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The 10-Year Trend for Healthcare Organizations in the United States

The reach of one’s globalization is defined by the limit of the pronoun “WE”…

The reach of one’s globalization is defined
by the limit of the pronoun “WE”…

This is a synthesis of the trends developed at the Future Research Lab on the “Evolution of Healthcare in the US” led by Peter Belohlavek.

The objective of this research was to find the trends that underlie the healthcare business in the US and to develop the future scenario that arose based on the changes introduced in medical regulations and on the possibilities opened by the use of new technologies.

 

The 10-year trends can be synthesized in:

  1. The trend towards expansive healthcare organizations
  2. The trend towards patient centered management
  3. The trend towards adaptive information technology solutions
  4. The trend towards using semantic objects to segment

Introduction

Two structural changes happened in the United States:

1) The transparency of the use of electronic medical records established a new starting point for medical practice.

2) The concept of the Accountable Care Organizations and its analogical multiplication in medical practice introduced the concept of profiting from healthcare improvements.

This triggered the need of adaptiveness for healthcare organizations.

New technologies that made structural adaptiveness possible:

  1. Adaptive Information Technology
  2. Semantic objects to manage adaptiveness
  3. The discovery of the human drivers of attitudes
  4. Double dialectical logic to manage adaptiveness

The integration of the structural changes and the now available technologies is predictable based on the understanding of the power of the archetype of the US which naturally allows integrating ideals with businesses:
www.unicistinstitute.net/blog/unicist-strategy-the-archetype-of-the-usa

If you are interested in learning about the unicist future research technologies that are used to develop future scenarios we recommend you to access:
www.unicist.org/sdp.shtml

These Trends are a Back to Hippocrates in the XXI Century

Back to Hippocrates means going back to the natural role of medicine.

In the XXI century it implies the use of an object driven organization model integrating processes with objects in order to ensure results and optimize the use of energy.

The Value Adding Approach is basically driven by the development of a model based on the use of the rules of Patient Centered Management.

The operational objective is to maximize the value added to patients considered as clients.

It is a backward-chaining-thinking approach beginning with the value being added and ending with the process and objects that are needed.

The process is centered on patient orientation, added value assurance and result assurance.

Access the complete synthesis at:
www.unicistinstitute.net/blog/the-10-year-trend-for-healthcare-organizations-in-the-united-states

Unicist Press Committee

NOTE: The Unicist Research Institute was the pioneer in complexity science research and became a private global decentralized leading research organization in the field of human adaptive systems. http://www.unicist.org


The next stage: Unicist Patient Centered Management

Patient Centered Management (PCM) is an organizational meta-model that allows empowering the work processes in healthcare institutions. It is homologous to Client Centered Management that is the natural model to guide work processes in businesses that was developed in the eighties.

Patient Centered ManagementOn the one hand, it works as a conceptual action guide to design work processes and, on the other hand, it is the main catalyst for continuous improvement, change management and innovation management.

PCM is driven by patient orientation. The purpose of the model is to assure results, and includes a quality assurance system that sustains the value added.

The information technology that sustains the PCM implies the integration of the three concepts that underlie healthcare IT:

  • EMR, to sustain physicians’ activities
  • EHR, to deal with the diseases
  • EPR, to provide a safety environment for patients

Based on the functional and legal context, this integration works in a different way in each culture.

The PCM provides a conceptual structure of rules that makes an optimal integration of these IT solutions possible and introduces the concept of adaptive interfaces in order to ensure adapting to the feedback.

Meta-models require being extremely focused in order to avoid being perceived as meaningless. By definition they need to be ambiguous because they need to allow adapting to the specific operation of different environments.

Meta-models describe the natural structure of an activity. Therefore, they are cross-cultural, needing to establish the operational rules respecting the characteristics of the environment. These meta-models make the saying “design globally, operate locally” become real.

The specific PCM is mainly focused on satisfying the needs of the patients within an environment where all participants win. The purpose of the model is to establish the unified field of the therapeutics process, taking advantage of all the technologies available and minimizing the participation of different “health” providers to solve the patients’ problems.

