusses how the principle of antifragility could be used to ensure that e-health projects benefit rather than suffer from the inherent volatility of complex adaptive systems.
Discussion: Antifragility posits that it is possible for systems to gain stability from unpredictability. It is different than resiliency or robustness, as antifragile systems are not only unperturbed by volatility, but are strengthened. An antifragile e-health system would include the following three elements: 1) a blending of core and peripheral components, without the intervention losing its integrity; 2) the e-health project should have built-in optionality; and, 3) evaluating early pilot projects should be done as holistically as possible, with attention to sense-making, non-linearity, and irreducible complexity.
Keywords:Antifragile; Complex adaptive system; Sense-making; Non-linearity; Irreducible complexity; Optionality; Intervention component; eHealth.