Patient Oriented Management


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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


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


Is Patient Oriented Management a Reality or an Utopia?

Ethical intelligence is what makes the difference in Healthcare. It allows developing a true patient orientation. That is why patient oriented organizations need to have a very special ethical environment to make it happen and not transform it into hollow marketing wordings.

“Ethical intelligence is the intelligence that structures stable and dynamic rules that determine the action of the individual in his environment. It determines his capacity to add value, his influence on the environment and on others and his time management.

On the one hand, the rules are stable since they respond to a purpose that is defined by the level of ethics within which the individual acts.

On the other hand, the rules are dynamic, because despite the fact that the individual is at a certain level, he is capable of determining alternative strategies that satisfy the objective he is seeking within that level.

Ethics is defined as a set of rules that are functional to a situation and to a certain perception of an accepted moral, and are supported by a complementary ideology.”

Access the content of the book “The Unicist Ontology of Ethical Intelligence” at the Unicist Library: http://www.unicist.com/books-pages/en/onto_ethical_intelligence_en14.php

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. https://www.unicist.org/healthcare/wp-content/uploads/2012/05/turi.pdf


Unicist Ethics, the driver of accurate healthcare diagnoses

Until the Unicist Approach was applied to healthcare, medical failures were considered mistakes or malapraxis.

The Unicist Approach allowed defining the necessary context and the personal attitudes that are necessary to avoid paradoxical diagnosis and maximize the accuracy of the real diagnoses.

“A paradox exists when something is self-contradictory or absurd but in reality expresses a possible truth.

Health, educational and research diagnostics are a fertile ground for planting paradoxes.

The first part of the research on paradoxical functioning explains how paradoxes behave in the field of work, human action and in the healing art.

Appearance sustains paradoxes and also leads to fallacious perceptions. Finally, it can be said that paradoxes are sustained by fallacies.

This research results are presented in a synthetic but abstract language. To explain the concept of paradoxical behavior, synthetic language is required.

Paradoxes corrode human activity. Individuals are unaware of their paradoxical behavior. Unless working with a permanent and actual feedback with reality, paradoxes are usually discovered when it is too late.

In the art of healing the antidotes for paradoxical behaviors are always the same:

  • Real interest in the patient
  • Secure knowledge
  • Hard work
  • Control – quality assurance”

Access it at:
http://www.unicist.com/books-pages/en/ontological_diagnostics_en16.php
First you need to register: http://www.unicist.com

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. https://www.unicist.org/healthcare/wp-content/uploads/2012/04/turi.pdf