Unicist Press Committee

NOTE: The Unicist Research Institute was the pioneer in complexity science research and became a private global decentralized leading research organization in the field of human adaptive systems. http://www.unicist.org


Clinical trial paradigms are changing

A couple of years ago Wyeth introduced a new R&D protocol in drug development. It was named “Learn & Confirm” and relies most heavily on biomarkers and pharmacogenomic approaches.

As part of Learn and Confirm, Wyeth drug-development teams were encouraged to examine each compound coming through the pipeline for ways that the company can employ a biomarker-based or pharmacogenomic approach that can help move it downstream.

This R&D Methodology was based on the research developed by Lewis B. Sheiner synthesized in the paper  “Clinical Pharmacology and Therapeutics”

This methodology is naturally consistent with the unicist complexity research methodology.  Therefore we working with CROs to expand this technology using the unicist healthcare cybernetic approach synthesized in the Unicist Cyberstation.

Diego Belohlavek

NOTE: We suggest you register in this “Conceptual Knowledge Reservoir” to receive updates on the new developments:
http://www.unicist.org/healthcare/wp-login.php?action=register 


Social viruses produce paradoxical results in businesses

Social viruses are the consequence of the use of anti-intelligence. Anti-intelligence is a “virus”. Anti-intelligence is the use of intelligence without ethical purposes. It substitutes ethical intelligence with a utopia (this utopia is homological with to proteins viruses use).

The mutation of social viruses is produced by the functionality or dysfunctionality that the utopia poses in the environment. If the utopia can take advantage of the conditions of the environment there is no need to change. If it is dysfunctional, then utopias change and thus the complete structure of the social virus mutates.

The Destruction Power of Social Viruses

We have discovered four levels of jeopardy of viruses:

  1. Social viruses that install in a social entity but remain as marginal elements that validate the structure of the institution or culture.
  2. Social viruses that work at a lower or different ethical level that degrade the institutional or cultural activity.
  3. Social viruses that work at a lower, different and incompatible ethical level that provoke an extreme degradation of the institutional or cultural activity.
  4. Social viruses that work at an incompatible ethical and functional level that provoke the destruction of the institutional and cultural perception. They provoke a “back to individualism” effects.

Diana Belohlavek

NOTE: The Unicist Research Institute was the pioneer in using the unicist logical approach in complexity science research and became a private global decentralized leading research organization in the field of human adaptive systems. It has an academic arm and a business arm.
http://www.unicist.org/repo/#Unicist


Adaptive EHR: simplifying medical practice as a complex system

We would like to introduce adaptive EMR/EHR as a way to materialize Patient Centered Management as a solution to sustain the upgrade introduced in Healthcare in the US.

This implies dealing with predictive interfaces transforming operational EMR/EHR into adaptive systems. We would like to discuss with colleagues the possibility of introducing these alternatives considering medicine as the most complex professional field.

Unicist Patient Centered OrganizationPlease access the approach to complexity: “Applying Complexity Science to Health and Healthcare” of the University of Minnesota:
http://goo.gl/C3pcb9

and the Unicist Logical Approach to complexity you can find at:
www.unicist.net/clipboard/

The basics of medicine are patient centered. That is why the regulation of the activity focusing on patients is just a back to basics. Patient Centered Management is an object driven solution to structure patient orientation.

Electronic Patient Records are the paradigmatic sign of this approach. Electronic Healthcare records are their natural complement in order to include the aspects that deal with the diseases that are being considered.

Electronic Medical Records, being focused on medical activity, allow putting this patient orientation into action. The EMR are the natural step to start with a structured patient orientation.

The debate I suggest is about alternatives to simplify complexity in medical practice with people who might be interested in this approach.

Peter Belohlavek

NOTE: The Unicist Research Institute was the pioneer in complexity science research and became a private global decentralized leading research organization in the field of human adaptive systems. https://www.unicist.org/healthcare/wp-content/uploads/2013/10/turi.pdf


What is the Unicist Approach to Healthcare Businesses?

Ontogenetic Intelligence of Nature

The discovery of the unicist ontogenetic intelligence of nature allowed defining the triadic structure that regulates any entity. It included the discovery of the complementation and supplementation laws. 

