Complexity in Healthcare

I have been reading the book Out of Control by Kevin Kelly about complexity science and the future. Although not stated out right, many of his analogies apply to healthcare.



One that hit home was the idea that anything in balance is dead.



Kelly shows us this concept through the analysis of planets atmospheres in the solar system. Any planet whose atmospheric elements are in text book equilibrium can sustain no life. But earth, earth is a stable instability of gases, and, of course, life thrives$

In complexity, stagnant and equilibrium is death. When movement stops, even to the cellular level, death occurs.



And what our our hospitals thriving on? Stability!



Policies and procedures provide a stagnant environment that takes enourmous energy to change, the AMA and other professional organizations are steeped in the traditions of a past paradigm, and the knowledge workers at the point of care have extreme difficulty in adopting new practices (17 years for research to reach the bedside). So what does all this mean...



Stagnation.



So to hit it home a little closer. The IOM reports that over 100,000 people die each year from medical error. But is that surprising when the system is working towards stability?



My questions are: what would happen if a hospital, clinic, practitioner office moved to a complex adaptive system model?

What if the policy was to find and utilize the best evidence to make a clinical decision?

What if there was a system out there to provide the best evidence to the practitioner, the patient, and the system so policies and procedures were then obsolete?



What kind of healthcare would happen then?