Unicist efficacy is defined as the capacity of individuals to produce results in a responsible way.
It implies the production of results having assumed the responsibility for producing them. This is convenient when managing administrative systems because it minimizes the cost of controlling the activity.
But efficacy is necessary when dealing with adaptive systems, because the individual needs to be able to adapt to the changes of the environment.
Individuals need to have the necessary internal knowledge to assume the responsibility for results. This internal knowledge is called “intrapersonal program”. It means that the individual knows what to do and is aware of the changes in the environment.
The work processes have to be designed providing the necessary programs to solve problems and to deal with the technical knowledge that is needed.
The workstation design defines the possibility of individuals to exert their efficacy. Investing in workstation design implies improving the possibilities of growth for the company and the quality of life of their members.
The culture of a company defines its positioning in the market, and the work procedures of a business are the observable elements of that culture.
The purpose of organizational cultural design is to ensure that the habits of the company are consistent with the market of the business. These habits are observable in the work procedures and are sustained by the beliefs of the members of the organization.
Cultural change is necessary when businesses extend their markets. The larger the markets are, the higher the level of programming of the work procedures of the businesses and the more adaptive they have to be.
The reliability of work processes has to be ensured when organizations expand their critical mass to influence the market. This increase of reliability implies that the expansion processes demand adjusting the procedures.
Adapting work procedures allows influencing the culture of an organization putting a higher level of work ethics into action.
The work process design defines the capacity of an organization to work as a system being reliable for the market and its members.
The objective of every work process is to produce a utility that might be an added value or risk avoidance.
The functionality of processes implies managing the necessary technology to be competitive and to produce the results in an optimal way.
The reliability of processes is given by the redundancies of such processes, when it is an administrative system, or by the quality assurance, when it is an adaptive system.
Revising the design of work processes every two years in order to adapt them to the new technologies is a must in any competitive organization. It allows growing and building or sustaining a “Best place to Work” for the members of the organization.
Medical efficacy implies that physicians need to work within the complexity of human biology. They work in the field of adaptive systems. This implies that their efficacy curve has to be functional to deal with low programmed activities. Protocols sustain this essentially low programmed activity.
1) Is it that EMR and EHR have little added value or is it that they were designed as administrative systems?
2) Is it possible to transform administrative EMR and EHR into adaptive systems with administrative information?
3) How can the misuse of the transparency of the system be avoided?
These are some of the questions that can be solved using an object driven approach to healthcare.
The objects included in the EMR and EHR should emulate the problems physicians need to solve in their minds in medical practice. The basic objects are:
d) Patients evolution
f) Decision making
g) Knowledge bank
Objects driven EMR or EHR are such when they become a necessary part for physicians practice such as a golf stick is for the golfer or a racket is for a tennis player.
There have to be objects for exclusive private use with no access to anyone, such as the decision making alternatives a physician considers, and other objects that can be shared.
Administrative EMR or EHR can only be information reservoirs, legal defendants and control systems. The integration of object driven systems including adaptive objects with administrative functions is the conceptual answer to the problem. Basically, a new concept for interfaces is required.
Changing the interfaces is the first step to enter in the new stage where the computer is a natural part of the physician’s practice.