Also within stage 13 of the systems engineering approach in service monitoring and update are areas of specialty. This is just one example. We often refer to this item in systems engineering as the ilities, and you'll understand what I mean in just a minute. It is important to remember these things. These things are sometimes conceptual and they are sometimes hard to address, as you start putting your design together. But as you think about a complex system, system of system or enterprise system, the things you need to think about are reliability, how reliable is the complex system or system of system, or enterprise system? There's different measures and metrics, but you can put requirements on that. Expandability, how much they need to expand? Do they need to make added pieces? Maintainability, this has to be maintained, this has to be kept in ready shape, how are you going to maintain it? what are you going to do? Also the fact that you never provide the 100 percent solution, how you going to upgrade it? What is your strategy? The other things you need to think about in this process, are the human factors associated with this, healthcare specifically? There are so many human factor elements, it's not just an engineering solution. So within an enterprise system, as well as to a complex system, how might you include the human to make sure that this is all going to makes sense? Safety is important and quality is important as well as we walk through the healthcare systems engineering approach. How are you going to monitor, articulate, as well as assemble and assure that it's going to take place? Then also, environmental issues. Where are you going operate and what are the hazards associated with working in a certain environment? These are just a few of the things you need to think about as you have systems in the in-service stage. We have now reached the end of module 4. We have gone through the systems engineering approach with some specific healthcare exemplars. We've talked about the stages and what you do at each stage, as it relates to healthcare. We talked through some of the objectives. We talked specifically about the different system types, and I gave you some examples earlier. I gave you some idea of how to baseline, how to articulate needs, how to go about exploring concepts, and developing architectures, but also putting them in functional terms and why that is so important. Because you're now going to get to the point where you're developing requirements, which sets the stage for the design. It is this turning of the corner, where we need to make sure that we're clear because as we start integrating and addressing the testing evaluation and a deployment, if we are not solid in our requirements, we're going to have very inconsistent answers and not have a good strong feel for what the measures and criterias, as we start evaluating and assembling. Also remember, at the end of stage 13, that is our new baseline. As we start improving the system over time, we're going to be doing some in-service monitoring and that's going to let us know how we improve things, and that's our new baseline that we start the process again. Closing for the short course, what we have gone through, is talk about healthcare system drivers. What is important for healthcare? What problems are there? We also talked about the different systems types. As we went through these different modules, you'll see, that there were different types systems and depending on the type system you have, you have different stakeholders and other approaches you need to take into account. We talked about the systems engineering approach. There are several different ways you can view the systems engineering approach, and we talked through a 13 stage approach which embodies the systems engineering concepts. We also went through and talked about systems engineering with healthcare exemplars, that helps bring things home. One thing I'd like you to do is listen to the video here. This is a link, where someone is talking through compassionate systems for healthcare. He does a great job talking through an example of an airplane. Just think about this, if you had an airplane and the people who worked on the brakes or people who worked on the engine, and the people who worked on the fuselage didn't communicate, that plane wouldn't fly very well. We need to think of healthcare in that same way. How are all these pieces coming together to work to a common good? Our systems engineering for complex system, system of systems and enterprise systems. We can't look at it in a defeatist attitude, this can be done, and it can be done with systems engineering. As with previous modules, I have a set of reflective questions for you to think about. Remember, there are different system types. Why does that matter? Also one thing that I'd like to emphasize, why is it important to baseline a problem? Remember you're base lining, because you need to understand where you're at at the moment, if you don't know where you're at, you don't know where you're going and you don't know how to measure progress. Also think about architectures. Why are they important? That's probably a new concept for many of you. Why are they so important? How will they help the systems engineering approach? Then requirements, I emphasize requirements quite a bit through this short-course. Why are they important? Why does it matter? Eventually, testing evaluation. Why do we need test and evaluation? What part does it play to realize a better system? This concludes the foundations for healthcare systems engineering short course. Recognize, this is simply an introduction to the concept of systems engineering applied to healthcare. As I mentioned in module 1, people are just beginning to understand the application of systems engineering in health care. As you learned, systems engineering by nature brings multiple parts together for a common good, which is exactly what we need in healthcare. There is so much to be studied, so much to be learned. If you're interested in pursuing a master's degree in healthcare systems engineering, look at this site for JHU, where we teach healthcare systems engineering and provide a master's degree. There's a lot that can be accomplished and there's a lot you can learn.