I've been reading tweets from an NHS technology conference that is on at the moment. I can't help thinking that there's a conversation missing... about Adaptive Change. The NHS is beginning a significant effort to digitise itself. The last one - the National Programme for IT (NPfIT) - was canned five years ago: it cost a lot and mostly didn't work. Getting this one right is vital for all of us.

A recent report called "Getting IT to Work" has been an important communications springboard for the new initiative. It's a good report from a comprehensive and sensible review. It was a 6-month piece of work led by Bob Wachter, a US doctor well known in medical technology circles, with team of 17 other eminent folk. It was substantial.

Part of it looks into the lessons of the NPfIT. This paragraph, a fundamental conclusion of the report, stood out...

I agree with Dr Wachter. There is a grave risk that history could repeat itself.

The concept of Adaptive Change comes from a professor from Harvard called Ronald Heifetz. He makes a distinction between Technical Change and Adaptive Change. Technical Change is the sort of approach needed to make change in predominantly predictable situations; it is based on analysis, planning and methodical delivery. Adaptive change is needed for unpredictable situations, where the approach is to support the emergence of new order through social dialogue, collaborative learning and iterative delivery of new capability.

Technical Change is for Complicated situations: Adaptive Change is for Complex ones - see Government doesn't get complexity.

If Dr Wachter is right, Adaptive Change should be on the agenda. There should be talk of it in every corner - particularly Trust boardrooms. Search Twitter for, say, "NHS adaptive"; at the moment, there's hardly anything. Even there.

But I am hopeful. Keith McNeil - previous Addenbrooke's Hospital Chief Executive and now NHS Chief Clinical Information Officer - has been promoting the importance of it. I do hope he is successful.