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.
Paradoxically, 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 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:
The trend towards expansive healthcare organizations
The trend towards patient centered management
The trend towards adaptive information technology solutions
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:
Adaptive Information Technology
Semantic objects to manage adaptiveness
The discovery of the human drivers of attitudes
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.
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 10-year Global Future Scenario of Objects driven Virtual Collaboration, developed by the Future Research Lab of The Unicist Research Institute and led by Peter Belohlavek, defines the trend towards this type of work organization when some of the following conditions are given:
Extreme specialized solutions are needed
There is a need for time saving
There is a need for timing
Transparency of work processes
Reliability systems
Customer orientation
Quality assurance in work process
About Virtual Collaboration
The communication and IT technologies allowed making the next step in organizational design, integrating personal and virtual collaboration, organizing roles and using business objects, to maximize results and minimize costs.
This is a change in working habits that is extremely valuable to manage the adaptive aspects of businesses.
The virtual collaboration allows developing both internal and external work processes. The introduction of this technology needs to begin with the activity where the productivity increase is needed the most.
Marshall McLuhan said: “The Medium is the Message”. There is no doubt that virtual media are less powerful than in-person activities to build personal relationships. Therefore it is necessary to compensate this characteristic with an increase of functionality in the group dynamics.
Functionality is increased by using business objects (that introduce functional adaptive automation into the processes). The use of business objects driven work processes allows increasing the functionality of virtual collaboration processes and building a context of simplicity.
In order to achieve group synergy, it is required that the group follows a protocol that establishes the rules of actions and the distribution of credits for its members.
It has to be considered that the bond established between the members of a group is basic to provide a collaboration context that allows achieving synergy and thus increases the productivity.
The fundamentals of this bond are given by the complementation between the members, the functionality of each role and the personal link between the members.
The drivers of this trend are:
The use of virtual collaboration at a personal level on Internet
The massification of the use of Internet
The use of virtual collaboration by many leading organization such a: Shell, IBM, Deloitte, Google, Cisco, etc.
The new technologies that sustain this trend:
Cloud computing
Audio/Video-conferencing
Data-sharing
Desktop-sharing
Web-conferencing
Imaging technologies
Object Driven Organization
Adaptive IT Solutions
Client Centered Management
Where will Virtual Collaboration be installed as a standard within the next 10 years?
Subjectivism is the killer of Virtual Collaboration
Subjectivism at work is the prevalence of subjective, ungrounded opinions, which prevail over any foundations that can be installed by a counterpart. Subjectivism implies the need of using distortive perceptions, denial and fallacies to avoid dealing with the actual problems.
Subjectivism is necessarily driven by manipulation which necessarily requires an extreme use of emotional influence to avoid dealing with the functional aspects of reality.
Therefore virtual collaboration requires working in functional environments where the roles of individuals are recognized by the results they can produce and their capacity of teamwork. Subjectivists can use virtual communication but not virtual collaboration.
What is needed to deal with Virtual Collaboration?
There are three aspects of organizations that need to be considered when installing virtual collaboration as a standard:
Client Centered Management, to organize towards the satisfaction of customers and clients.
Object Driven Organization, to use objects and personal roles to introduce functional adaptiveness in the processes.
Adaptive IT solutions in order to provide a framework to sustain the efficacy of the participants.
1) Client Centered Management (CCM)
CCM is a management model that was developed to establish the rules for an optimum use of the company’s energy so as to satisfy its internal and external clients. When talking about the external client in the company we necessarily refer to the customer and the shareholder. CCM is a meta-model to provide result-assurance, client orientation and secure added value to an organization. It is the natural model to expand businesses.
CCM is a paradigmatic adaptive system integrated by multiple business objects.
The core objects are:
1) The Unicist Reliability System
2) The Unicist Scorecard
3) The Unicist Quality Assurance System
The principles that integrate the CCM meta-model are:
1. Divide the processes into client-supplier units
This division aims at determining which operating units have a clear “output” so as to be suppliers and which have a clear “input” so as to be considered clients.
2. Minimize intermediaries
This principle follows the natural concept of “the larger the number of intermediaries, the bigger the entropy”.
3. Services or products received are paid for
This principle makes the organization become more aware of costs and benefits and enables negotiating goals to obtain measurable and predictable results.
Maximal Strategy
4. Each client has only one supplier
The principle that each client has only one supplier defines the role of the supplier which drives towards a solution driven approach and not only a task driven approach.
5. First giving, then receiving
It implies that services are paid for once rendered and not during the rendering process or in advance. There can be grounded exceptions to this in the organization.
6. Delivered out of time is considered undelivered
In practice, it ends up in an incentive system for each delivery on time and a punishment system if the dispatch is made out of time.
Minimum Strategy
7. Every client may change his supplier
The organization’s success is given by its capacity to satisfy the clients’ needs. This obliges the organization to manage the unfulfilled situations a supplier may have.
