Uncertainty, Decision-Making and Team Work in High-tech Healthcare

"Medicine has an obsession with certainty. From risk models to diagnostic accuracy to survival estimates, modern healthcare increasingly works determinedly towards precision medicine. While this preoccupation is warranted as improvements in diagnosis and treatment have not only improved health outcomes but have also helped patients and their families better manage expectations and plan for the future, no matter how good our understanding of disease or the amount of data we capture, uncertainty is inherent to the practice of medicine. Odds are baked into everyday medical decision making, and always will be. Inattention to uncertainty is not benign. Ignoring uncertainty can thwart planning for unexpected adverse outcomes, while also potentially undermining hope." [Read Full Review]

Professor Federica Raia, PhD, is a complexity scientist. She studied at the University of Naples 'Federico II', Italy, and the University of California, Santa Barbara where she analyzed and modeled complex natural systems. After academic career progression in New York to tenured professor, Dr Raia was recruited to UCLA with a joint appointment in the School of Education and Information Studies (SE&IS) and in the David-Geffen School of Medicine (DGSOM) at UCLA.

Professor Raia is concerned with the role of the self, of relationships of multiple perspectives in the context of encounters that traditionally can promote disempowerment and detachment such as the one of a patient with a healthcare professional. As an educator, she is interested in translating these findings into creative learning environments for students and professionals.

Based on her background as a Complex Systems researcher, Prof. Raia has developed Relational Ontology, a ground-breaking practice-based theory to study and teach practices of caring-for-the-Other who is in need of developing a new and integrated sense of being. Professor Raia is particularly interested in situations of uneven power-m knowledge- and need distribution situations such as teacher-student and doctor-patient relationships.

In the context of this work, Prof. Raia is the co-founder and co-president, with Prof. Mario Deng, of the Relational Medicine Foundation, a non-profit organization in support of the on-going collaboration among different stakeholders: patients, caregivers, healthcare providers, education researchers and artists/theater professionals to improve the understanding and practice of high-tech modern medicine.

Professor Murray Kwon, MD, is an American Board of Thoracic Surgery certified Thoracic and Cardiac Surgeon. After completing his undergraduate education at UC Berkeley (BA 1988), Medical School at Northwestern University Medical School (MD 1996) and a business degree at Kellogg Graduate School of Management (MBA 1996), Dr Kwon completed General Surgery Residency (1996–1998), Cardiac Research Fellowship (1998–2001), Surgery Residency (2001–2004) and Cardiothoracic Surgery Residency (2004–2007) at Stanford University before joining UCLA for a UCLA Cardiothoracic Transplantation Fellowship (2007–2008). Subsequently, Dr Kwon was appointed as UCLA faculty, is an Associate Clinical Professor of Surgery and the Surgical Director of the UCLA Mechanical Circulatory Support Device Program.

Professor Mario Deng, MD, is a cardiologist, specialized in the care of patients with advanced heart failure, mechanical circulatory support devices and heart transplantation. After medical training in Germany and a postdoctoral cardiology research fellowship at Stanford University, he served as the Medical Director of the Interdisciplinary Heart Failure & Heart Transplantation Program at Muenster University (1992–2000), Director of Cardiac Transplantation Research at Columbia University (2000–2011), and Medical Director of the UCLA Integrated Advanced Heart Failure/Mechanical Support/Heart Transplant program (2011–2016).

As Principal Investigator / Joint-Principal Investigator of continuously since >25 years federally, philanthropy- and industry- funded translational systems biology projects, Dr Deng co-developed the first diagnostic leukocyte gene expression profiling test in transplantation medicine that gained US-FDA-regulatory clearance to rule out rejection without tissue biopsies (AlloMapTM). Based on this success, Dr Deng's lab was invited by the NIH/US-Critical Illness and Injury Trials Group (USCIITG) to develop a molecular immunology blood test to better predict survival outcomes in patients with various phenotypes of advanced heart failure (MyLeukoMAPTM) that gave rise to the molecular startup company LeukoLifeDx. In 2021, Dr Deng's lab was awarded an NIH/NIAID-grant to develop a multi-dimensional immunology blood test to better predict longterm outcomes of COVID-19.

Embedding systems biological outcome precision prediction tools into the clinical framework of a humanistically sound high-tech modern medicine practice is reflected in Dr Deng's research collaboration with Prof. Federica Raia (UCLA SE&IS and DGSOM) in the "Relational Medicine™" project. Together with Prof. Raia, he developed the Relational Medicine Theory with the core concept of the RelationalAct to improve the understanding and practice of modern medicine. In the context of this work, Prof. Deng is the co-founder and co-president, with Prof. Raia, of the Relational Medicine Foundation, a non-profit organization in support of the on-going collaboration among different stakeholders: patients, caregivers, healthcare providers, education researchers and artists/theater professionals to improve the understanding and practice of high-tech modern medicine.

Sample Chapter(s)
CHAPTER 1: INTRODUCTION