Convergence Health Care: A Coherence-Based Framework for Measuring and Reducing Systemic Fragmentation in the U.S. Health System

Convergence Health Care: A Coherence-Based Framework for Measuring and Reducing Systemic Fragmentation in the U.S. Health System | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 16 January 2026 V3 Latest version Share on Convergence Health Care: A Coherence-Based Framework for Measuring and Reducing Systemic Fragmentation in the U.S. Health System Author : Peter Brunzelle 0009-0005-7109-6745 [email protected] Authors Info & Affiliations https://doi.org/10.22541/au.176556195.52029025/v3 325 views 116 downloads Contents Abstract Supplementary Material Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Importance-Fragmentation is widely recognized as a defining weakness of the U.S. health system, yet it remains weakly defined and rarely measured as a structural system property. Objective-To propose Convergence Health Care (CHC), a conceptual and measurement framework that treats systemic fragmentation as a quantifiable loss mechanism and coherence as an improvable engineering target. Design-Synthesis of evidence on administrative waste, integrated-delivery performance, behavioral-health integration, interoperability failures, and workforce instability into a unified coherence architecture. Supplementary Material File (convergence_health_care__a_coherence_based_framework_for_measuring_and_reducing_systemic_fragmentation_in_the_u_s__health_system (1).pdf) Download 177.10 KB Information & Authors Information Version history V1 Version 1 12 December 2025 V2 Version 2 14 January 2026 V3 Version 3 16 January 2026 Copyright This work is licensed under a Creative Commons Attribution 4.0 International License Keywords administrative burden care coordination coherence fragmentation health system reform payment reform Authors Affiliations Peter Brunzelle 0009-0005-7109-6745 [email protected] Convergence Sciences Initiative View all articles by this author Metrics & Citations Metrics Article Usage 325 views 116 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Peter Brunzelle. Convergence Health Care: A Coherence-Based Framework for Measuring and Reducing Systemic Fragmentation in the U.S. Health System. Authorea . 16 January 2026. DOI: https://doi.org/10.22541/au.176556195.52029025/v3 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu . Format Please select one from the list RIS (ProCite, Reference Manager) EndNote BibTex Medlars RefWorks Direct import Tips for downloading citations document.getElementById('citMgrHelpLink').addEventListener('click', function() { popupHelp(this.href); return false; }); $(".js__slcInclude").on("change", function(e){ if ($(this).val() == 'refworks') $('#direct').prop("checked", false); $('#direct').prop("disabled", ($(this).val() == 'refworks')); }); View Options View options PDF View PDF Figures Tables Media Share Share Share article link Copy Link Copied! Copying failed. 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