Organizational Design


Transforming EMR into Adaptive Patient Centered Systems

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.

healthcare-cyberneticsParadoxically, there is a widespread perception that EMR/EHR has a low added value for medical practice. This perception hinders the upgrade of medical practice.

But:

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:

  • Diagnoses
  • Cures
  • Palliatives
  • Patients evolution
  • Prevention
  • Decision making
  • 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.

Diego Belohlavek

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


Organizations and their parts have a beginning and an end

The “Unicist Ontology of Organizational Equilibrium” describes the nature of organizational evolution. It is integrated by nine principles.

unicist-ontology-organizational-evolutionWe are presenting here one of the principles which is the one that rules the necessary action to develop maximal strategies to make business grow.

a) Every change of values implies the elimination of values, meaning that there is an end and a beginning.
b) Every organizational change implies a change of the values of the organization.
c) Organizations change from the outside to the inside and from top to bottom.
d) The results of changes need to be measured in the short and the long term.
e) The elapse of time makes the organizational structure of benefits obsolete.

Values are the materialization of ethics at an operational level. Organizations that seek for permanence need to die and rebirth with each change in order to adapt. No beginning nor change can exist if the ends are not accepted.

The apparent paradox is that the “end” is the energy conservation element. Beginning something new without finishing the preexisting organization is a utopia.

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


The coordination of Unicist “A” Groups to introduce changes

The leadership of Unicist Avant Garde Groups requires fostering extreme synergy among the members. It is based on three differentiated roles: the coordinator, the fallacy-shooter and the ombudsman/woman.

Unicist A groups leadership“A” Groups are the “institutionalized” way to introduce medium size changes in an organization. They are fully participative and democratic. Democracy in business implies that all the opinions have the power of their groundings.

Medium size changes are introduced to increase the level of security in work processes to empower an organization to increase the added value in their internal and external environment.

Changes are introduced through the operational modifications of work processes or in the business objects that are being used.

To ensure the success of an “A” Group its leadership has to fulfill the following objectives:

1) The Coordinator has to guide participants’ work and delivery. If participants have problems with their delivery the coordinator has to solve them somehow.
2) The Fallacy-shooter has to confirm the validity of the proposals. S/he has to ensure that the necessary knowledge to develop the work is available and also support her/his colleagues.
3) The ombudsman has to ensure the achievement of the value adding solutions for the internal/external clients of the group.

The external counselor is responsible for providing the necessary technologies, the democratic context for the group and for managing the structure of the change-project, providing the necessary alternatives to achieve the change that underlies the operational aspects of the activities.

The preparation period of an “A” Group demands between 2 weeks and 2 months until it has the concept of what is being done. Then the implementation process is very short.

Success, recognition and diplomas close the process of an “A” Group.


Save energy optimizing the healthcare work process design

The work process design defines the capacity of an organization to work as a system being reliable for the market and its members.

unicist-process design1“Best Place to Work” has two basic drivers:
a)  the success of the stakeholders of an organization
b)  the growth of the business

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.


Availability is the core value for professional evolution

Availability is what makes the difference between a high-rank military and a low-rank officer. It is the driver for reliability. When availability lacks reliability cannot exist.

unicist availabilityIt requires having a giving attitude in order to feel the pleasure of being available without suffering the stress of an imposed duty.

When the giving attitude is there, availability begins to exist. It requires the integration of empathy and aesthetics. Empathy is necessary to be able to introject others’ needs.

Aesthetics is necessary to complete the need of others in a desirable and harmonic way.

As researches demonstrated empathy has genetic aspects, but it also has trainable aspects.

We strongly recommend training empathy in order to expand the possibilities given by the consequent increase of availability and reliability.

We recommend entering the Unicist Reflection methodology. A first approach can be the understanding of the “Actors Method” you can find at:
http://en.wikipedia.org/wiki/Method_acting