3. Introduction
This chapter take a closer look at the gradual breakdown
of conventional thinking about organized health care
delivery systems.
review general systems concepts and discuss how these
concepts relate to the e-health care system and
environment.
examine chaos theory and concepts of quantum
mechanics
4. General Systems Concepts
General systems theory (GST) begins with the
observation that what we see, hear, and interact with
may be rationalized as a hierarchical network of systems
and subsystems.
hospital information systems, the e-health care system,
and the general health care system.
5. General Systems Concepts
A system must have a purpose.
set of interrelated parts that function together as a whole
toward achieving a common purpose
open or closed.
6. General Systems Concepts
Open complex systems are characterized by input-process-
output triads and feed- back loops.
GST easily describes the flow of appropriate and relevant
information about sick patients (input), who are placed into
the different subsystems of the acute health care system to be
treated and cared for (process) until they are ready, perhaps,
to be transferred to another subsystem such as a group home
(intermediate output) before being discharged as healthy
individuals who can continue to contribute to their work
organizational systems (final output).
7. General Systems Concepts
the principles of GST concerning the behaviors of
organizational systems and subsystems were used to think
about the design of different classes of clinical and
administrative health management information systems.
e-health records (EHRs)
8. General Systems Concepts
Systems Thinking and Analysis:
Systems thinking means seeing the connections among the
processes of change, not just snapshots of changes; in other
words, the focus should be on interrelationships rather than
linear cause-effect chains.
not only should key factors and variables be tracked carefully,
but moderating and intervening variables should also be
monitored, to ensure more complete and intelligent
management and decisions
9. General Systems Concepts
Systems Thinking and Analysis:
Example: in developing an e-public health statistical system
to examine and investigate the health of a population, key
indicators such as average life expectancy (measured in
number of years) and infant mortality (measured in infant
deaths per 1,000 live births) must be tracked, and gender,
age, race, and other moderating variables such as location
and diet should also not be neglected. Ignoring intervening
variables could result in an incomplete picture with too many
unanswered questions.
The power of e-technologies makes tracking all of these
variables a less difficult task than it may seem.
10. General Systems Concepts
Systems Thinking and Analysis:
emphasizing the part to emphasizing the whole.
objects as of primary importance to viewing relationships as
being of primary importance (network thinking)
paying attention to a single system level to moving between
system levels.
……
11. General Systems Concepts
Metaphors and Mental Models as Systems Analysis Tools:
Final point in the systems thinking and analysis approach to
decision making is the development of models
used to obtain valuable insights into thebehavior of a system
Within the context of the e-health care system and its
environment, variables often are not easy to quantify; for
example, consider the variables involved in ethical, legal, and
privacy issues.
intangible factors that affect the behavior of the system are not
considered.
Because many of these factors are too difficult or complex to
simulate or model
12. General Systems Concepts
Metaphors and Mental Models as Systems Analysis Tools:
complex information and network needs eye-opening and
refreshing approach as neural network.
neural network (NN) may be conceived as a simplified emulation
of the connections of the human brain.
Neural networks, with their remarkable ability to derive
meaning from complicated or imprecise data, can be used to
extract patterns and detect trends that are too complex to be
noticed by either humans or simple mathematical and
programming techniques.
an e-health organization is capable of adaptive learning, self-
organization, and real-time operation.
13. General Systems Concepts
Metaphors and Mental Models as Systems Analysis Tools:
If system neural net- works function in such a way as to pull
together all of the necessary information and decision
making processes of the organization, then we can argue that
not only will these neural networks
capture,store,process,and disseminate massive amounts of
pre- viously learned information, but they will also be able to
coordinate and structure learning of new methods and better
approaches among users so as to improve themanagement
of the enterprise system
14. General Systems Concepts
Metaphors and Mental Models as Systems Analysis Tools:
To extend our NN metaphor and its implications for e-health
networks and e-communities, evolving organizational
knowledge and other enterprise wide networks could have
major implications in altering or redirecting the bureaucratic
principles of centralized control to a self-learning paradigm.
The key here is to create a sharing net- work of interactions
that can self-learn—that is,help generate further learning,
shaped or driven by the intelligence of everyone involved in
primary decision making through- out the virtual enterprise.
15. General Systems Concepts
Metaphors and Mental Models as Systems Analysis Tools:
Mental models are also useful in systems thinking because they
provide simplifi- cations of complex e-health system structures.
Networks can be designed using different mental models,
depending on the perspectives of system users.
For B2C models,a service model perspective is most important
because the avail- ability of a convenient tool for e-transactions
or e-purchases; on-line connection for inquiries to e-
stakeholders,includinge-providers,e-vendors,ande-insurers;and
real- time access to relevant information resources are all key to
meeting e-consumer needs.
16. General Systems Concepts
Metaphors and Mental Models as Systems Analysis Tools:
For B2B models,the mental models reflect the views of the
participating business entities. For instance, an e-vendor
supplying prescription drugs wholesale to one or more
retailers on-line will want to know the inventory status of
the retailers, their account standing, and average monthly
sales volume. An accounting model is there- fore most
relevant and appropriate.
17. General Systems Concepts
Metaphors and Mental Models as Systems Analysis Tools:
Finally, for C2C models, active information exchange and
potential for trading transactions lead to a model that
balances the perspectives of the consumer-oriented service
model and the transactional,accounting-oriented model;in
other words,ahy- brid model may be the best framework to
pursue.In any case,mental models provide a starting
point;system designers and leaders must interpret and
determine what con- sumers and stakeholders expect and
want from the system,since those consumers and
stakeholders will eventually dictate the success of the new
system.
21. Tutorial
Q: Imagine that you’re living in the age of mobile health where
wireless connections prevail. How might you choose among a
list of available mobile physicians? What criteria will you use?
Cost? Response time? Other measures? How would you go
about determining and measuring these criteria?
