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design whereby CSOs continued to deliver their service over the telephone and only counsellors participated in the video service. This decision was made prior to implementation of the video service, as a direct result of the research findings. While there are many process mapping tools that enable an understanding of work processes, FRAM is the only tool that enables variation in processes to be directly mapped. FRAM is therefore most useful for mapping processes that are non-linear, and that have many co-dependencies among tasks. A disadvantage of the method is that a FRAM can quickly become complicated and unwieldy, especially if the mapping is done at a level that is too granular for the problem at hand or if the boundaries of the system are not sufficiently constrained. Because FRAM involves mapping Work-as- Done, those who actually do the work must participate in its development; this may be a burden on resources for some organisations. Finally, while FRAM can be taught to novices such that they could produce basic models after one day of training, manipulation of the FMV software and useful interpretation of the results can be dependent on the skill and experience of the modeler. 3.2. Designing information systems to cope with unexpected events Analysis of the thunderstorm asthma event revealed deficiencies in information systems that precluded a whole-of-system response to the emergency. In particular, information systems were found to be inadequate to support the ability to anticipate and the ability to respond. In terms of anticipation, a notification process should be developed that disseminates early information about an emerging incident to all relevant emergency management organisations. In terms of response, a centralised online system should be established to link all hospitals to ensure that they receive timely and relevant information on the medical implications of emerging events. Using the RAG provides additional insight into the dynamic aspects of systems, particularly monitoring and anticipating, than that provided by more conventional investigation tools such as Root Cause Analysis. The RAG, however, is very dependent on the quality of the probing questions developed to assess each of the four capabilities of resilience. The questions must be designed for the specific case, and this may require specialist subject matter expertise. In addition, the combination of interviews, focus groups and ethnography required to elicit answers to the questions requires familiarity with qualitative research methods. 4. Discussion The theory of RHC is relatively new, and tools such as FRAM and the RAG are still in their infancy. Despite this, we have learned that effective implementation in healthcare must consider that the system is dynamic, that behaviours are emergent and never wholly predictable, that causality is not knowable, and that validity of results will be limited by context. We know that local problems will impact, and will be impacted by, the larger system of which they form part, and that multiple interventions will interact, often in unpredictable ways.[9] Planning implementation and evaluation collaboratively with clinicians and patients will assist in understanding Work-as-Done and support the intervention so that it can be better matched to the needs of the workforce. Overall, RHC is showing great promise for implementation and sustainability of complex health service interventions, including digital health systems. R.Clay-WilliamsandJ.Braithwaite /ResilientHealthCare 143