1. 1. FG 2014 Academic vs Health System Driven Research: Overcoming Dichotomy through an Integrated Public System?
2. 2. FG 2014 We are talking about A.Evolution B.Discoveries C.Innovation D.Sustainability
3. 3. 5FG 2012 from evolution to sustainability
4. 4. FG 2014 A.Evolution Survival of the fittest Herbert Spencer (27 April 1820 8 December 1903) Principles of Biology (1864)
5. 5. FG 2014 A.Evolution from Darwin better designed for an immediate, local environment Carles Darwin (12 February 1809 19 April 1882) On the Origin of Species (edition 1869)
6. 6. FG 2014 A.Evolution to Gould Our evolutionary colleagues also failed to grasp the implication(s), primarily because they did not think at geological scales Stephen Jay Gould (10 September, 1941 20 May 2002)
7. 7. FG 2014 A.Evolution Punctuated Equilibrium
8. 8. FG 2014 A.Evolution Evolution is inefficient
9. 9. FG 2014 Cambrian sea
10. 10. FG 2014 A.Evolution in culture Rosvall and Bergstrom (2010) PLoS One 6:e18209
11. 11. FG 2014 A.Evolution of culture is quite lamarckian 1. Use and disuse Individuals lose characteristics they do not require and develop characteristics that are useful 2. Inheritance of acquired traits Individuals inherit the traits of their ancestors Jean-Baptiste Lamarck (1 August 1744 18 December 1829)
12. 12. FG 2014 B.Discoveries
13. 13. FG 2014 B.Discoveries: Basic research needs contamination
14. 14. FG 2014 B.Discoveries we cant know the future in advance
15. 15. Principi Metodi Strumenti www.leanuk.org Conventional Workshop Examples Through Time "...so many centuries after the Creation it is unlikely that anyone could find hitherto unknown lands of any value. Committee advising King Ferdinand and Queen Isabella of Spain regarding a proposal by Christopher Columbus, 1486 "The view that the sun stands motionless at the center of the universe is foolish, philosophically false, utterly heretical, because contrary to Holy Scripture. The view that the earth is not the center of the universe and even has a daily rotation is philosophically false, and at least an erroneous belief." Holy Office, Roman Catholic Church, ridiculing the scientific analysis that the Earth orbited the Sun in edict; 1616 "Everything that can be invented has been invented. Charles H. Duell, Commissioner, U.S. Office of Patents, 1899. "Stocks have reached what looks like a permanently high plateau. Irving Fisher, Professor of Economics, Yale University, 1929. (two weeks later, the stock market crashed and the Great Depression started) "We don't like their sound, and guitar music is on the way out anyway. President of Decca Records, rejecting The Beatles after an audition, 1962 Copyright Lean Enterprise Academy 2009
16. 16. Principi Metodi Strumenti www.leanuk.org Conventional Workshop Examples: Aviation "Man will not fly for 50 years. Wilbur Wright, American aviation pioneer, to brother Orville, after a disappointing flying experiment, 1901 (their first successful flight was in 1903) "Airplanes are interesting toys but of no military value. Marechal Ferdinand Foch, Professor of Strategy, Ecole Superieure de Guerre, 1904(?) "Flight by machines heavier than air is unpractical and insignificant, if not utterly impossible. Simon Newcomb, Canadian-born American astronomer, 1902 "If God had intended that man should fly, he would have given him wings. Widely attributed to George W. Melville, chief engineer of the U.S. Navy, 1900 "It is apparent to me that the possibilities of the aeroplane, which two or three years ago were thought to hold the solution to the [flying machine] problem, have been exhausted, and that we must turn elsewhere. Thomas Edison, American inventor, 1895 "Heavier-than-air flying machines are impossible. Lord Kelvin, British mathematician and physicist, president of the British Royal Society, 1895 Copyright Lean Enterprise Academy 2009
17. 17. Principi Metodi Strumenti www.leanuk.org Conventional Workshop Examples: Computing " 640k ought to be enough for anybody. Bill Gates, 1981 "There is no reason anyone would want a computer in their home. Ken Olson, president, chairman and founder of Digital Equipment Corp., 1977 "But what ... is it good for? Engineer at the Advanced Computing Systems Division of IBM, 1968, commenting on the microchip. "I think there is a world market for maybe five computers. Thomas Watson, chairman of IBM, 1943 "Computers in the future may weigh no more than 1.5 tons. Popular Mechanics, "predicting" the relentless march of technology, 1949 "The world potential market for copying machines is 5000 at most. IBM , to the eventual founders of Xerox, saying the photocopier had no market large enough to justify production, 1959Copyright Lean Enterprise Academy 2009
18. 18. Principi Metodi Strumenti www.leanuk.org Conventional Workshop Examples: Telephone "It's a great invention but who would want to use it anyway?" Rutherford B. Hayes, U.S. President, after a demonstration of Alexander Bell's telephone, 1872 "The Americans have need of the telephone, but we do not. We have plenty of messenger boys. Sir William Preece, Chief Engineer, British Post Office, 1878 Transmission of documents via telephone wires is possible in principle, but the apparatus required is so expensive that it will never become a practical proposition. Dennis Gabor, British physicist and author of Inventing the Future, 1962 "A man has been arrested in New York for attempting to extort funds from ignorant and superstitious people by exhibiting a device which he says will convey the human voice any distance over metallic wires so that it will be heard by the listener at the other end. He calls this instrument a telephone. Well-informed people know that it is impossible to transmit the human voice over wires. News item in a New York newspaper, 1868 "Well-informed people know it is impossible to transmit the voice over wires and that were it possible to do so, the thing would be of no practical value. Boston Post, 1865 Copyright Lean Enterprise Academy 2009
19. 19. FG 2014 Human Genome Sequencing
20. 20. FG 2014 C.Innovation we cant know in advance which discovery will lead to innovation
21. 21. FG 2012 21 innovation novelty in action 12-12-12
22. 22. 6FG 2012 Garjon et al. BMC Health Services Research 2012
23. 23. FG 2014 C.Innovation are new drugs actually innovative? me-too!?
24. 24. FG 2014 C.Innovation
25. 25. FG 2014 C.Innovation
26. 26. FG 2014 C.Innovation
27. 27. FG 2014 C.Innovation
28. 28. FG 2014 C.Innovation Innovation is expensive
29. 29. FG 2014 D.Sustainability Is innovation sustainable?
30. 30. FG 2014 D.Sustainability closed systems that maintain processes of productivit Melvin K. Hendrix, Sustainable Backyard Polyculture: Designing for ecological resiliency. Smashwords Edition, 2014
31. 31. FG 2014 D.Sustainability
32. 32. 23FG 2012
33. 33. 24FG 2012
34. 34. 25FG 2012
35. 35. FG 2014 D.Sustainability Public value allows us to consider the role of hospitals in meeting object Public value thus goes beyond utilitarian objectives of outcomes and eff The diverse public values wider, ethical objectives like equity, due proc
36. 36. FG 2014 Sustainability is for the future Innovation is expensive We cant know in advance which discovery will lead to innovation Evolution is inefficient
37. 37. FG 2014 but... evolution is ineludible, simply we need it!