These discoveries established the groundings to develop the unicist double dialectical logic that underlies all systems in nature.

The use of the double dialectical logic made the emulation of the organization of nature possible, developing objects to install into human adaptive systems to make them faster, safer and reliable.

The unicist double dialectical approach to medicine allowed (*):

Pyramid of Ethical Intelligence1) Defining and managing diagnoses as adaptive systems and transforming them into medical objects integrating the triadic structure of cures, fundamental diagnoses and technical-analytical diagnoses.

2) Managing therapeutics as a complex adaptive system, integrating the triadic structure defined by cures, palliatives and recovery.

3) Managing the triadic structure of Health IT integrating software, hardware and peopleware.

4) Integrating the triadic structure of electronic records for medical practice, integrating EMR, HER and EPR.

5) Managing drugs as medical objects integrating their functionality with the adverse effects and the positive side effects.

6) Managing the triadic structure of patient centered management integrating the patient, medical practice and management.

7) Installing the Object Driven Organization Metamodel to materialize the Patient Centered Management.

8) Developing a unicist scorecard to monitor the metrics of the medical business activities.

(*) A condition to manage the unicist approach is to go beyond the use of dualistic logic and use the double dialectical logic in order to be able to emulate dynamic processes in mind. It implies leaving behind the use of the disjunction “or” substituting it by the use of the functional conjunction “and”.

Healthcare: the use of Unicist Adaptive IT Architectures

Adaptive IT solutions are systems that have been designed to interact with the external and internal environment. Nowadays, there are multiple programming solutions available to sustain the unicist adaptive architecture. The solutions include aspect objects architecture with unicist logical inferences to manage adaptiveness.

Adaptive IT ArchitectureThe evolution of Information Technologies allowed integrating the adaptive aspects of business management in the operational systems of hospitals.

The integration of the unicist logical approach and the resulting business objects included in the business processes within an adaptive IT environment allows driving business processes to the next level.

To be able to organize by objects it is necessary to use both adaptive and administrative systems to organize the work processes. This widened the possibilities of hospitals to expand the boundaries of their activities within an environment of assured quality.

There are four levels of adaptiveness that can be managed:

1) Analogical drivers

This level is based on the recognition of the significant behavioral patterns of the segments of patients.

2) Rules based drivers

This level is based on the use of analogical patterns and the logical rules defined by the fundamentals that influence the processes.

3) Empirical drivers

This level is based on the previous level and the integration of mathematical models to infer behavior based on the observable aspects of the fundamentals of the processes.

4) Objects based drivers

This level is based on the previous level plus the use of medical objects that work as interdependent drivers to influence the attitude of patients. The feedback is defined by the results produced by these objects.

The level of adaptiveness varies according to the needs of the system. Adaptiveness is based on the medical, therapeutics and disease segmentation.

Unicist Press Committee

NOTE: The Unicist Research Institute was the pioneer in complexity science research and became a private global decentralized leading research organization in the field of human adaptive systems. http://www.unicist.org


Unicist Logical Approach: Diagnoses managed as medical objects

Medical objects are encapsulated adaptive processes that have the necessary quality assurance to generate a predefined result.

Diagnostics Quality AssuranceMedical diagnoses happen within the scope of medicine but are regulated by the functional rules of universal diagnostics and are driven by the semiotic signs the diagnostician identifies.

Diagnoses can be considered from two different points of view. Seen from the diagnostician’s standpoint, they are a process that needs to be done to identify the problem that needs to be cured. But seen from the point of view of the therapeutic process, they are a medical object that defines the objective of the therapeutic process.

As a medical object, they need to have the necessary quality assurance to be fully reliable. To achieve this reliability they need to be based on reliable knowledge and develop the necessary destructive and non-destructive tests to confirm their validity.

As an object, they work as an adaptive system that modifies the diagnosis based on the feedback from the environment until the therapeutic process has shown its accuracy. The destructive tests are necessary to evaluate the limits of validity of the diagnoses while the non-destructive tests are done to confirm their functional validity.

To manage diagnoses as medical objects it is necessary that the EHR includes the possibility of managing them as adaptive systems.

