7. Emergence & System-Level Patterns

Lens: Look for emergent patterns arising from many local decisions.

• Emergent behavior: Patterns like regional inequities, informal payments, overuse of hospitals, underuse of prevention.
• System-level performance: Health status, equity, efficiency, resilience, trust, user experience as emergent outcomes.
• Unintended consequences: Second- and third-order effects such as task shifting, new disparities, gaming of metrics.