8. He who needs claims
“He who needs claims” is a principle based on the KANBAN approach which is closely associated with the natural tendency of satisfying one’s own needs.
9. Each supplier counts on his client’s trust
One of the basic principles of any successful large company is having a high reliability level. Reliability and trust are “sine qua non” principles for CCM’s application.
2) The Object Driven Organization
The unicist organizational approach is based on emulating nature in organizations. An extremely effective organization can be developed integrating both structural aspects that sustain evolution and incidental aspects that allow dealing with conjunctures. Emulating nature implies integrating the abstract apprehension of reality with the concrete operational design.
A unicist object driven organization is a result driven model that, according to the predefined objectives, designs the necessary processes and uses and reuses business objects to produce the expected results.
The object driven organization requires having a high level of maturity in business. It can be defined as the organization of processes and the use of objects to achieve the objectives that have been established in a strategy.
An object driven organization implies the development of a maximal strategy that includes the design of processes based on taxonomic procedures to put them into action and also a shared vision that makes these processes consistent with the business.
The vision of the organization is the catalyst of the minimum strategy. If it does not achieve its threshold, it works as an inhibitor of the minimum strategy and destroys the organization. The minimum strategy is based on the use and reuse of objects within the context of methodic procedures to ensure their use and functionality. This is sustained by an action plan (a “to do” list) to guarantee the fulfillment of the minimum strategy.
The use of business objects structures the timing and synchronicity of business processes. It also provides the necessary acceleration to achieve the needed critical mass and the required speed to adapt to the environment.
Types of Business Objects
There are five business objects which are: the drivers, the entropy inhibitors, the inhibitors, the catalysts and the gravitational objects.
The first three ones belong to the process of a system while the catalysts are part of the restricted context and the gravitational objects belong to the wide context of a system.
Objects can be designed integrating these three functions as part of their functionality or they can exist as three different objects to provide the driving, inhibiting and entropy inhibiting functions in a process.
Catalysts and gravitational objects are not part of the system. If one integrates them into the system, these objects do not work as such and destroy the system’s functionality.
The use of business objects requires individuals who understand the business processes in order to use the objects and replace them when their functionality has been exceeded
Unicist Business Objects are provided for the following uses:
Driving Objects To drive processes
Catalyzing Objects To accelerate processes
Entropy Inhibiting Objects To inhibit the entropy of business processes
Inhibiting Objects To inhibit dysfunctional events in a business
Gravitational Objects To influence the results of processes
3) Adaptive IT Solutions
The available IT technologies made the development of adaptive systems meaningful. The objective of building adaptive systems is to integrate software, hardware and peopleware in adaptive work or business processes to assure the quality of the results produced.
The development of the adaptive IT technology became possible because of the discovery of the unicist laws of evolution, the object driven organization that emulates the organization of nature and the drivers of human behavior that allow designing the necessary peopleware.
Before the existence of adaptive systems, the solution was fully focused on the efficacy of individuals, which increased the responsibility of the person who was doing a job. This forced individuals to consider all the details of the feedback from the environment which increased the probability of errors.
The catalyst of an adaptive IT system is its capacity to learn from the feedback to improve its adaptive structural behavior. The entropy inhibitor of the system is given by its capacity to learn to ensure conjunctural adaptiveness.
Adaptiveness is based on the existence of drivers that make it possible. There are different levels of adaptiveness beginning with the most basic and ending with the most flexible. The levels of the adaptive drivers are the following:
There are analogical drivers that are based on the recognition of patterns.
There are rule based drivers that include the preexisting and add rules that correspond to the activity.
There are empirical drivers that include the preexisting and add empirical information obtained using mathematical models.
There are objects based drivers that include the preexisting and add concept based objects as intrinsic adaptive systems.
The integration of the adaptive aspects with the operational and administrative aspects is necessary in order to develop user oriented information systems.
The level of adaptiveness of a system has to be designed according to the characteristics of a work process. Administrative and operational systems can be transformed into adaptive systems by adding and integrating an adaptive interface.
Quality Assurance: The Unicist Standard
The Unicist Standard was developed to sustain the application of the Unicist Logical Approach to Adaptive Systems Architecture and to the building of Unicist Business Objects.
The researches developed at The Unicist Research Institute allowed managing the unified fields of human complex adaptive systems in a reasonable, understandable and provable way.
The discoveries of the ontogenetic intelligence of nature, the anthropological invariables and their evolution, the human ontointelligence and the double dialectical behavior made the research & development and management of adaptive systems possible.
The Unicist Standard defines the ontogenetic maps that have to be followed in an adaptive system in order to structure it and achieve the results that have been defined as possible.
