Regarding your comment on “Putting together CAS principles so that they take advantage of CAS may be the feat”… yes, I agree. There is an interesting program called “The Game of Life”, in which some simple rules give rise to varied behavior (‘adaptive’) over time.

I use that game/computer simulateion as a metaphor for finding the “right rules”. The book “Crossing the Quality Chasm” ended up with 10 rules, which is too many. There really should be just two rules, I think: one looking out at the society of which ‘healthcare’ finds itself a part, and the second an inward ‘maintaining homeostasis’ kind of rule. One to maintain balance and coherence. All other rules should ideally be subsumed under a “rule tree”, and support the “Great Commandments”. At least that is my current thinking.

Anyway, the trick is to have simple rules, not complex ones, AND to have the ‘right’ simple rules.

To see the “Game of Life” simulation, see here

http://www.bitstorm.org/gameoflife/

for example/

As you know, “Crossing the Quality Chasm” was/is a major text in medical informatics. Putting together CAS principles so that they take advantage of CAS my be the feat.

I found the subject so fruitful that after some reading I started my own website, http://www.adaptingsystems.com which I would invite anyone to visit. It has some applications of CAS that I am trying to develop and present.

Ironically, the book “Crossing the Quality Chasm”, which was trying to address healthcare quality issues (especially medical error) didn’t really apply the ‘principles of CAS’, in my view. They ended up with a complicated and expensive ‘solution’, which was ignored. Surprise, surprise.

Sounds like a great topic!

I searched around and do not have a pdf of that paper. (I may have had access to it when I was a student via the medical library.) Unfortunately, I am no able to find it on the Academy Health site, although maybe it is there somewhere.

Best of luck with your studies.

I am a masters student in Lisbon – Portugal, and im interested in evidence of Vertical Integrated care as Complex Adaptive Systems.

I can´t get acces to this pdf:
Complex Adaptive System Behavior and Healthcare Expenditures: Evidence and Implications.

Is it possible that you send it to me?
Congratulations about your site.

Ricardo

(BA Philosophy UCSC)