1Framework: Integrated Healthcare



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1Framework: Integrated Healthcare




    1. Introduction

Technology needs to interact with an individual as a whole: not just the different parts of an individual. I focus on developing a methodology for health technology design that considers interaction with this whole. A vision for an integrated health technology: integrated across disciplines and yet specific to human needs.


I present a conceptual framework to understand the influence of technology on individual healthcare. Towards this goal, I modify Wilber’s 4-Quadrant model to develop an integrated framework to understand an individual and his interaction with the environment. This framework is then used in the domain of healthcare to describe the interaction between health technology and an individual. By no means complete or sacrosanct, it encourages the reader to adopt an approach to technology design that considers an individual as a complete whole with a conscious and not just an empirical system. This benefits both: the designer and the user.
    1. Integrated Framework

      1. Individual Interacts


An individual can be modeled as a system that can be considered to be completely and uniquely specified by its state. The individual itself belongs to a hierarchy: being composed of sub-systems and being part of meta-systems. Figure * gives an example of one possible hierarchy.
      1. State Changes

The individual undergoes state transformation due to his interaction with the environment or due to changes within himself. The state of an individual can be considered as the set of all properties associated with the individual at a given instant of time at a specific location. The space and time constraint are important to determine the context of the state. A modification of Wilber’s Four Quadrant Model can be used to classify the different properties that constitute the state. Wilber has used the model to integrate findings and conceptual insights from different disciplines to provide a Theory of Everything []. Based on the model, the different properties constituting the state of an individual can be classified based on the domain of observation. The domain of observation determines the domain of the individual under consideration: affective, cognitive, moral, interpersonal or spiritual. The domains of observation are not independent of each other and should not be considered as independent dimensions. For example, a change in the emotional change of an individual changes his cognitive state as well.

Each domain of observation can have different levels of observation. The level of observation determines the level of abstraction at which the individual is being observed: body, mind, soul or spirit. Each of the property at a specific level of observation within a particular domain of observation can have four components based on the mode of observation:


  • Individual Subjective Component: The subjective observation made by an individual of his property due to its consciousness.

  • Individual Objective Component: The objective empirical observation made by the environment of a property of an individual.

  • Collective Subjective Component: The subjective observation made by the universe of a property of an individual due to the individual being part of a larger system: a collective consciousness.

  • Collective Objective Component: The objective empirical observation made by the environment of a property of an individual due to the individual being part of a larger system.

Within each domain are four levels of observation, each having its four components depending on the mode of observation. Figure * provides a diagrammatic representation of the state of the individual based on the domain of observation.

It is important to note that the four components are manifestations of the same property and differ just in the mode of observation. Thus, a change in one of the components of the property changes the other components as well. For example, a change in the internal emotional state of an individual (individual subjective component) is reflected in the corresponding physiological change (individual objective component). Other individuals can understand this change if they have access to this change and share the same meaning for the particular emotion (collective subjective component). This collective understanding can also be sampled through a questionnaire given to these individuals (collective objective component).

      1. Influence of Technology

Technology plays a role in this state transformation by changing the individual, its environment or the interaction between them. Thus the role of technology is multifold:

It can be used to change the form of interaction between existing systems and the constraints associated with the interaction. This changes the individual if the interaction influenced by technology is within him. If technology influences an interaction is within the environment, it changes the environment else technology changes the interaction between the individual and the environment.

It can be used to create new systems. This changes the environment and allows new interaction to happen between the individual and his environment. The new system can also be a channel of communication to interact with other entities in the environment.


Here the difference in the above two roles is small but philosophically important. When a new system is created using technology, the state associated with the system has different domains of observation and has the four components associated with each of the different domains. The presence of different levels would be dependent on the level of abstraction of the created system. The system is capable of interaction with the individual in the different domains: affective, cognitive, interpersonal, moral and spiritual. The realization of the capability and the extent of interaction in the different domains depend on the level of complexity of the system.




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