title: Grip on health: A complex systems approach to transform health care.
abstract: This article addresses the urgent need for a transition in health care to deal with the increasing prevalence of chronic diseases and associated rapid rise of health care costs. Chronic diseases evolve and are predominantly related to lifestyle and environment. A shift is needed from a reductionist repair mode of thinking, toward a more integrated biopsychosocial way of thinking about health. The aim of this article is to discuss the opportunities that complexity science offer for transforming health care toward optimal treatment and prevention of chronic lifestyle diseases. Health and health care is discussed from a complexity science perspective. The benefits of concepts developed in the field of complexity science for stimulating transitions in health care are explored. Complexity science supports the elucidation of the essence of health processes. It provides a unique perspective on health with a focus on the relationships within networks of dynamically interacting factors and the emergence of health out of the organization of those relationships. Novel types of complexity science-based intervention strategies are being developed. The first application in practice is the integrated obesity treatment program currently piloted in the Netherlands, focusing on health awareness and healing relationships. Complexity science offers various theories and methods to capture the path toward unhealthy and healthy states, facilitating the development of a dynamic integrated biopsychosocial perspective on health. This perspective offers unique insights into health processes for patients and citizens. In addition, dynamic models driven by personal data provide simulations of health processes and the ability to detect transitions between health states. Such models are essential for aligning and reconnecting the many institutions and disciplines involved in the health care sector and evolve toward an integrated health care ecosystem.
authors.affiliation: Department of Microbiology and Systems Biology, TNO Netherlands Organization for Applied Scientific Research, PO Box 360, 3700, AJ, Zeist, The Netherlands.
authors.forename: Herman A
authors.initials: HA
authors.lastname: van Wietmarschen
authors.affiliation: Department of Microbiology and Systems Biology, TNO Netherlands Organization for Applied Scientific Research, PO Box 360, 3700, AJ, Zeist, The Netherlands.
authors.forename: Heleen M
authors.initials: HM
authors.lastname: Wortelboer
authors.affiliation: Department of Microbiology and Systems Biology, TNO Netherlands Organization for Applied Scientific Research, PO Box 360, 3700, AJ, Zeist, The Netherlands.
authors.forename: Jan
authors.initials: J
authors.lastname: van der Greef
mesh_terms: D002908:Chronic Disease / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology; D019033:Delivery of Health Care, Integrated / Q000379:methods / Q000458:organization & administration; D019317:Evidence-Based Medicine / Q000379:methods / Q000458:organization & administration; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008019:Life Style; D009426:Netherlands / Q000453:epidemiology; D011788:Quality of Life; D013597:Systems Analysis; D000069341:Transitional Care / Q000458:organization & administration*
keywords: health care; patient-centered care; public health