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characteristics) are emergent properties of the system-as-a-whole. The complexity of
modern systems is such that solving one performance issue or bug may introduce others
and a holistic perspective on the system together with a deep respect for the complexity
of its internal structure becomes essential.
As our computer systems have become more complex, they have become, following
Boulding’s Level 7, more human. Holistically they can display emergent properties of
being buggy, annoying, slow stubborn, inflexible – to the extent that we may find
ourselves shouting “stupid computer” at them or complaining about them as though they
were a troublesome colleague. From a GST perspective, none of this should be a surprise
- most health informatics systems fit comfortably into Boulding’s definitions of Level 5
and above and may have many of the characteristics of Level 7, and perhaps Level 8 too.
Especially as modern advances in computing such as AI, neural networks, distributed
systems and edge computing increasingly follow biologic models of systems of
competing sub-components. The result is that even their designers cannot know exactly
how they work. For healthcare this presents an unusual problem: should clinicians trust
a computer system that no-one can adequately explain? Medical devices have been
regulated on the basis that their programming is rules-based (GST Level 3 and 4) but
complexity in general and medical AI in particular have advanced computing well
beyond these levels. GST may be needed to help regulation, legislation, the professions
and society adjust to human-level computer-based systems.
One significant difference between all computer systems and all biologic systems is
the relationship with data. Biologic systems process and act on information and store
useful information and successful responses to it as knowledge for future reference, and
they have used this learning system process to evolve successful survival skills over
many thousands of years. Our current computing systems are an awkward fit with GST;
they are less than 70 years old and they work differently. Specifically, they can and do
store huge amounts of raw data and it is their reliance on data, rather than information
and knowledge that can make them appear “stupid”. Future, bio-inspired computing may
evolve similar intelligence but for now the key opportunity for organizations is to mine
the wealth of big data stored within legacy computer systems. In healthcare, data mining
of electronic health records is seen as having the potential to transform our understanding
of medicine [8]. Locked away in these records is the history of millions of clinical
encounters and their successful or unsuccessful outcomes.
2.3. Applications of GST in Learning Health Systems
In health informatics, there has been growing interest in Learning Health Systems, a
phrase coined by Charles Friedman [9] in the USA which envisaged rapid learning based
on a federated, national approach to exploiting EHR data gathered by different US
healthcare providers. More generally, Learning Health Systems are seen as organization-
wide or pan-organizational regional and national systems that deliver healthcare to a
large population. In Friedman’s vision there is a symbiotic relationship between the
health provider system and the health information systems that it uses. The Learning
Organization concept was developed from systems theory by management theorists,
notably Peter Senge [7]. In learning organizations, systems approaches that reward
effective learning are embedded within management culture at all levels of hierarchy.
The organization is seen as organic with structures evolving through continuous learning
to meet changing environments and ensure survival in a fast paced, ever changing world.
O.Johnson /GeneralSystemTheoryand theUseofProcessMining to ImproveCarePathways 17
zurĂĽck zum
Buch Applied Interdisciplinary Theory in Health Informatics - Knowledge Base for Practitioners"
Applied Interdisciplinary Theory in Health Informatics
Knowledge Base for Practitioners
- Titel
- Applied Interdisciplinary Theory in Health Informatics
- Untertitel
- Knowledge Base for Practitioners
- Autoren
- Philip Scott
- Nicolette de Keizer
- Andrew Georgiou
- Verlag
- IOS Press BV
- Ort
- Amsterdam
- Datum
- 2019
- Sprache
- englisch
- Lizenz
- CC BY-NC 4.0
- ISBN
- 978-1-61499-991-1
- Abmessungen
- 16.0 x 24.0 cm
- Seiten
- 242
- Kategorie
- Informatik