Conclusion
Virtual collaboration is the natural way to organize when there is a need of expert knowledge. Nowadays expert knowledge can be integrated in most of the cases by using the IT technologies that allow sharing data and images.
The time saving and productivity increase is significant when the conditions for virtual collaboration are given. It allows providing full synchronicity with the needs of customers and clients.
But there are several requirements for virtual collaboration to be implemented:
Virtual collaboration needs transparency of work become part of the culture of an organization.
It needs reliability systems that monitor work processes.
It requires customer orientation that fosters fulfillment, synchronicity and reliability.
Personal roles need to be complemented by quality assurance processes to ensure results.
If you want to access more information about this study please contact n.i.brown@unicist.org
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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
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.
On 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
The Unicist Business Process Model uses the model defined with the Unicist Business Modeler and transforms it into strategic actions and organizational design.
Thus the business process becomes defined and it is possible to introduce business objects and systems to install the necessary efficiency and foster the efficacy of the members of an organization.
The purpose is to transform the Unicist Business Model into operational procedures.
The active function is given by the definition of an adequate strategy that covers both the maximal and minimum strategies.
The energy conservation function is defined by the organizational design.
The unicist technology for Business Modeling allows modeling business concepts and transforms them into operational procedures.
The Unicist Business Modeler uses the Unicist Ontological Algorithms that have been researched and developed, the Unicist Standard Language and the Facts of an activity to define the necessary processes and objects to develop a business.
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. https://www.unicist.org/healthcare/wp-content/uploads/2015/08/turi.pdf
This research began in 1976 with the hypothesis that in nature there are mutations that are random but others that are driven by a purpose.
If this hypothesis was confirmed and there were a purpose, Peter Belohlavek concluded that there would have to be an intelligence that defined such purpose.
For this reason, Belohlavek researched on the essential structure implicit in nature’s intelligence to be able to predict and exert influence on the evolution of complex adaptive systems when possible.
Charles Darwin demonstrated the adaptation process of species that, having the same structural constitution, developed adaptive changes to live in a certain environment.
The hypothesis of Belohlavek’s research was that these changes were driven by an intelligence that underlies nature.
He concluded that each living creature’s evolution is ruled by its ontogenetic intelligence, that defines it as unique both in its species and individuality and that the essential structure of this intelligence is integrated by a purpose, an active principle (entropic function) and an energy conservation principle.
The research was focused on the unified field of living beings.
The basic assumption that sustains this development is that the evolution of living beings, their behaviors, actions and deeds are driven by the same logical structural framework.
This implies that there is an intelligence that defines the structural behavior of any entity that integrates this framework that allows predicting the behavior of all the entities where this intelligence is known.
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
The Unicist Research closed the gap between macro and micro behaviour. The unicist complexity research approach implies dealing with applications while researching, which requires that the lapse of research time be very long in order to achieve fully accurate predicted results before validating a hypothesis.
As it has been done every year since its foundation, The Unicist Research Institute synthesized this January the researches that had been finished until that time. After 38 years, 2013/2014, can be considered the year in which the integration of macro and micro behavior could be confirmed.
The gap between the macro and the micro cosmos has been and is still a problem that theoretical physicists are closing. The integration of the field of macro and micro behavior, that has been solved by Peter Belohlavek, is homologous. It allows integrating social behavior with individual behavior, making human complex adaptive systems manageable.
The publication of Conceptual Economics, Conceptual Anthropology and Conceptual Psychology are some of the milestones of this process that included the researches developed in 2013-2014 (see image above).
If you want to access the “Drivers of Human Behavior” that explain the structure of human intelligence, please access: www.unicist.org/repo/#Psychology
Unicist Press Committee
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
The Unicist Ontology of amino acids allows understanding its functionality and the possibilities of their integration to build proteins. Their purpose is given by the side chain which defines the different functions amino acids can fulfill.
It has to be considered that the Unicist Ontology emulates the ontogenetic intelligence of nature that was discovered which defines that there is always a purpose, an active and entropic principle and an energy conservation principle. The unicist ontology of amino acids is a demonstration of how this intelligence works.
The active function of an amino acid is given by the carboxyl group that establishes a supplementary relationship with the R-group. The energy conservation function is given by the amino group, which establishes a complementary relationship with the R-group.
Amino acids are biologically organic compounds integrated by amine and carboxylic functional groups, driven by a side-chain specific to each amino acid. The key elements of an amino acid are carbon, hydrogen, oxygen, and nitrogen, though other elements are found in the side-chains of some amino acids.
Amino acids are the building blocks of peptides and proteins. They are composed of amine and carboxylic acid groups, separated by the alpha-carbon but the side chains on the alpha carbon vary with the acid. They are the subunits of proteins: amino acids make peptide chains, peptide chains make polypeptides, polypeptides make proteins.
