Discrete Event System Specification Framework for Self-Improving Healthcare Service Systems

A healthcare service system (HSS) is made of humans and technology where for the foreseeable future, self-improvement will be primarily based on human understanding rather than machine learning. Therefore, for such a system to continually self-improve, it must provide the right data and models to support human decisions on selection of alternatives likely to improve the quality of its services. Our focus in this paper is to show how modeling and simulation (M&S) can help design service infrastructures that introduce coordination and bring into play the conditions for learning and continuous improvement. To do this, we discuss the application of the discrete event system specification (DEVS) formalism within system of systems engineering (SoSE) to develop coordination models for transactions that involve multiple disparate activities of component systems and that need to be selectively sequenced to implement patient-centered coordinated care interventions. We show how such coordination concepts provide a layer to support a proposed information technology for continuous improvement of healthcare as a learning collaborative system of systems (SoS).

[1]  Bernard P. Zeigler,et al.  Activity-Based Credit Assignment Heuristic for Simulation-Based Stochastic Search in a Hierarchical Model Base of Systems , 2017, IEEE Systems Journal.

[2]  Bernard P. Zeigler,et al.  Guiding Principles for Data Architecture to Support the Pathways Community HUB Model , 2016, EGEMS.

[3]  Bernard P. Zeigler,et al.  Integrating web-based simulation on IT systems with finite probabilistic DEVS , 2015, SpringSim.

[4]  Mark W. Maier,et al.  The Role of Modeling and Simulation in System of Systems Development , 2014 .

[5]  Mark Redding,et al.  Pathways Community Care Coordination in Low Birth Weight Prevention , 2014, Maternal and Child Health Journal.

[6]  Bernard P Zeigler,et al.  Pathways community HUB: a model for coordination of community health care. , 2014, Population health management.

[7]  Bernard P. Zeigler,et al.  The role of Modeling and Simulation in coordination of health care , 2014, SIMULTECH.

[8]  Bernard P. Zeigler,et al.  Expanding DEVS and SES applicability: using M&S kernels within IT systems , 2014, SpringSim.

[9]  Qining Wang,et al.  Concept, Principle and Application of Dynamic Configuration for Intelligent Algorithms , 2014, IEEE Systems Journal.

[10]  David W. Bates,et al.  Let the left hand know what the right is doing: a vision for care coordination and electronic health records , 2014, J. Am. Medical Informatics Assoc..

[11]  M. Porter.  Value-Based Health Care: From Idea to Reality , 2013 .

[12]  M. Porter,et al.  The Strategy That Will Fix Health Care , 2013 .

[13]  J. Heyrman,et al.  Care pathways across the primary-hospital care continuum: using the multi-level framework in explaining care coordination , 2013, BMC Health Services Research.

[14]  Tag Gon Kim,et al.  Multifaceted modeling and simulation framework for system of systems using HLA/RTI , 2013, SpringSim.

[15]  Xiaolin Hu,et al.  Linking information and energy—activity-based energy-aware information processing , 2013, Simul..

[16]  Bernard P. Zeigler,et al.  Refounding of the activity concept? Towards a federative paradigm for modeling and simulation , 2013, Simul..

[17]  Bernard P. Zeigler,et al.  Guide to Modeling and Simulation of Systems of Systems , 2012, SpringerBriefs in Computer Science.

[18]  Bernard P. Zeigler,et al.  System theoretic foundations of modeling and simulation: a historic perspective and the legacy of A Wayne Wymore , 2012, Simul..

[19]  M. Gunal.  A guide for building hospital simulation models , 2012 .

[20]  H. J. Honig,et al.  Multi-perspective modelling of complex phenomena , 2012, Comput. Math. Organ. Theory.

[21]  Elena Tanfani,et al.  A simulation-based modeling framework to deal with Clinical Pathways , 2011, Proceedings of the 2011 Winter Simulation Conference (WSC).

[22]  J. Herrin,et al.  Health and social services expenditures: associations with health outcomes , 2011, Quality and Safety in Health Care.

[23]  Carlos Del Rio,et al.  The spectrum of engagement in HIV care and its relevance to test-and-treat strategies for prevention of HIV infection. , 2011, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[24]  Mo Jamshidi,et al.  Modeling and Simulation for Systems of Systems Engineering , 2008 .

[25]  Nilmini Wickramasinghe,et al.  Health Care System of Systems , 2008 .

[26]  S.C. Brailsford,et al.  Tutorial: Advances and challenges in healthcare simulation modeling , 2007, 2007 Winter Simulation Conference.

[27]  Harlan M Krumholz,et al.  Strategies for reducing the door-to-balloon time in acute myocardial infarction. , 2006, The New England journal of medicine.

[28]  Brian J. Sauser,et al.  System of Systems - the meaning of of , 2006, 2006 IEEE/SMC International Conference on System of Systems Engineering.

[29]  Lee W. Schruben,et al.  A survey of simulation optimization techniques and procedures , 2000, 2000 Winter Simulation Conference Proceedings (Cat. No.00CH37165).

[30]  A Foss,et al.  Measuring health outcomes , 1996, BMJ.

[31]  J Cairns,et al.  Measuring health outcomes , 1996, BMJ.

[32]  Vincent Augusto,et al.  A Modeling and Simulation Framework for Health Care Systems , 2014, IEEE Transactions on Systems, Man, and Cybernetics: Systems.

[33]  Joachim Denil,et al.  Design, verification and deployment of software-intensive systems : a multi-paradigm modelling approach , 2013 .

[34]  Paul P. Maglio,et al.  Steps Toward a Science of Service Systems , 2007, Computer.

[35]  L. De Bleser,et al.  Defining pathways. , 2006, Journal of nursing management.