Healthcare EQ collaborates with professionals, organizations and institutions dedicated to the health and well-being of people and  communities.  Members of the company operate as reflective practitioners with expertise and experience in business transformation and the adoption of advanced information technologies.  Some of the foundation frameworks that influence our approaches include:

Combining an industry alignment in healthcare with a deeper appreciation of leading practices and theories guides our collaborations with reason, pragmatism and maturity.

1. Service systems science is a 21st-century perspective on institutions and the world of work in the 21st century.

  • For healthcare organizations, the service systems perspective emphasizes the value to patients and society, over the production-oriented perspective associated with 20th century industrial organizations. [IfM and IBM 2008, p. 6]
  • Beneficiaries of healthcare systems receive interactive value through ongoing engagement, rather than value-added through a service transaction. [Ramirez and Wallin 2000]
  • The improvement of healthcare services advances through communities of practice, where social participation is a process of learning and knowing.  The design of learning can be expressed as dualities in four dimensions:(i) participation and reification; (ii) the designed and the emergent; (iii) the local and the global; and (iv) identification and negotiability.  Learning involves not only members of communities of practice, but also the technical world of tools with which work is carried out. [Wenger 1999, p. 233]

2. Dynamic stability informs the design of organizations, in recognition of needs to manage product change and process change.  Feasible paths of maturity progress from:(i) invention (dynamic product, dynamic process), to (ii) mass production (stable product, stable process), to (iii) continuous improvement (stable product, dynamic process), to (iv) mass customization (dynamic product, static process).  [Boynton, Victor and Pine 1993].  In the delivery of services, software developers have been strong advocates on the formalization of business designs.

  • In modularizing capabilities within the IBM services organization, configurable development processes center on a “work product” approach. [Cameron 2002, pp. 73-74]
  • Some of this intellectual capital now appears in the Eclipse Process Framework Project, as an open source contribution by IBM. [Eclipse Foundation 2006]
  • These foundations have been further tailored into Disciplined Agile Delivery. [Ambler and Lines 2012]

3. Systems thinking is a perspective on wholes, parts, and their relations.  As such, it is general framework that can be applied both in organizational settings and with technologies.

  • The design of service systems, such as those in healthcare, can be informed through organizational systems science, with the legacy of the socio-psychological systems perspective, the socio-technical systems perspective, and the socio-ecological systems perspective. [Takala 2012]
  • The strategic alignment model conceptualizes four fundamental domains of strategic choice in business strategy, information technology strategy, organizational infrastructure processes, and information technology infrastructure and processes. [Henderson and Venkatraman 1993, p. 6]
  • The sense-and-respond organization is a managerial paradigm that contrast with the make-and-sell behaviors of industrial-age organizations. [Haeckel 1999]

The frameworks of service systems science, dynamic stability and systems thinking overlap, and are mutually reinforcing.  They are not the only foundations on which our practices are based, but do represent a complement which members of the company share.


Ambler, Scott W., and Mark Lines. 2012. Disciplined Agile Delivery: A Practitioner’s Guide to Agile Software Delivery in the Enterprise. IBM Press.

Boynton, Andrew C., Bart Victor, and B. Joseph Pine. 1993. “New Competitive Strategies: Challenges to Organizations and Information Technology.” IBM Systems Journal 32 (1): 40–64. doi:10.1147/sj.321.0040.

Cameron, John. 2002. “Configurable Development Processes.” Communications of the ACM 45 (3): 72–77. doi:10.1145/504729.504731.

Eclipse Foundation. 2006.  “Project Description”. Eclipse Process Framework Project

Haeckel, Stephan H. 1999. Adaptive Enterprise: Creating and Leading Sense-and-Respond Organizations. Boston, MA: Harvard Business School Press.

Henderson, John C., and N. Venkatraman. 1993. “Strategic Alignment: Leveraging Information Technology for Transforming Organizations.” IBM Systems Journal 32 (1): 4–16. doi:10.1147/sj.382.0472.

IfM, and IBM. 2008. “Succeeding Through Service Innovation: A Service Perspective for Education, Research, Business and Government”. Cambridge, UK: University of Cambridge Institute for Manufacturing.

Ramírez, Rafael, and Johan Wallin. 2000. Prime Movers: Define Your Business or Have Someone Define It Against You. Chichester, England: Wiley.  [preview on Google Books]

Takala, Minna.  2012.  “Revisiting the Socio-ecological, Social-technical and Socio-psychological Perspectives”, Sixteenth IFSR Conversation (April 14-19, 2012), Gerhard Chroust and Gary S. Metcalf (editors), International Federation for Systems Research.

Wenger, Etienne. 1999. Communities of Practice: Learning, Meaning and Identity. Cambridge, UK: Cambridge University Press.  [preview on Google Books]