Industrial and Systems Engineering
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A workshop on "Industrial and Systems Engineering and Healthcare: Critical Areas",
held in 2009 was co-sponsored by the NSF and the Agency for Healthcare Research and
Quality. It envisioned an ideal health care system that is unlike today's fragmented,
loosely coupled, and uncoordinated assemblage of component systems. The workshop concluded
that, "An ideal (optimal) health care delivery system will require methods to model large
scale distributed complex systems." Our research objective was to develop such methods.
As illustrated in the Figure (Care Coordination Model), we visualize an "as is" health
care system in which a patient is treated for a medical problem and emerges with a,
hopefully, improved condition. Coordination is shown as an additional component that
identifies the various community partners involved in health care and rigorously lays
out how their interactions are more effectively coordinated to improve the care that a
patient receives and consequently, the quality of the outcome. The most cost effective
care aims to treat the neediest patients that cost the most.
Criteria
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The criteria for such a model are that it should be:
Flexible to meet variety of stakeholders' interests and variety of accountable care implementations.
Scalable to accommodate increases in scope, resolution and detail.
Integrate system of system concepts system, components, and agent concepts extended to human behavioral limitations.
Enhance Electronic Medical Records and Health Information Technology systems as needed to support coordinated care.
Support services based on model, e.g., patient tracking, medication reconciliation, etc.
The Pathways Community HUB Model
❯
The Pathways Community HUB Model is a model of care coordination that was developed by the Ohio Community Health
Access Project (CHAP) in Richland County to improve health and preventative care for high-risk mothers and children
in difficult-to-serve areas. In order to focus model development and to enable data access for calibration and
validation, CHAP agreed to work with us as the test bed for our model development. In this regard, CHAP agreed
to provide access, under suitable data sharing agreements, to its data base of client and pathway records.
This provided an instance of the Pathways Community Care Coordination framework as a basis for our systems-level
simulation model. In the initial phase, our objective was to construct and validate the model when applied to
high-risk mothers and children in difficult-to-serve areas following the CHAP coordinated care pathways for the
case of successful normal birth outcomes. We collected de-identified personal health and behavioral data (such
as demographic, socio-economic, etc.) for successfully and unsuccessfully treated clients from the EMR data
base employed by CHAP.
Plugins
❯
Spreadsheets
JoinOfServiceCodesWDescWDatesWBirthWeight
AdmissionDemographicPlanSourceData
Example Test Code
PathwayTools.java
Article
Pathways Community HUB: A Model for Coordination of Community Health Care
The Role of Modeling and Simulation in Coordination of Health Care Keynote at
SIMULTECH 2014 - 4th International Conference on Simulation and Modeling Methodologies,
Technologies and Applications
Report
Care Coordination: Formalization of Pathways for Standardization and Certification
Videos
Formalizing Porter's Integrated Practice Unit with System-of-Systems Modeling and Simulation
Extra-Clinical Care Coordination: Pathways Community HUB Model Continuing From: Formalizing Porter's
Integrated Practice Unit with System-of-Systems Modeling and Simulation
The Role of Modeling and Simulation in Coordination of Health Care, Keynote for SIMULTECH, 2014