We have been working on many fronts.

Carolyn Turkovich: Team development

Jack Homer and Gary Hirsch: Systems dynamics modeling and simulation for cross-organizational policy making.

Bill Mahoney: Social Network Modeling to understand, strategize, and communicate relationships and spread (contagion). Also, Bill thinks that teamwork at the microsystem level is the key to change and I certainly agree with him.

Gene Nelson: Bill has recently directed me to the work at Dartmouth on microsystems.

Bobby Milstein: innovated by linking System Dynamics and Social Network Modeling and he has focused on the community level.

Jack Silversin: teamwork and cooperation in health care.

I have worked for years on the information flow and human connections between microsystems and between organizations.

This interesting book pulls much together and I think the models articulated here will form the basis for models we can share in this community to show how the community health care system (however dysfunctional) works and how it can work. I recommend it for all of us: Small Groups as Complex Systems: Formation, Coordination, Development, and Adaptation.

http://www.amazon.com/exec/obidos/ASIN/080397230X/102-3988174-1364949

I am not a research scientist of any persuasion so I hope these authors stand up to your review. In any event I see lots of options for using System Dynamics and Social Network Modeling to help folks understand the world in this new way. We may be able to usher in the needed paradigm shift called for in the IOM report--shifting understanding and focus from the parts (generally disconnected and sometimes broken) to systems. Rearrangement of parts alone will not get us where we want to go.

Several of you have heard me say that I hope Whatcom County becomes the next Framingham, but instead of the domain being population medicine it will be the sociology of medical systems at the community level. I believe that it is here that the customers experience the disjunctions and here that the capacity for leverage exists. In the literature and among my acquaintances I see very little attention to connections or to community. People may to be working on the things that seem possible or amenable to research, even if they cannot provide the level of transformation called for it the IOM Chasm report.

I hope that we can explain the situation in these terms, reorganized by these authors, and I hope that we do it in graphical and understandable ways.

Let me know what you think.