You know I want to try to utilise Christopher Alexander’s design insights here. If we want to have a living system that adapts to the natural complexity in the underlying problem (as distinct from ignoring it or adding to it accidentally) then the system must be unfolded. This means to start with something very simple, and develop good design choices at each of the subsequent steps, where each step deals with a particular issue and generates living complexity in a controlled fashion.
Of course the key is to know the process (not Prince or Cramm) that allows us to take the decisions in a sequence that gives the minimum of backtracking and reworking. The proper subject of study is precisely what this order might be and there are some ways of approaching this problem that use similar insights to Bill’s that we discussed below. I think for example that we might find that the issues of patient/doctor trust and choice was pivotal to the entire system and unless the way in which trust might support choice and choice might support trust was worked through then the entire technical infrastructure was likely to be non-functional.
So as a complexity generator for the system what do doctors need to know about patient choices and what do patients need to know about doctors’ choices and can a workable system be shown to generate trust and choice?