Author:
Bernard P.Zeigler
Affiliation:
University of Arizona, United States
Keyword(s):
System of Systems, Coordination of Activities, Healthcare Coordination, DEVS Modeling and Simulation.
Abstract:
US healthcare, the most expensive in the world, has been diagnosed as an assemblage of uncoordinated
component systems embedded in a market economy that promotes independent pricing with few points of
global control over delivered quality of care and cost. Stimulated by the Affordable Care Act and other
initiatives, efforts are underway to increase the level of information technology (IT) to improve patient
record keeping and portability as well as to price services based on performance rather than amount
provided. Yet such an IT infrastructure by itself will not provide significantly greater component
coordination since it does not provide transparency into the threads of transactions that represent patient
treatments, their outcomes, and total costs. In the traditional formulation of the coordination problem, the
goal of the system-of-systems conflicts with those of its components. In contrast, our concern here is the
coordination of activities among disconnected provider
systems to deliver the appropriate services to an
individual client. In this paper, we discuss the Pathways Coordination model, a generic construct that
enforces threaded distributed tracking of individual patients experiencing certain pathways of intervention,
thereby supporting coordination of care and fee-for-performance based on end-to-end outcomes. DEVSbased
Modeling and Simulation methodology is discussed as the means to design, simulate, and implement
such client-based coordination in systems engineering.
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