Issues in Higher Education Conference "Harnessing Systemness | Delivering Performance" slated for November 2012. In Precipice or Crossroads?, the term is highlighted in a section titled "Cultivating systemness to take the land-grant mission to scale" where the term is used in its context to describe the modernization of the principle of land grant schools: Between and among the land grants, there is no universal or agreed-upon curriculum, no transfer pipeline or assurances of articulation, no umbrella for administrative oversight or shared administrative functions. These schools were not originally designed to function thus; they were designed as individual and separate institutions to serve local needs and to bolster local agrarian and industrial economies. Use in healthcare The term has been used ambiguously throughout healthcare until the 2008–2012 global recession. At that period, professionals began to use systemness to describe their combination of IT assets and services to provide efficient healthcare. The term was the centerpoint on August 20, 2007 at The Kaiser Permanente Institute for Health Policy's roundtable on “Improving Health Care ‘Systemness’: A Look at the Evidence and Policy Implications." The conference applied the term to describe how the Kaiser Permanente consortium can consolidate medical resources to achieve higher-quality output for all parties involved. The Kaiser Permanente Institute names seven characteristics of systemness in healthcare: Governance, strong physician leadership, organizational culture, clear & shared aims, accountability & transparency, patient-centeredness and teams. Similarly, the Governance Institute of California in 2005 explored systemness in healthcare in 'Pursuing Systemness: The Evolution of Large Health Systems': "...Leaders generally use the term to define looking and acting more like a single integrated organization rather than a collection of independently functioning pieces. Systemness means being more tightly- knit, shifting decision-making responsibility and authority away from the subsidiary operating units to the corporate level, and centralizing or standardizing key management systems and processes. Systemness is consistent with the corporate enterprise model of governance." References Computer networking 1980s neologisms State University of New York