Handbook of Systems and Complexity in Health, 2013

This book is an introduction to health care as a complex adaptive system, a system that feeds back on itself. The first section introduces systems and complexity theory from a science, historical, epistemological, and technical perspective, describing the principles and mathematics. Subsequent sections build on the health applications of systems science theory, from human physiology to medical decision making, population health and health services research. The aim of the book is to introduce and expand on important population health issues from a systems and complexity perspective, highlight current research developments and their implications for health care delivery, consider their ethical implications, and to suggest directions for and potential pitfalls in the future.

1. Complexity in Health - An Introduction.- 2. Complexity, uncertainty and mess as the links between science and the humanities in healthcare.- Part 1 - Complexity Theory and Methods.- 3. Understanding Complex Systems.- 4. The Complex Nature of Knowledge.- 5. Mathematical Principles: Tales of Tails.- 6. Modelling.- 7. A methodology for the analysis of medical data.- 8. Psychological Rhythmicities.- 9. Modeling Illness and Recovery with Nonlinear Dynamics.- Part 2 - Dynamics in Human Health.- 10. Homeostasis: The Dynamic Self-regulatory Process that Maintains Health and Buffers against Disease.- 11. Fractals in Physiology & Medicine.- 12. Bio-complexity: challenging reductionism.- Part 3 - Concepts of Health.- 13. Trying to Make Sense of Health.- 14. Picture Health.- 15. Health - A personal complex-adaptive state.- 16. Understanding Health By Building Better Bio-Medical Models.- 17. Health – a systems and complexity based definition.- Part 4 – Clinical Application.- 18. Complexities of the Consultation.- 19. Inflammation through a Psychoneuroimmunological Lens.- 20. Diabetes control: insights from complexity science.- 21. Complexity and the onset of psychosis.- 22. Understanding intimate partner violence through its dynamics.- 23. Multi-level interdependencies and constraints in panic disorder: Many triggers, few responses.- 24. Nonlinear Relations of Cardiovascular Risk Factors to Neuropsychological Function and Dementia.- 25.  Pain and Complex Adaptive System Theory.- 26. Complexity in Movement Disorders:  A Systems Approach to Intervention.- 27. Avoidable hospitalizations in older adults.- 28.  Continuous Multiorgan Variability Monitoring in Critically Ill Patients – Complexity Science at the Bedside.- Part 5 - Health Services.- 29. An overview of complexity theory: understanding primary care as a complex adaptive system.- 30. Real-time Analytics and Quality of Care.- 31. Medical Sociology and Case-Based Complexity Science: A User’s Guide.- 32. The Drug Prescription Process: a Network Medicine Approach.- 33. Applications of Complex Dynamics, an Approach to Refractory Health Policy Interventions.- 34.  Designing for Health Promotion, Social Innovation and Complexity: The CoNEKTR Model for Wicked Problems.- 35.  The Dynamical Behaviours of Diseases in Africa.- Part 6 - Health System.- 36. Health Transition Funds Initiatives: Implications for Health System Reform and Evaluation.- 37.  Putting complexity to work - supporting practitioners in health systems.- 38. Implementing Adaptive Health Practice — A Complexity-Based Philosophy of Health Care.- 39.  Mayo Clinic: Making Complex Healthcare Simpler.- 40. Embracing Uncertainty: Complexity Inspired Innovations at Billings Clinic.- 41.  A Complexity Science Perspective of Organizational Behavior in Clinical Microsystems.- 42.  Reverse the Epidemic Tides of Unhealthy Habits: Personal, Professional and Leadership Challenges.- 43. Health Professions Education:  Complexity, Teaching and Learning.- 44. Understanding Clinical Complexity through conversational learning in medical social networks: Implementing User Driven Health care.- Part 7 – The Future of Healthcare.- 45.  Making sense – from complex systems theories, models and analytics to adapting actions and practices in health and health care.- 46.  Modeling the Paradox of Primary Care.- 47.  Health Care Reform – the need for a complex adaptive systems approach.- 48.  A Complexity Science Approach to Healthcare Costs and Quality.- 49.  Opportunities in Delivery of Preventive Services in Retail Settings.- 50.  Complexity Science in the Future of Behavioral Medicine.- 51.  Systems Medicine – A New Model for Healthcare.- Epilogue.

 

Joachim P Sturmberg MBBS, DORACOG, MFM, PhD, FRACGP I am Adjunct A/Prof of Monash University, Melbourne, and Conjoint A/Prof of General Practice in the Department of General Practice in the Department of General Practice, General Practice, The Newcastle University, Newcastle, Australia. I am a graduate from Lübeck Medical School, Germany, where I also completed my PhD. Since 1989 I work in an urban group practice on the NSW Central Coast, with a particular interest in the ongoing patient-centred care of patients with chronic disease and the elderly. In 1994 I started to pursue systems and complexity research with an inquiry into the effects of continuity of care on the care processes and outcomes. Since then my research has expanded and includes the areas of understanding the complex notion of health, health care and healthcare reform, showing that health is an interconnected multi-dimensional construct encompassing somatic, psychological, social and semiotic or sense-making domains, that health care has to embrace the patient’s understanding of her health as the basis for effective and efficient care, and that an effective and efficient healthcare system ought to put the patient at the centre. I am joint chief editor of the Forum on Systems and Complexity in Medicine and Healthcare in the Journal of Evaluation in Clinical Practice. Together with Carmel Martin and Jim Price I chair the Complexity SIG in WONCA.

Carmel C Martin MBBS, MSc, PhD, MRCGP, FRACGP, FAFPHM I am Visiting Academic Department of Public Health and Primary Care, Trinity College, Dublin, and an Associate Professor of Family Medicine at the Northern Ontario School of Medicine. I am active in clinical general practice with a particular interest in chronic disease and illness and patient centered care and integrated care using information technology, informed by complex adaptive systems theories. I am an Australian medical graduate from the University of Queensland. I completed my Masters in Commu