Compared to peer countries, US health outcomes remain poorer. So much so, that the US has been labelled by the National Research Council and Institute of Medicine as having a “health disadvantage.”

When it comes to population health, it is clear there are many issues, for instance, rising rates of chronic lifestyle diseases such as type 2 diabetes and obesity. While the objective of population health is to identify target segments of the population and determine what to do to support prevention and improved health outcomes, the problem remains with ‘how’ to do that.

What has become apparent is, despite efforts of collective inter-agencies working together, the efforts are not working. Frequently, healthcare activities that are implemented are poorly coordinated, fragmented, misaligned and lack the ability to track the results and changes that matter most.

systems-thinking-700x467 Could Systems-Thinking Be The Solution To Population Health Issues?

Could Systems-Thinking be the Solution to Population Health Issues?

A recent paper, published in Systems Research and Behavioral Science, suggests the way to solving the ‘how’ is to use a systems-thinking approach.

According to Rajagopalan and Midgley, “Systems thinking’ is an approach to a problem that considers how components within the larger structure operate and interact over the lifecycle of the system and how to optimize the design, implementation, and evaluation of that system. Systems thinking can best be described as the application of system concepts to frame our understanding of the world, and it is also about possible future action—what ought to be or could be.”

Rather than fragmented efforts, systems take each element into consideration with a longer term view on the feedback loops that will likely occur as a result of each other, and toward the purpose. Rather than agents working independently toward the common goal, systems encompasses how these agents fit into the holistic picture, where everything is assessed from a big picture, comprehensive viewpoint to solidify objectives that will actually address the overall challenge being faced.

Systems-Thinking for Population Health

Systems-thinking is often applied to organizations such as companies but the authors of this recent paper propose that looking at population health from an organizational profile, sets it in a system.

Here is the breakdown of the conceptual framework of their systems-thinking approach for population health.

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Featured Image Credit: Kapp et al. A Conceptual Framework for a Systems Thinking Approach to US Population Health

As far as implementation, the authors recommend that one of the first steps would be creating a shared evidence based reporting dashboard based on strategic-oriented outcomes rather than action-oriented outcomes. This would be a ‘living’ dashboard that would contain evidence indicators such as five-star ratings to provide transparency that would reinforce the feedback loop of efficiency, growth, and progress over time. If dashboard indicators don’t change, decision-making can occur to implement faster changes toward the main objective.

The challenge that needs to be overcome, is not just implementing activities that are meant to drive change, but in working toward the strategic outcome of changing behaviors – the key thing that is really needed to bring about true changes to the health of our population.

The systems would also incorporate increased operational effectiveness in the workforce. Having both large and smaller community-based organizations involved in evidence-based outcomes and performance. And before receiving government funds, all organizations would be required to engage in “a government-approved certification in evaluation, logic model planning, organizational capacity, quantitative metrics, and assessment (balancing feedback loop).”

If this could be implemented, it would be powerful. And it would more closely align many holistic and allied professionals with mainstream and traditional medicines to achieve collective goals for everyone in the population. It would encourage collaboration and communication across sectors and it would put all the great efforts that are occurring in population health into a management framework that would amplify the efforts of the collective, which is exactly what we need.