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Will the “Moment of Complexity” Be Coming to Health Care?

by Fred Fortin
A Möbius strip, an object with only one surface and one edge; such shapes are an object of study in topology.

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Mark C. Taylor’s intriguing book, The Moment of Complexity: Emerging Network Culture, is one of those brilliant boiling pot examinations of social theories and philosophy which forces one to think and re-think where we are heading in this new flat world. Of course, when confronted with such intellectual challenges, my initial thoughts are always to line up the questions good authors generate and put them to the test in health care — my personal anchor to all things real and important.

The processes of globalization and proliferation of information technology, according to Taylor, is “creating a new network culture whose complex logic and dynamics we are only beginning to understand.”

Falling between order and chaos, the moment of complexity is the point at which self-organizing systems emerge to create new patterns of coherence and structures of relations.

Poised between too much and too little order, the moment of complexity is the medium in which network culture is emerging.

Taylor is studying that site between chaos and catastrophe, where boundaries are shifting, power relationships are becoming quite shaky, but order has not been overthrown - at least not just yet. And in theory it is never quite eliminated because “separation is always incomplete, for we remain entangled with that from which we struggle to escape” as Taylor puts it.

So a question that this theoretical assault raises for health care could be this: Will there be a “moment of complexity” where the ‘grid’ that structures health care — the systems, hierarchies, roles, science, authority and the rest of it — gets, well . . . torqued. As he describes,

Whereas walls divide and seclude in an effort to impose order and control, webs link and relate, entangling everyone in multiple, mutating, and mutually defining connections in which nobody is really in control. As connections proliferate, change accelerates, bringing everything to the edge of chaos.

One could argue that the brewing excitement in US health care — the crisis of health care costs, the catastrophe often proffered by futurists and economists, the explosion of health 2.0 and beyond, the perplexity of the public will — all speak to our hapless entry into this unnerving social space: health care’s very own ‘moment of complexity.’ The future may well indeed already be here.

One of the problems of being in this space, says Taylor, is the issue of whether the noise, the information glut, and the “confusion and debilitating sense of vertigo” it engenders will overwhelm the controls. For health care, that possibility could have both liberating and devastating consequences.

One response is to simplify and strengthen the stranglehold of the authority structures that govern and control medical practice and information distribution. Yet, if complexity is inevitable, then these attempts although well intentioned, will be more or less futile. No, the question really revolves around focusing our intellectual attention to this changing landscape, its “fluid dynamics” and how we adapt to its effects.

Taylor argues that education is the currency of the realm in network culture. If that is the case, then how we train our physicians, nurses, allied health professionals, technicians and the rest will be of critical importance in confronting this emerging challenge.

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