Complex systems

Mike Tremblay April 17, 2017

A central feature of any high performing healthcare system or organisation includes best practice in medicines use and management. As all aspects of healthcare are under varying degrees of financial stress these days, cost controls and appropriate use of medicines must support the highest standards of clinical practice and safe patient care. Medicines optimisation is […]

Mike Tremblay February 9, 2017

The King’s Fund, a UK health charity ran a scenario essay writing competition, and here is the link and of course congratulations to the winner: (winner, runner up and other scenarios, but not mine). My scenario builds on the notion of service unbundling and draws on strong and weak signals of changes likely to impact […]

Mike Tremblay January 19, 2017

Healthcare systems are often seen as requiring an economy of scale. This in part is a function of how prevalent diseases are, such that in some small countries they would have one case in 2 years, rather than one case per million of population. Healthcare technologies can be incredibly pricey; for instance, a proton therapy […]

Mike Tremblay April 24, 2016

It is in the interests of the Commission to play countries off against each other in order to demonstrate the inescapable logic of the “European project”. The Commission suffers from the so-called “secretariat problem”: it is not a member state but a “secretariat” for the member states, and in this way pursues its own interests […]

Mike Tremblay March 11, 2015

The direction the NHS is now taking is evidence that some aspects of NHS performance arise from fundamental design flaws. The mistake was likely made in 1948 to separate healthcare and social care. Today, as care processes shift into the community and the early forces of consumerisation in healthcare emerge, the underlying separation logic is […]

Mike Tremblay October 12, 2014

Ebola¬† is really quite a horrible little bit of DNA. Its route to humans is via the fruit bat and between humans through body fluids. So much for the public health model. The virus is taking advantage of humans with poor lifestyle, illiteracy, folk medicine, weak healthcare systems and lack of awareness. If it is […]

Mike Tremblay June 18, 2014

The US-based Commonwealth Fund has released a new 11-country comparative ranking of health systems. Before the UK pops the champagne corks, let’s decode this ranking a little bit. Oh yes, before we also get too excited, rankings like this are useful only as a discusion tool. What does it say say operationally, if you had […]