In the framework of the ISSS2017 Vienna in July 2017 one of the conference days focused on “From Public Health to Health Systems”.

Following that programme the BCSSS Research Group “Systems Medicine and Healthcare Systems” joined the day and Prof. Dr.Dr.Dr. Felix Tretter, leader of the research group, attended a panel session together with Dr. Niki Popper, chairman of the project DEXHELPP (Decision Support for Health Policy and Planning: Methods, Models and Technologies based on Existing Health Care Data), Dr. Josef Probst, General Manager of the Main Association of Austrian Social Security Institutions (Hauptverband der österreichischen Sozialversicherungsträger), and Prof. em. Dr. Markus Schwaninger, professor of management at the University of St. Gallen as well as member of the Advisory Board of the World Organization of Systems and Cybernetics (WOSC).


Basic questions were discussed:

  • What is health?
  • Is health a value or can it be described sufficiently by prices?
  • How can we govern health care as a whole?
  • How can we manage units of health care?


The conference day presented selected experts from the field:

The scientific keynote was held by Dr. Patricia Mabry, Executive Director and Senior Research Scientist at the Indiana University Network Science Institute (IUNI), USA. She reported on her experiences with the implementation of Systems Thinking at the National Institute of Health (NIH), part of the U.S. Department of Health and Human Services (HHS). Mabry underlined the multiple options of increasing the understanding not only of health care services, but also of applications in medicine, for instance in context of Molecular Systems Medicine. Especially to understand the complex bio-psycho-social interrelationships which determine diseases such as obesity, diabetes, cardio-vascular disorders, infectious diseases systemic understanding appears to be fruitful. The multifactorial and dynamic view of Systems Science might also be advantageous in therapy, prevention and health policy.

The current challenges for the Austrian Health Care System were described by Dr. Clemens Martin Auer, Head of Department at the Austrian Federal Ministry of Health (BMGF). He emphasized the high diversity of insurance companies and tried to bring into consideration possible inefficiencies through complicated patterns of financial flow. Options for integration of the services were proposed.  

Further on, Prof. Gerald Midgley, Professor of Systems Thinking at the Centre for Systems Studies, University of Hull, UK, demonstrated the strategy of Systems Thinking in order to enhance community involvement in public health and health service design. Significant is the bottom-up way of design of health care, especially based on the needs of the users that should participate (interactive planning).

Finally, Prof. Dr. oec. habil. Fredmund Malik, Chairman of the Malik Management Center, St. Gallen, CH, explained his approach of Systemic Management in order to reorganize units of health care. These are meta-systems as master controls of management, leadership and governance. He described the procedure of re-designing hospitals, one of his projects currently taking place at Hannover Medical University, Germany. From this perspective Malik assumes the hospital to be a living system that works for living systems.


During the panel session Prof, Dr.Dr.Dr. Felix Tretter presented options to understand health care in an interdisciplinary or even supradisciplinary way by Systems Science.

Dr. Niki Popper demonstrated Systems Thinking by a talk that was devoted to the development and implementation of methods for decision support in the Austrian health care system.

Dr. Josef Probst expanded on the complexity of challenges for health care insurances in Austria.

Dr. Markus Schwaninger presented a project that focus on the development of health care for oncology in Carinthia by using the methods of Systems Thinking. His aim is to establish a viable regional health care system where doctors and nurses are basically the planners of health care, a process that makes a significant difference to usual top-down planning processes.


The subject of the afternoon workshop was “From Qualitative to Quantitative Systems – Methods and Interventions in Health Care Systems”. After a brief introduction by the moderator Prof. Dr.Dr.Dr. Felix Tretter, the speakers presented their initial propositions, explicated their view and exchanged questions and comments.


Following the successful and promising “Health Day” during the 61st ISSS World Conference in Vienna together with the BCSSS Research Group “Systems Medicine and Healthcare Systems” the Bertalanffy Center for the Study of Systems Science is going to encourage the Systems approach on health care.

It is necessary to identify the operational structure of the system that determines the quality of the provided health care. This is not yet represented on data that are available by insurance companies. Also a health economic approach alone is inappropriate to represent the significant processes in health care. One starting point could be the analysis of patient-related processes in hospitals. It is planned to establish an international and interdisciplinary/transdisciplinary network of researchers interested in this field connected to researchers in public health. Occasional meetings will be held in order to focus on this issue.