The Teams of Leaders (Tol) Concept: The Grid, the Mesh, and the People in the World of Information and Knowledge-Based Global Healthcare

The Teams of Leaders (Tol) Concept: The Grid, the Mesh, and the People in the World of Information and Knowledge-Based Global Healthcare

Dag von Lubitz (MedSMART, Inc., USA & Bieda Poco Dargante Institute, Denmark)
DOI: 10.4018/978-1-61692-010-4.ch004


The revolution in computer, information, and telecommunication sciences facilitated revolution in “the way we do business.” Despite the wealth of new actionable information and actionable knowledge that this revolution created in healthcare, it was not enough to break the barriers of thought, bureaucracy, and politics. Thus, although the knowledge and professional expertise that are required to avert the threatening collapse of global healthcare are readily available, they remain locked in isolated pools separated by historical barriers, increasing intra- and interdisciplinary specialization, and by stiflingly narrow perception of healthcare complexity. Based on maximum integration of CT, IT, IM, KM, and multidimensional human expertise, the concept of “Teams of Leaders” (ToL) has been employed with rapidly growing success. Implementation of ToL leads to the development of “actionable understanding” that converts highly capable but isolated islands of creative power, into unified mission and task oriented “swarms” endowed with a vastly expanded, collective expertise and operational capabilities. With its roots deep in the advanced technologies of IT/IM/KM, Teams of Leaders transcend bureaucracies and politics, and the collaborative outputs generated through ToL-based operations may constitute one of the pivotal elements of the desperately needed healthcare restructuring.
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Multae manus onus levant


Global Healthcare In Crisis

Thomas Barnett divided the world into two entities – the functioning core and the non-integrating gap (Barnett, 2004) - where the functioning core represents either the Western societies or those fully embracing Western sets of values. The non-integrating gap consists, on the other hand, of states in social or economical disarray or disintegration. Although Barnett’s division may be viewed as a Westerner’s condescending view of the impoverished and struggling nations, it is also true. The chasm separating the core and the gap is seen with particular clarity in the access to one of the most basic human rights – health and its maintenance (WHO, 1946).

While the Western nations (e.g., European Union, USA) make giant steps toward the widest access to highest possible quality of healthcare to all citizens (European Institute of Medicine, 2003; National Coalition on Healthcare, 2004), within the “gap” even rudimentary services are often non-existent (Akhtar, 1991; Gesler, 1983). Thus, in 1983, among the developed countries (such as US, UK, France, Japan, etc.) there were, on the average, 19 physicians per 10.000 people. In Mexico, the number fell to seven, while in Tunisia there were only 3 physicians serving the population of 10,000 people (Gesler, 1983). Statistically, in several African countries the number is less than one (Gesler, 1983). Most importantly, twenty years later, the situation has not improved (Chen et al., 2004; Scheffler et al., 2008).

Per capita expenditure on healthcare is not the best indicator of money spent on actual maintenance of health. The average expenditure in the EU is about 50% less than in the US, yet, compared to their US counterparts, the Europeans appear to receive equal if not better quality of care (World Health Organization Report, 2000; 2004). However, the differences in the healthcare expenditure between the richest countries and the rest of the world may still provide a striking measure of the existing disparities in the level of healthcare available to citizens of individual countries of the globe: in 2001 the United States spent nearly $ 4,900 per person while Mexico spent only $ 370. Mali could afford only $ 12. (World Health Organization Report, 2004, see also Abel Smith, 1989). In the end, there are only so many syringes or typhus vaccines that can be obtained for 12 instead nearly 5.000 dollars!

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