Systems Engineering

This paper describes how to use a positive deviance-inspired process for improving the practice of systems engineering, and how positive deviance fits into an evolutionary improvement strategy. It illustrates the process with examples from both systems engineering and cases studies outside of systems engineering. In particular we cite the experience of the team that authored the DoD systems engineering guide for systems of systems (SoS) [Ref 1]. They developed a representation of how successful SoS engineering practitioners view and do systems engineering that is substantially different from their individual system counterparts. The cases outside of systems engineering relate to an antistarvation program in rural Vietnam and a 150-year old problem of inadequate hand scrubbing and infections in hospitals [Ref 2]. Even with substantial progress in technology, processes, and efficiencies, complex problems from enterprise systems engineering to nutrition to medical needs still stubbornly resist improvement. By using a positive deviance-inspired approach, this can be reversed.

While healthcare organizations strive to increase control of network access, clinicians need unencumbered access to data. Clinicians make unconscious decisions daily to comply with security measures or to live with a certain level of insecurity to get their job done.

Healthcare providers and network administrators, already grappling with the tradeoff between the timely availability of electronic health records and patient confidentiality concerns, now have to consider the implications of complying with HIPAA mandates. In an effort to balance appropriate accessibility with HIPAA's stricter security mandates, many are considering the use of single network sign-on approach for authentication and password management. While this seems to be a simple and viable solution, our field work in a regional hospital revealed fundamental mis-matches with routine work practices that will significantly impact its effective adoption.