Integrative research into the entirety of Burns (2005) value chain is
largely non-existent, despite itsmanifest relevance (Stremersch, 2008).
Health care systems posit themselves as ecosystems perpetually evolving
and transforming under the triple constraint of: first, their network
interrelations; second, the economic and ethical injunctions of state, citizenry,
and regulatory bodies; and lastly, the development of medical,
biological, and technological knowledge. The field of health is characterized
by organizational reconfigurations /integrations that tend to erase
its boundaries, melding them in a common objective encapsulating prevention,
health promotion, treatment, and patient support. This malleability,
as much institutional as organizational, affects: (1) national
health care systems in their entirety through the definition of new market
rules; (2) the missions of health organizations and their modes of
operation; and (3) professional practices redefining approaches to the
coordination of individuals and groups that are actors within given territories.
These processes evolve under the nascent control of a complex
information system operating not only for accounting and statistical
purposes, but directed also at the evaluation of the efficiency of therapeutic
activities and the provision of frameworks for medical practices.