Throughout the world, people are living longer, and chronic and degenerative diseases are on the rise (Bloom et al. 2011; National Institute on Aging and WHO 2011; Yach et al. 2004). These factors place great demands on healthcare systems and threaten sustainability. Fundamental changes are needed to improve health outcomes and reduce costs. Changes that affect desired outcomes include aligning and understanding stakeholders’ motivations and behaviours as well as gaps in key processes. Through that understanding, when desired outcomes are not achieved, we can answer why. A system perspective provides insight into what changes to make, and system maps are critical tools to help gain that system perspective.