Health systems science

Health systems science (HSS) is a foundational platform for understanding healthcare delivery, how professionals collaborate, and how to improve patient care and health systems. It is one of three pillars of medical education, alongside basic and clinical sciences. HSS includes core domains such as healthcare structure and process, system improvement, value in healthcare, population and public health, clinical informatics, policy, and economics, as well as functional domains like ethics, change agency, teaming, and leadership. Systems thinking connects these areas, with patients, families, and communities at the center.

HSS emerged from systems-based practice, recognizing that effective care requires more than clinical expertise. The World Health Organization highlighted the need in 1978, and the quality movement of the 1980s-1990s emphasized systems thinking. Key milestones include the inclusion of system-based competencies by organizations like AAMC and ACGME in the late 1990s and early 2000s. Despite challenges in teaching these concepts, frameworks were developed to integrate HSS into medical education.

Future efforts focus on expanding HSS across healthcare professions, with initiatives like the National Academies' workshops. Global adaptations include Korea replacing medical humanities with HSS, South Africa collaborating with the AMA, and the UK referring to it as clinical governance. Notable figures like Susan Skochelak and institutions such as Brown University's Warren Alpert Medical School have contributed significantly. New schools are integrating HSS into their curricula, reflecting its growing importance in navigating modern healthcare complexities.