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Healthcare and Complexity Science

Healthcare and Complexity Science

During the past forty years, behavioral economics and complexity theory have emerged in helping to explain why organizations and individuals act the way they do. Behavioral economics has become very main stream because of a number of best selling authors book production including, Richard H. Thaler, Daniel Kahneman, Dan Ariely, Charles Duhigg, Jonah Berger, Steven D. Levitt, Stephen J. Dubner and Robert B. Cialdini. On the other hand complexity theory or the study of complex systems continues to remain the purview of a small number of scientists and the Santa Fe Institute (SFI).

Interestingly, Margaret Wheatley in 1992 wrote the book, Leadership and the NEW SCIENCE, Learning about Organization from an Orderly Universe and followed that in 1999 with the book, Leadership and the New Science, Discovering Order in a Chaotic World which connected complexity theory and organizational leadership. The study of complexity science is a work in progress and still lacks a single definition by the scientific community. There is a growing number of books and articles about complexity, but they are not those you would find on the New York Times Best Seller’s List. Intertwined in the study of complexity are a number of other scientific fields including, dynamical systems theory, chaos theory, quantum physics and thermodynamics to name just a few. With a seemingly growing number of unexpected events around the world like, the 2008 global financial crisis, the 2016 referendum vote resulting in the United Kingdom’s withdrawal from the European Union and the 2016 United States presidential election, more interest is being focused on Complexity Science as possible method for predicting these types of occurrences. To avoid any further brain cramping, let’s proceed on the path of what is a complex system.

In our every day living, we encounter many things that are complicated. Complex systems are different. Complexity scientists have identified the following characteristics of complex systems:

• The system contains a collection of many interacting objects or “agents.”
• These objects’ behavior is affected by memory or “feedback.”
• The objects can adapt their strategies according to their history.
• The system is typically “open.”
• The system appears to be “alive.”
• The system exhibits emergent phenomena which are generally surprising, and may be extreme.
• The emergent phenomena typically arise in the absence of any sort of “invisible hand” or central controller.
• The system shows a complicated mix of ordered and disordered behavior.

Source: Simply Complexity, A Clear Guide to Complexity Theory, by Neil Johnson

Billions and billions of dollars are spent every year by organizational leadership to find solutions to organizational challenges. Simultaneously, hundreds of books are written every year espousing solutions to these same organizational challenges. Despite all of these efforts, organizations and the people in these organizations continue to struggle. There is no benefit to be gained by retracing how and why organizations are structured, led and managed the way they are today. There have been numerous books chronicling companies thought to be “excellent” only to find out later when things changed in some cases the companies no longer existed and in other cases became only shadows of themselves. Then more books were written explaining why the previous books omitted some new finding that would now account for companies becoming excellent. With these fleeting success stories, the only real certainty was continued success was highly uncertain.

As scientists have been researching areas like the human immune system, adaptive nature of living organisms, weather and climate change, artificial intelligence, genome research and a host of other projects that have presented questions not answerable with the scientific methods of Newton and others. In a relative short period of time, we have witnessed new companies in old industries use new approaches to significantly disrupt those industries. Southwest Airlines, Toyota, Walmart, Apple are a few of the best known stories.

So what you might ask? What if the present organizational model of healthcare delivery system is obsolete and the only reason it continues to exist are rigid regulations and archaic business structures? What if the healthcare delivery system is a Complex System? What will you do in the event the System begins to exhibit “extreme emergent phenomena” and “disordered behavior?” Will you recognize when the System is attempting to be adaptive? How will you respond? Will you welcome the chaos or quickly implement more control? Will you be aware of emerging organizations seeking to fill the needs of the “interacting agents?”

The case studies and business books are filled with the post-mortem of many former U.S. blue ribbon companies that no longer exist. Capitalism and nature in their purest forms are very harsh teachers. On this website, we are going to begin monitoring the Complex System broadly described as the U.S. healthcare industry. Our objectives are to highlight the attributes of the Complex System, identify emergent phenomena, identify the feedback the System is responding to and attempt to predict when the System will enter in to disorder.