OBJECTIVES: To clarify the different meanings and processes associated with developing, implementing, and sustaining the theoretical constructs required to define a health system as a complex adaptive system (CAS) for greater use of innovation in it.

METHODS: The starting point of this work is the problematization of the concept of “solving health problems”, through the incorporation of innovative strategies or interventions in formulating health policies. The existing conceptualization is insufficient or at least conflicting, so a sort of change of perspective and scope is required to further alienate this construct to rectify some of its inconsistencies.

RESULTS: Health systems are based on interactions between their agents and organizations in a complex adaptive environment. Their relationships, then, should be managed as such to "generate valuable, new and unpredictable capabilities that are not inherent to any of the parties acting alone" (Plsek and Wilson, 2001). These systems have mutated from a centralized and sequential model of value creation to a more distributed and open model (Figure 1) where beneficiaries are co-creators of their state of health, well-being, and functionality (Bessant et al., 2012). Thus, the results of innovation take the form of a constellation of improvements. Moreover, these ecosystems involve a wide number of actors considered "a fluid mix of experiences, values, contextual information, and expert insight that provides a framework for evaluating and incorporating new experiences and information" (Davenport and Prusak, 2000). Such a perspective favors knowledge co-production processes to advance scientific knowledge or develop new services, solutions, and prototypes.

CONCLUSIONS: CAS can be applied in healthcare to help explain the leadership characteristics that will lead to improved performance and to provide an additional way to consider the social, organizational, and behavioral changes needed to accelerate innovation in healthcare. Similarly, this theory can be used in healthcare research and policy design.