Unicist quality assurance


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.

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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


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.

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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


Simplifying Organizations: The Unicist Object Driven Approach

Unicist Cybernetics is the approach to institutions considered as complex adaptive systems. Unicist Cybernetics is a breakthrough both in organization of institutions and cybernetics based on the unicist ontological design using the taxonomic structures that have been researched.

Learn more accessing the video:

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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


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


Diego Glancszpigel: Unicist Quality Assurance in Healthcare 1

This lecture on the Unicist Standard applied to Healthcare Quality Assurance is fostering an upgrade in quality in the business.

Envisioning quality assurance requires a mind opening attitude. It requires thinking about reality and its context to define the necessary objects to achieve the objectives.

To have a reliable knowledge, in order to produce results, it is necessary to have installed redundancies in processes. Designing objects implies increasing the amplitude of the unified field one is working on.

This requires a higher level of knowledge on the actual reality. It is necessary to have assured quality in order to grow. But the sound knowledge of the context is necessary in order to assure quality. Therefore this lecture works as a mind-opener.

Contact the Lecturing Agent: http://www.unicist.org/lectures/

Request more information: n.i.brown@unicist.org

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NOTE: The Unicist Research Institute is the major research organization in the world in its specialty based on more than 3,000 researches in complexity sciences applied to individual, institutional and social evolution.