Prospective healthcare decision-making by combined system dynamics, discrete-event and agent-based simulation

Abstract

Prospective Health Technology Assessment allows early decision making for innovative health care technologies. The main idea is to combine available domain knowledge with advanced simulation techniques in order to predict the effects of medical products and to find bottlenecks and weaknesses within the health system. In our recent publications a hybrid simulation approach with System Dynamics and Agent-Based Modeling has been presented. Hospital workflows have been modeled by state charts within agent behavioral models and have to be instantiated each time an agent is entering a hospital. This paper presents a mechanism to generate agents dynamically from SD models and extends the previously presented hybrid approach by process-oriented Discrete Event Simulation for hospital modeling. It connects processes to health care institutions and not to persons traversing them. Two extended example case studies show potentials for medical decision making using the three simulation paradigms in a common environment.

Modeling of healthcare systems: Past, current and future trends

“…Brailsford (2015) argued that the increasing popularity of AnyLogic and the launch of other commercial software packages were evidence of the growing demand for hybrid modeling. In healthcare technology evaluation, (Djanatliev and German 2013) proposed a multi-paradigm simulation mechanism to evaluate health technology innovations prospectively. This extends a previously presented hybrid approach using process-oriented DES for hospital modeling and generates agents dynamically from SD models.…”

Hybrid simulation studies and Hybrid Simulation systems: Definitions, challenges, and benefits

“…An alternative approach to SSM is qualitative systems dynamics (QSD) which has the merit of being more similar in its representative structure to that of simulations (and indeed through toolsets like iThink© and Vensim© can be translated, with chosen boundary conditions, into a quantitative simulation format) (Sterman 2000; Powell and Coyle 2005;Powell and Swart 2010;Swart and Powell 2006) In summary the approach consists of using a soft systems approach prior to simulation specification (Viana et a1. 2014;Djanatliev and German 2013) in order to identify the key mechanisms which span a physical infra-system and the surrounding SOCially-constructed systems (typically, a local social valuation system, such as the direct victims of flood and a more distant political valuation system (Liddell and Powell 2004), as depicted in Figure 3.…”

Individual versus integrated simulation techniques in healthcare applications

“…Studies for combining the three individual methods are very scarce. The only study we have found that considered the integration of the three methods in one healthcare model was [24]; Anatoli and Reinhard have developed a combined SD, DES and ABS for Prospective Health Technology Assessment (ProHTA) that allows early decision making for innovative health care technologies.…”

“…Based on the review, no study has considered the utility of integrating the three individual techniques (DES, ABS and SD) in a single model in healthcare context except that combined system for (ProHTA) [24].…”