Health Systems Engineering Call to action APICS DC Metro Chapter Presenters: Satish Gattadahalli and Bill Barton Date: July 21, 2015 Property of Whitney, Bradley & Brown, Inc. 2012.
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Establishing HSyE Context Healthcare ecosystem - complex system of systems Ecosystem: Insurance companies, drug companies, hospitals, ERs, nursing homes, physician offices/clinics, employers, regulators, patients, Govt. agencies, pharmacies, Integrated delivery networks, ACOs, etc Objectives and economic structures vary/conflicting: Supply - demand matching a challenge Healthcare spend: 18% GDP, 20% 5yrs 7/15/2015 4
Context and Drivers Contd. US spends $3T annually, 1/3 is waste Unnecessary care costs $210 billion/year (IOM 2012) 98k deaths from broken processes, 1.7 million hospital acquired infections, $5 billion treating harmed patients 40% CHF Medicare patients readmitted within 90 days Medical care practice variation common Emerging disruptive models: Personalized medicine, retail clinics, ACOs, Uber/Airbnb/OpenTable/Amazon type telehealth models, virtual care, decentralized care, medical home, VBP, P4Value..M&A 7/15/2015 5
A Compelling Case Complex industries use Systems Engineering: Aviation Transportation Telecom Manufacturing Pharma Aerospace Proven supply chain and lean methods: Wal-Mart, Dell, Amazon, Toyota Significant industrial supply chain body of knowledge Imperative to improve healthcare: quality, safety, value, efficiency, reliability, and productivity Cross-pollination opportunity 7/15/2015 6
What is HSyE Systems view: Process to ecosystem healthcare Evidence-based measures Solving problems/ making improvements Analytics, and mathematical, computer, and graphical models understand, improve, control, and optimize process and system performance Proven practices: Industrial engineering, operations research, IT, human factors engineering, and quality management 7/15/2015 7
Potential Applications: Use Cases Supply chain and inventory management Patient demand modeling Patient flow optimization Utilization management and readmissions prevention Hospital occupancy Capacity planning Risk analytics Predictive modeling/analytics Organization and business process optimization 7/15/2015 8
HSyE The Landscape 7/15/2015 9
Potential Benefits Prevented hospitalizations Reduced length of stay Enhanced patient throughput Reduced medical errors, adverse events, HAI Improved logistics and capacity Reduced readmissions Optimized demand management Enhanced safety and reliability Process standardization and streamlining Reduced waste and redundancies Improved patient experience and satisfaction 7/15/2015 10
Institutions Providing Advocacy Veterans Affairs: VA (VERC, MyVA-lean), National Academy of Engineers, IOM, AHRQ, IHI, NASA, ASQ White House: PCAST report on Health Systems Engineering Universities: MIT, Northeastern, Lehigh, University of Wisconsin, Georgia Institute of Technology, Rochester Institute of Technology, University of Michigan, and Wayne State University 7/15/2015 11
Examples of Methods and Tools Human factors engineering Knowledge management and lessons learned Failure analysis Discovery and predictive analytics Operations research Optimization Queuing Decision analysis Modeling and simulation Statistical and reliability analysis Economic analysis Lean, Six sigma Benchmarking Supply chain management Improvement tools Value stream, Pareto, Fishbone, SPC, PDSA AI, Cognitive Computing, NLP, Deep Learning (Dr. Watson) IHI Model 7/15/2015 12
Technology Enablers Real Time Location Services (RTLS) Big Data Analytics Internet of Things Cloud Computing Robotics Artificial Intelligence Virtual reality Virtual Health mhealth (Connected Health) 7/15/2015 13
Who is doing it: Best Practices US Department of Veterans Administration (VA) Johns Hopkins Medicine Mayo Clinic Denver Health Kaiser Permanente Geisinger Health System Cleveland Clinic Inova Health Virginia Mason Medical Center ThedaCare Group Health Intel (Healthcare Marketplace Collaborative, Lean Methods) 7/15/2015 14
Potential Risks/Barriers Healthcare information privacy and data security Infrastructure and Interoperability (Data, Process) Metrics/Measures and Benchmarking Data Quality and Accuracy Leadership, Culture, and Incentives Limited systems engineering tools and best practices knowledge 7/15/2015 15