(Analyzing Healthcare as a Complex Adaptive System (CAS)
One of my fellow students at OHSU turned me on to CAS, and I’ve been researching it in my spare time. It really strikes a cord with me, and I am curious to develop a pragmatic understanding of it. I plan to summarize this in a paper. I would be very curious to hear from others in this area.
So here’s my summer reading list:
A quick note of explanation:
There have been numerous attempts to change healthcare. Examples include the difficulty implementing an EMR at a small clinic or at the national level. Why do these attempts routinely fail? CAS posits that a healthcare system encompasses multi-relational agents that change and learn. This is unlike the more typical analysis of the system as a machine, with standard parts and processes. Merely bolting on new parts, or replacing old ones will not do. One needs a broader view of the system, and a way to work within its deeply dynamic culture(s). CAS tries to provide this.
I’ve currently read the following. They are available on the Internet: (Forgive the improper citation formatting.)
What is a COMPLEX ADAPTIVE SYSTEM?
Quick read and definition of CAS.
Healthcare Organizations as adaptive systems
j Begun, B Zimmerman, K Dooley
Advances in Health Care Organization Theory 2003, pp 253-288
Nice introduction to CAS, its history, and Healthcare.
A Complex Adaptive Systems (CAS) Approach to Public Policy Decision Making
Society for Chaos Theory in Psychology in the Life Sciences
Glenda H. Eoyang
Although not strictly about healthcare, more in-depth about CAS style management and how it is supposed to work.
Health Care as a Complex Adaptive System: Implications for Design and Management
William B. Rouse
Volume 38, Number 1 – Spring 2008
Use CAS to help give value. Management with incentives. Suggested matrices. Good article and a quick read.
Healthcare Organizations as Complex Adaptive Systems
Sean Park, MA Candidate
University of Toronto
Jagger Smith, MHA Candidate
University of Ottawa
Nice explanations, especially Complicated Vs Complex. Some management tips.
Complex Adaptive System Behavior and Healthcare Expenditures: Evidence and Implications.
Rupper R; AcademyHealth. Meeting (2004 : San Diego, Calif.).
Abstr AcademyHealth Meet. 2004; 21: abstract no. 1517.
Attempts to prove that Healthcare has at least one attribute of CAS.
Clinical Quality Needs Complex Adaptive Systems and Machine Learning
Stephen Marslanda and Iain Buchana,
Only 5 pages and mostly about machine learning. Some info on healthcare.
Finally, I’m in almost done reading the book, “Edgeware: insights from complexity science for health care leaders” by Brenda Zimmerman, CreateSpace 1998. You’ll have to purchase this one, or get it though your library. It’s quite good. Lots of examples on how to use CAS.
I’ll be digging up more Internet available information as well.