Formulating policy for public health action can be characterized as designing solutions within a complex adaptive system-of-systems (CASoS). Public health systems are complex due to the large number of interdependencies and non-linear interactions among autonomous agents, such as individuals, health care organizations, and governmental agencies. They are adaptive in that the behaviors of individuals, organizations, and diseases are highly responsive to the behaviors of other such agents, as well as to hazards and natural disasters. The Department of Veterans Affairs (VA), Veterans Health Administration (VHA) is collaborating with CASoS Engineers to capture the health care system as a complex adaptive system-of-systems,with the intent of identifying and addressing health-threat scenarios of consequence.
In our approach, the VA health care system was decomposed into the fundamental building-blocks of medical physics, organizational physics, and social physics. A model was developed that allows the investigation of how local policies affect the organization as a whole, and vice versa, producing a framework capable of analyzing organizational behaviors and constraints within complex hierarchical networks.