Diego Belohlavek

NOTE: The Unicist Research Institute was the pioneer in complexity science research and became a private global decentralized leading research organization in the field of human adaptive systems. http://www.unicist.org


The Intelligence Quotient only measures dualistic logic

Our work and research with gifted people, having an IQ above 130 drove to the conclusion that this gift allows adapting to aspects of reality that can be managed with dualistic logic. Gifted people are extremely successful when dealing with dualistic environments solving systemic problems.

But, on the other hand, they tend to generate fallacious behaviors when they are forced to enter into complex adaptive systems if they do not have the skills for developing action-reflection-action processes. In this context these processes allow apprehending the nature of complex systems in order to be able to manage them.

These individuals tend to use systemic palliatives to avoid dealing with complexity (such as: statistics, analogies, etc.). What allows them to deal with complexity is their level of ontointelligence, which includes their type of thought, their strategic intelligence and their ethical intelligence.

The problem with many high IQ individuals is that their gift is also their handicap. And this “handicap” hinders their reflection capacity unless they are able to use conceptual thinking and have a value adding ethical intelligence to approach reality.

The conclusion is that an extreme high IQ is not an advantage to deal with complex adaptive systems such as businesses. It is a gift to manage the systemic aspects of processes but it is a handicap to deal with the adaptive aspects.

Learn more:
https://www.unicist.org/healthcare/wp-content/uploads/2013/02/human_complexes_en.pdf 

Dualistic logic is functional to deal with systemic problems but drives to “aprioristic” fallacies when dealing with complex problems. The IQ allows managing dualistic logic to deal with systemic problems and ontointelligence allows managing the double dialectical logic to solve complex problems.

Unicist Press Committee

NOTE: The Unicist Research Institute was the pioneer in complexity science research and became a private global decentralized world-class research organization in the field of human adaptive systems. http://www.unicist.org


What is Unicist Decision Making?

Unicist decision making is a conscious process of an individual or group where the justifications and foundations of possible action alternatives are evaluated to make a decision. It is focused on ensuring that the objectives are possible and not only probable.

The unicist double dialectical approach allows integrating the justifications of the purpose that needs to be achieved, with the justifications of the necessary actions, integrating them with their foundations to ensure the accuracy of the decision.

The dualistic approach hinders the integration of justifications and foundations, dividing the process into an independent analysis of the “what for” of the actions to be decided and the “why” the actions will produce the expected results.

The dualistic decision making process drives decisions into a voluntaristic, rationalistic or subjective context. This tends to produce paradoxical results and the need to have scapegoats for their consequences.

Learn more:
https://www.unicist.org/healthcare/wp-content/uploads/2013/01/decision_making_ontology_en.pdf 

Unicist Press Committee

NOTE: The Unicist Research Institute was the pioneer in complexity science research and became a global decentralized world-class research organization in the field of human adaptive systems. http://www.unicist.org


Ontological approach to Electronic Health Records

The approach to EMR/EHR needs to include both administrative and adaptive aspects in order to work as a driver for patient oriented healthcare.

We strongly recommend accessing the paper on the adaptive aspects of EHR prepared by Lowell Vizenor, Barry Smith and Werner Ceusters representing:

1. Institute of Formal Ontology and Information Science, University of Saarbrücken, Germany
2. University at Buffalo, Department of Philosophy, Buffalo, New York, USA
3. European Institute for Ontological Research, Saarbrücken, Germany

“Despite the recent advances in information and communication technology that have increased our ability to store and circulate information, the task remains of ensuring that the right sorts of information reach the right sorts of people.

In what follows we defend the thesis that efforts to develop efficient means for sharing information across healthcare systems and organizations would benefit from a careful analysis of human action in healthcare organizations, and that the communication of healthcare information and knowledge needs to rest on a sound ontology of social interaction.

We illustrate this thesis in relation to the HL7 RIM, which is one centrally important tool for communication in the healthcare domain.”

Access the complete paper at:
http://ontology.buffalo.edu/medo/HL7_2004.pdf

Learn about the trend of ontology based solutions for businesses at:
http://unicist.net/obs.shtml