Health System Modeling and Simulation: Coordinated Care Example

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The research objective of this award is to develop a general modeling framework for national health care that will enable simulations to study specific approaches to improve care while reducing cost. For example, simulations will allow Accountable Care Organizations (ACOs) to study specific coordinated care systems to fill the gap between hospital and doctor aimed at reducing re-admissions and medication errors. ACOs will also be able to examine the tradeoff between quality and cost of such coordinated care. A range of simulation tools will be developed to support the design of coordination architectures and predict important quality metrics that are applicable to diverse populations. The modeling approach will integrate mathematical system and agent modeling concepts extended to include human behavioral limitations. The overall model will significantly extend an established coordinated care framework and will be validated against data obtained from a successful program for women with high risk pregnancies.The results of this research will show how to systematically model the behaviors of patients who require coordinated care interventions, thus rendering these behaviors amenable to health care system design and engineering. The systems-level simulation models will identify the various community partners and how they can be effectively coordinated using emerging health information networks and electronic medical records. Beyond impacting health care, the new methodology for system-level modeling and simulation will support constructing and testing alternative architectures for coordinating component systems prior to implementation in diverse societal sectors such as engineering, defense, and agriculture. The tool set employed to build the models will be widely distributed through the proposer?s software distribution services. The model library will be promulgated by a collaborating coordinated care institute to a wide network of organizations set up to provide such care.