Amino acids are the structural units that build proteins. They join together to form short polymer chains called peptides or longer chains called either polypeptides or proteins. These polymers are linear and unbranched, with each amino acid within the chain attached to two neighboring amino acids.
Peptide Formation
Amides can be thought of as forming from the reaction of an amine and a carboxylic acid. In the same way, two amino acids can combine to form a dipeptide, held together by a peptide bond.
Peptides
A fourth amino acid would form a tetrapeptide, a fifth would form a pentapeptide, and so on. Short chains are referred to as peptides, chains of up to about 50 amino acids are polypeptides, and chains of more than 50 amino acids are proteins. Amino acids in peptide chains are called amino acid residues.
Classification of Amino Acids
Acidic amino acids and their amides: aspartic acid, asparagine, glutamic acid, glutamine.
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. https://www.unicist.org/healthcare/wp-content/uploads/2015/02/turi.pdf
The research on the unicist ontology of health, which began in 2001, was focused on finding the essential structure of health that allows understanding the multiple medical specialties and medical approaches that deal with “the art of healing”. This research was developed at The Unicist Research Institute and was led by Peter Belohlavek.
Paradoxically, it could be finished after the ontological structures of healthcare were discovered. This research integrated health and medical approaches in a “unified field”. The previous researches that sustained this discovery were:
-The Unified Field of Healthcare -Homology between Concepts and Stem Cells -The Ontogenetic Intelligence of Nature -The Fallacy of Organs and Chronic Diseases -The Unicist Structure of Viruses -The Ontogenetic Map of Chronic Diseases -The Ontogenetic Map of Addictions -The Ontogenetic Map of Stress -The Ontogenetic Map of Cures -The Ontogenetic Map of Immune Systems -The Ontogenetic Map of Therapeutics -The Ontogenetic Map of Diseases
Health can be defined as the integration of organic functionality, psychic functionality and the functionality of the inner energy flow.
The organic functionality is defined by the functionality of organs which, working as complex adaptive systems, can only be measured based on the consequences of their function. Organic functionality also includes the functionality of inner systems, although they cannot be considered as organs (e.g: the immune system). The fallacy of organs functionality is a proof of the limits of the possibilities of organic functionality. http://www.unicist.org/healthcare/unicist-ontology-of-health-the-fallacies-of-organs/
The psychic functionality is defined by the functionality of the instinctive, spiritual and psychological processes whether they are conscious or unconscious that allow individuals to adapt to the environment. The psychic functionality deals with the interpersonal and intrapersonal adaptive processes and with the meaning of life.
The energy-flow functionality can only be measured by the consequences of its lack of functionality. It implies that the human being considered as a system flows internally in a harmonic way. This allows individuals to live and adapt to the environment.
Fostering health requires ensuring that the psychic functionality, which is the active function of health, maintains and does not hinder the energy flow that sustains the functionality of organs. Fostering health requires stimulating a meaningful life where the interpersonal and intrapersonal adaptation conflicts can be managed.
Unicist Press Committee
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. https://www.unicist.org/healthcare/wp-content/uploads/2015/01/turi.pdf
The discovery of the unicist ontological structure of complex systems developed at The Unicist Research Institute provided the final input to develop a methodology for adaptive clinical trials. The unicist ontology of health that was discovered provided the basic background for this methodology: http://goo.gl/Ruwsr3
This approach is based on the integration of aspects of traditional clinical trials, the concept of the “learn and confirm” standard and the unicist approach to complexity sciences.
This approach is based on the use of destructive tests, which are a special kind of falsification test (Karl Popper), to sustain the Phase I and Phase II clinical trials.
The objective of destructive tests is to confirm the limits of the functionality that is being tested.
They are necessary in the previous research work but their application in these phases allows providing a safe input to develop the following phases. Destructive tests are based on universal experimenting and on the knowledge of the conceptual foundations of what is being researched.
Phase III and IV are approaches that use non destructive tests that are analogous to the traditional clinical trials but with the inclusion of a quality assurance process that triggers a “learning” process when predefined limits are exceeded.
The “learn & confirm” methodology introduced at Wyeth changed the paradigms of clinical trials and introduced a conceptual simplification in the R&D processes that could not expand massively because of the non-evident economic benefits of this technology.
The unicist approach to adaptive clinical trials is an approach based on the complexity science research methodology developed at The Unicist Research Institute that simplified the discovery-learn-confirm method introduced by Wyeth and provides a secure approach to life-sciences.
A research consortium, coordinated by Peter Belohlavek, is being organized to develop this solution in real application fields. It is expected that this methodology becomes a standard within the next two years based on the shortening of the R&D processes and the saving of up to 50% of the costs.
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. https://www.unicist.org/healthcare/wp-content/uploads/2014/10/turi.pdf
Paradoxically, there is a widespread perception that EMR/EHR has a low added value for medical practice. This perception hinders the upgrade of medical practice.
