This is an excerpt from a report on inter-organizational network strategies to reduce cancer (sponsored by National Cancer Institute): " Report on the Cancer Collaborative Northeast Demonstration: An organizational approach for fighting cancer: Cultivating communities of practice at local, state, and national levels,” W.M. Snyder, 2004.

I have included this schema (work in progress...) as reference point for Lee Teitel's framework on organizational interdependencies.

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Types of partnerships: Organization-centric to system-centric

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Connected Organization
Learning System
Organizing principle
Organization-centric, arms-length market transactions
One-off, hub-and-spoke alliances, mostly operational
“Community network(s)” of players for shared learning and joint actions
Collaboration strategy
Emphasis on self-sustainability; transactional “community outreach”
Opportunistic, self-serving alliances with others with complementary strategies
Leverage the organization’s distinctive competencies in a system-wide context; learning-driven
Value for organization's targeted beneficiaries (e.g., customers, investors)
Value for organization’s beneficiaries and partners’ in context of joint ventures
Optimal collective value (defined jointly) for all system beneficiaries/ stakeholders; new capabilities as well as specific outcomes
Level-limited, whether local clinic or national council; if multi-level, then federated hierarchical structure
Opportunistic sponsor/partner/beneficiary relationships that reach across levels
Strategically “saturated participation” of players from multiple scale levels who engage at each level (local, state, national, and others)
Learning orientation
Learn and innovate to compete and to improve results
Learn for improving organization results and for developing sustainable partner synergies
Learning for results, for integrating system players, and as a core value for ongoing development at individual, organizational and societal levels
System governance
Balkanized authority anchored in disparate, often competitive and uncoordinated organizations
Pockets of collaborative decision-making according to trust levels; often along lines of leaders’ own affiliations versus deeper synergies
Multi-scale, multi-stakeholder system with transparent, participative governance structure and decision-making processes
Inter-organization coordination
Depends largely on the efficiency of market forces to “signal” coordination
Supplemental staff time/support for partner/network coordination
Dedicated “network coordinators,” partnership liaisons, and overall system-stewardship group
Top-down, bottom-up
Every which way through private, formal or ad-hoc, informal channels
All-directions via facilitated formal/informal channels, supplemented by a shared knowledge-management platform
Organizations’ strategies and structure more or less adapt to market—clients, competitors, regulators, etc.
Hairball-like aggregation of overlapping partnerships responding to various opportunities
“Quasi-evolutionary” dance of organic emergence and intentional guidance via ongoing, strategic collaboration of stakeholders
Major challenges
Market shifts and competition
Negotiating growing number of agreements and relationships with disparate partners
Time/skills/funds/legitimacy to coalesce diverse players for system stewardship; organization inertia and change-resistant leaders/practitioners
Figure 1. Comparison of organizing approaches: organization-centric, connected-organization, and system-centric

Shifting paradigm: Organization-centric to system-centric
The logic for learning systems (and communities) is, in short: Building system-wide connections fosters both synergistic relationships and catalytic learning, which in turn make it possible to achieve extraordinary results. The logic often falters in practice, however, because current institutional structures and incentives discourage organizations from investing in partnerships and alliances. Indeed, moving from an organization-centric to system-centric way of working, with an equal emphasis on both learning and action, entails a fundamental shift in mindset, capabilities, and environment. It means “acting locally while connecting globally”—that is, acting to address specific problems while more broadly cultivating system-wide relationships and resources. This shift was briefly outlined in the introductory section as it applies at the community level; it is further explored here because it becomes much more complex at the increased scope and scale of a learning system.

The nature of the shift from organization- to system-centricity recalls the Copernican revolution in the 16th century when the astronomer Nicolaus Copernicus asserted that the sun, not the earth, was the center of the solar system (as it came to be known). Copernicus’ model fit astronomical data much better than Ptolemy’s, and it eliminated the need for excessive epicycle adjustments that had accumulated over the years to account for confounding observations. Similarly, interrelated organizations in complex market environments may reach a tipping point at which a thickening tangle of disparate partnerships becomes too unwieldy to manage; and meanwhile, emerging opportunities to collaborate more systematically may become too attractive to ignore. Given the right incentives, organization leaders may choose to participate in alliances in which the system’s priorities—not necessarily the organization’s—are central. For leaders with organization-centric perspectives, this may appear to entail less control and more uncertainty. Yet under the right conditions, system-centric strategies increase control over more inclusive desired outcomes and help manage inescapable market uncertainties.

To highlight this contrast between the organization-centric paradigm and the system-centric one, consider the comparisons illustrated in Figure 1 above. The spectrum of structures shows an evolution, reading left-to-right, from 1) a straight organization-centric approach, to 2) a “connected organization” that is supplemented by network relationships, and finally to 3) a system-centric, network-based model.

