Seite - 13 - in Applied Interdisciplinary Theory in Health Informatics - Knowledge Base for Practitioners

GST was a development of Bertalanffy’s work on open systems in biology. In physics, the laws of thermodynamics are based on conservation of energy and a tendency towards entropy (disorder) in a theoretical “isolated system”. Bertalanffy noted that such isolated (or closed) systems rarely, if ever, exist in nature and, in biology, organismic systems (his phrase) tend towards order rather than disorder and, most obviously, organismic systems can grow and replicate as they interact with their environment, exchanging energy, matter and information. Many organismic systems are able to dynamically respond to their environment in order to maintain a steady state (homeostasis) in, for example, body temperature. More generally, the tendency towards order can be found in atoms, molecules, cells, organs, organisms such as people and organizations such as social groups and even health care providers. Structures emerge based on finding effective relationships between components whether these are protons and neutrons in an atom or a surgical team trying to save the life of a critically ill patient. Bertalanffy’s development of GST was motivated by his desire to provide a fundamental language of systems that would improve scientific understanding across all disciplines [5]. 1.2. What is General System Theory? General System Theory in the narrowest sense was defined by Bertalanffy as the attempt to derive a general definition of “system” as a complex of interacting components that together have the characteristics of an organized whole [5, pg 91]. The emphasis of a system as an “organized whole” incorporates the concept of holism developed by Aristotle and commonly expressed as “the whole is more than the sum of its parts”. GST makes the connection that holism is an emergent characteristic of systems as a product of the relationships between its components as they work together to collectively interact with their environment. There are three key principles that follow from this general definition and the emphasis on holism. Firstly, GST asserts that this definition of a system should be generally applicable across all disciplines and that the systems perspective can generate new, and hopefully useful, insights. Secondly, GST states that components of systems are often systems in their own right. Each member of a surgical team is also a person with similar but also unique emergent characteristics that might included their degree of experience in the specific role, their skills but also their affinity with other members of the team and degree of tiredness, hunger etc. which could be traced to their digestive systems and maintenance of blood sugar levels. From the perspective of GST, systems can be seen as being both composed of, and existing within, a hierarchy of systems. Our surgical team may be part of a busy Accident and Emergency department within a large hospital that is part of a larger healthcare provider and a regional or national health system. The team’s performance will be affected by their immediate environment, which will include other systems (teams, departments, etc) within the hospital that it interacts with (in collaboration with or even in competition against) and also external environment factors such as the arrival of more patients. Thirdly, GST places the emphasis on the relationship between components rather than simply the components themselves. The fact that surgical teams generally cope so well with all the complexity thrown at them is a testament to the relationship between team members - roles are clear but also sufficiently flexible and dynamic to adapt quickly to each other’s needs as well as the patient’s. An emergent property of a surgical team is O.Johnson /GeneralSystemTheoryand theUseofProcessMining to ImproveCarePathways 13