Fannie E. Rippel Foundation

Seeding innovations in health
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The ReThink Health Dynamics project is helping to create the next generation of tools for understanding and influencing local health system innovation.  Our main products are a suite of place-based simulation models and an experiential game.  Both offer powerful resources for innovators who are serious about crafting a more effective, equitable, and less costly health system.
Steps in Modeling Dynamic Systems

The science and art of system dynamics modeling has evolved over the past 50+ years.  Its main steps are to:

  • Map the forces that drive persistent problems (e.g., poor health, inadequate care, rising cost)
  • Mathematically model those forces using the best information available
  • Simulate “What if…” scenarios of possible interventions, alone and in combination
  • Critique the model, test its sensitivity to uncertainties, and guide future research
  • Convene “Action Labs” for model-supported planning by diverse stakeholders
  • Distill robust lessons into a simplified game to inspire and inform new innovators

Simulation and gaming compensate for common obstacles that threaten to delay, dilute, or defeat even the most sincere system change ventures.

Unaided planning is fraught with…
Simulation and gaming offer…
Imprecise vocabulary
Unproductive conversations
Unintended consequences
Narrow self-interests
Short-term focus
Incomplete, disjointed data
Hidden trade-offs
Fear and cost of experimenting		 Precise vocabulary
Focused engagements
Robust results
Expansive self and social values
Balanced short- and long-term view
Integrated evidence
Explicit priorities
Freedom to experiment

 

Beyond offering greater foresight, these methods also motivate action by letting leaders see and feel what high-leverage innovation could accomplish.

Diverse teams in several cities are now tailoring an early version of the ReThink Health model to reflect their circumstances.  That tool, in turn, will help them to question how their local health system is structured, how it may change or resist change, and what they could do—alone and together—to achieve better results.

Goals

Our goals in working with change agents and regional cross-sector collaborations are both ambitious and pragmatic:

  1. Design a realistic but simplified portrait of a health system for experimental learning
  2. Assemble essential information into a credible—and testable—analytic framework
  3. Let planners create and play out the likely consequences of their own intervention scenarios
  4. Embrace uncertainty while dramatizing the potential for change—as well as the stakes of inaction
  5. Convey trustworthy insights about what it takes to enhance health system performance
Testing Hypotheses to Enhance Innovation

In the process of working to achieve these goals, the following hypotheses are being tested:

  • The ability to see the health system as a wider and more dynamic enterprise will result in better insights and more transformational short and long term interventions
  • Innovators will develop greater foresight and motivation for action if they can first test their ideas in the virtual world of a model or game
  • Seeing the results from simulated scenarios will generate optimism, urgency, humility, and useful insights for shaping an effective system change strategy
  • Comparing intervention scenarios with colleagues, in facilitated sessions, will foster stronger networks and reveal opportunities to better align their work
  • An online game will reach new audiences of potential champions for health system change