In an organization-centric approach, leaders rely predominantly on internal resources to serve clients and meet stakeholder requirements as best they can. Stakeholders, in turn, depend on efficient market forces to ensure that organizations maximize their utility.
Leaders of a “connected organization” expand the organization’s strategic scope and open its structural boundaries to engage various market players in mutually beneficial arrangements. Partnerships and joint ventures leverage complementarities among organizations that enable each of them to meet its own goals while contributing to others’.
In a “learning system” a fundamental shift occurs: Strategy development is a collective activity by organizations throughout the system. It begins with a compelling, jointly-defined problem to solve, (say, reducing the prevalence of cervical cancer in a metropolitan population). Further, as the term implies, the emphasis throughout is as much on learning as it is on action. Thus, with both “learning” and “system” in mind, an inter-organizational network of players establish a collaborative governance structure for setting priorities, defining initiatives, allocating resources, etc.

It should be noted that the goal of a system-centric approach is not to eliminate autonomous organizations and establish a hegemonic regime. Rather, the point is to leverage the energy and creativity of various players not by merging them but by connecting them. (As difficult as partnerships can be, mergers and acquisitions are equally so.[[#_ftn1|[1]][1]) It is expected that individual players will participate in system-stewardship activities at different levels, depending on their capabilities and resources and other factors. Further, system participants will continue to disagree, compete, and grow or decline even in a thriving learning system context. But in a mature system, a critical mass of players consciously and consistently behave as highly interdependent actors. System-centricity thus entails a quantum shift in worldview: from an exclusive focus on one’s own organization’s results to a perspective anchored by a collective commitment to solve a systemic societal problem.

The evolution from organization- to system-centricity occurs along various dimensions, including the number of organizations committed to system-wide collaboration; extent of partnership activities and overlaps; maturity and accessibility of facilitating structures; visibility of successes; and others. While the development process cannot be definitively delineated, it might look something like this:

A growing number of “connected organizations” wade in by selectively contributing to system-building via activities that require minimal costs and staff time, yet contribute to useful, self-serving partnerships. Borrowing from Himmelman, these initial system-centric efforts are likely to be relatively shallow ones such as information-sharing, activity coordination, and exploratory projects (as were seen in the Northeast Demonstration). Over time, as these interactions prove their value and evolve, a critical mass of organizations may engage in broader and deeper collaborations.
Meanwhile, the “community infrastructure” (or “partnership infrastructure”) develops, including elements such as a population health-status database, shared online library and communications platform; public meeting facilities with support for participative deliberations; mechanisms for coaching leaders and evaluating results; and a governance system for system-wide decision-making. These mechanisms are complemented by behavioral norms for open communication and reciprocity.
In multi-level learning systems, communities emerge at local, state, and national levels, as do mechanisms for connecting them: many stakeholders create linkages by participating at multiple levels; and “cross-hatching” communities defined by roles (such as nurses) or topics (such as types of cancers) cut across levels and thus help interweave players and activity among them..
Eventually, it becomes common knowledge that organizations—individually and collectively—thrive best when they collaborate on strategies and share capabilities; and it becomes best practice for independent players to act accordingly.
Finally, system-centricity is established as the dominant paradigm when it becomes easier and more productive to collaborate than to go it alone, and when the governing ethic among players favors system effectiveness over organization-centric priorities.

This system-stewardship shift, of course, is far from linear and does not happen cleanly or in lock-step. The process is organic, evolutionary, and involves a seemingly chaotic concatenation of interactions.[[#_ftn2|[2]][2] In fact, it is best described as “quasi-evolutionary” because it combines both intention and emergence.[[#_ftn3|[3]][3] A robust conceptual model helps participants guide action and learn from experience. The description below of learning-system structural elements and process flows draws on the Northeast Demonstration experience, and it points towards opportunities to strengthen and scale a national learning system for fighting cancer.

[[#_ftnref1|[1]][1] Estimates vary, but generally the failure rate of mergers and acquisitions is estimated to be between 60 and 80% (KMPG 1999, “Mergers and Acquisitions: A Global Research Report”).
[[#_ftnref2|[2]][2] It thus resembles what is defined as a “complex adaptive system”: “They are complex in that they are diverse and made up of multiple interconnected elements and adaptive in that they have the capacity to change and learn from experience.”
[[#_ftnref3|[3]][3] William McKelvey (1997) calls a design strategy that combines strategic intention and unpredictable emergence a “quasi-evolutionary” strategy. He asserts that both intention and emergence are inescapable in social systems, so it is best to consciously work with both.