HEALTHCARE: A COMPLEX SERVICE SYSTEM

Healthcare is indeed a complex service system, one requiring the technobiology approach of systems engineering to underpin its development as an integrated and adaptive system. In general, healthcare services are carried out with knowledge-intensive agents or components which work together as providers and consumers to create or co-produce value. Indeed, the engineering design of a healthcare system must recognize the fact that it is actually a complex integration of human-centered activities that is increasingly dependent on information technology and knowledge. Like any service system, healthcare can be considered to be a combination or recombination of three essential components-people (characterized by behaviors, values, knowledge, etc.), processes (characterized by collaboration, customization, etc.) and products (characterized by software, hardware, infrastructures, etc.). Thus, a healthcare system is an integrated and adaptive set of people, processes and products. It is, in essence, a system of systems which objectives are to enhance its efficiency (leading to greater interdependency) and effectiveness (leading to improved health). Integration occurs over the physical, temporal, organizational and functional dimensions, while adaptation occurs over the monitoring, feedback, cybernetic and learning dimensions. In sum, such service systems as healthcare are indeed complex, especially due to the uncertainties associated with the human-centered aspects of these systems. Moreover, the system complexities can only be dealt with methods that enhance system integration and adaptation.

作 者： James M. TIEN Pascal J. GOLDSCHMIDT-CLERMONT   作者單位： James M. TIEN(Dean, College of Engineering, University of Miami, Coral Gables, Florida, USA)

Pascal J. GOLDSCHMIDT-CLERMONT(Dean, Miller School of Medicine, University of Miami, Coral Gables, Florida, USA) 

刊 名： 系統(tǒng)科學(xué)與系統(tǒng)工程學(xué)報(bào)（英文版）  英文刊名： JOURNAL OF SYSTEMS SCIENCE AND SYSTEMS ENGINEERING  年，卷(期)： 2009 18(3)  分類號(hào)：   關(guān)鍵詞： Services   healthcare   system integration   system adaptation   system complexity   system of systems   customization   co-production   decision informatics   real-time decision making  

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