MASHnet : Confronting the Challenges of Healthcare Modelling and Simulation

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MASHnet Confronting the Challenges of
Healthcare Modelling and Simulation

• Martin PittPeninsula Technology Assessment Group
• Peninsula Medical School
• Universities of Exeter and Plymouth

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Whats MASHnet ?
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Whats MASHnet Formation

• Workshop in Healthcare Simulation Reading 2003
  - Identified need for stronger links between the
  difference parties engaged in healthcare
  simulation and modelling.
• Proposed preparation of an application to the
  EPSRC for network funding.
• Application prepared late 2003 and submitted to
  EPSRC in 2004
• Funding 60,000 for three years, agreed Sept 2004
• MASHnet officially started Jan 2005

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Whats MASHnet Aims and Objectives

• AIM
• To improve the application of modelling and
  simulation techniques within healthcare decision
  making.
• Objectives
• To establish a steering group
• To create a dedicated web site to disseminate
  information
• To organise regular (eg twice yearly) seminars of
  the membership
• To foster links with other key organisations
• To develop a dedicated e-journal and to promote
  the publication of papers and articles in the
  field of healthcare modelling and simulation.
• To establish a directory of practitioners in
  healthcare modelling and simulation in the UK.
• To build a web based bibliography of healthcare
  modelling and simulation publications
• To develop educational resources to encourage
  learning of healthcare modelling and simulation
• To stimulate the use of modelling in healthcare
  decision making through active dialogue with
  professionals in healthcare.

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Whats MASHnet Guiding Principles

• Make use of existing work and organisation
  (not re-invent wheels and tread on toes)
• Ethnically Diverse (not dominated by concerns of
  one group e.g. academics)
• Dynamic and responsive to change
• Outwardly directed (not cozy and introspective)
• Willing to engage in difficult areas of health
  policy and politics
• Should be fun

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Themes in Healthcare Modelling Simulation

• Lots of interest
• Lots of research
• Lack of integration and co-ordination
• Lack of serious implementation
• Unrealised Potential

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Systematic Review of use of simulation in
population health and health care delivery -
Fone et al 2003

• Despite the increasing numbers of quality papers
  published in medical or health services research
  journals we were unable to reach any conclusion
  on the value of modelling in health care because
  the evidence of implementation was so scant.

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Editorial to a Special Issue of Journal of
Operational Research on Health care- Davis and
Bensley 2005

• Despite the wealth of contributions, relatively
  few academic papers on health issues on
  Operational Research or Management Science
  journals address issues of outcome,
  implementation, or the use of the work reported.

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The Three Key Communities
Health services
Academic research
Industry
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Web based Resources

• Case Studies Listing
• Directory of Practitioners
• Bibliography/Database
• E-Journal
• Links to other organisations
• News/reports of events
• Membership area possibility
• Web based dialogues, blogs, wikies, etc

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Events

• Promotional Workshops
• OR Society, London and Birmingham
• ORAHS, Southampton
• Launch Event
• Workshop NHS Confederation
• Cardiff Workshop
• Presence at workshops, conferences

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Launch event

• Warwick Business School, 20 Sept 05
• Over 70 delegates drawn from all areas of
  healthcare modelling and simulation
• Participatory workshop Gathering Input
• Good Food

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Launch event

• Geoff Royston Head of Operational Research NHS
• Big Challenges
• Accelerate flexibility and responsiveness of
  tools
• Focus on application
• See modelling as a partner to experimentation

• Ruth Davies - Prof. of OR Warwick Business School
• Pros and cons of academics role
• -Viable approaches
• Importance of clear goals and perspectives

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Launch event

• Mark Elder CEO Simul8
• industry perspective
• Lessons from other sectors
• Crucial to have modelling EARLY in design

• Simon Dodds Vascular Consultant, Goodhope
  Hospital
• obligate doer
• Win-win-win
• Design the best process using modelling as a
  flexible test-bed

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Launch event group work
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Why Important?

• Health services
• Improve effectiveness and efficiency
• Understand the system
• Make rational (evidence based) decisions
• Academic/Research
• Publication, Teaching, RAE
• Add value to the NHS
• Industry
• Profit, Large Consistent Sector
• Help the NHS/ Goodwill etc.

Evidence Based Management
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What obstacles?

• Health Services
• Awareness and culture
• Capacity i.e. time, expertise
• Academics
• Funding, Time
• Opportunities for engagement with health service
• Data issues
• Industry
• Ownership
• Resources in trusts
• Complexity of NHS and decision processes
• Applicability of tools, lack of stable, generic
  user-base

No common language
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What actions?

• Health Services
• Champions top level commitment
• Integrate into planning
• Training and education
• Academics
• Feedback from users and work together
• Raise profile
• Persevere!
• Industry
• Find Champions
• Promote successful examples
• Build strategic relationships

Top level commitment Success stories
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Key Issues

• Health Services
• Time
• Innovation overload
• Ownership and language
• Academics
• RAE (how to match this to useful applications)
• Resources
• Industry
• Firefighting vs strategic development
• Sustainability

Sustained Collaboration
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Launch eventBig Ideas

• Promotion
• Promulgate success stories
• Target key decision makers
• Keep it local
• Education
• Training for NHS users and modellers
• Collaboration and Communication
• Resources
• Recognition
• Champions

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NHS Confederation Workshop

• Held on 3rd March 2006
• 38 Delegates drawn mainly from NHS managerial and
  clinical backgrounds
• Highly participatory

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NHS Confederation Workshop

• Plenary Presentations practical applications to
  whet the appetite!
• Then group sessions gather info.

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NHS Confederation Workshop

• Barriers to use of modelling
• Capacity
• Lack of dedicated staff
• Perceived value
• Recognition at senior levels
• Chief Execs, Consultants !
• No experience of use/success
• Lack of usable tools
• Data Limitations
• Constantly shifting objectives
• Communication (lack of) between key professional
  groups

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NHS Confederation Workshop Proposed Research
Observations

• Wide Range of modellable problems identified
• Problems expressed in fairly nebulous terms
• Not unique to management challenges
• Lack of understanding of potential for solution
  makes it difficult to frame the problem in the
  right way
• Solution collaboration early
• Timescales often mismatch between healthservice
  and research

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Summary

• Encouraging interest in MASHnet
• Collaboration with existing organisations and
  groups
• Common themes around barriers and opportunities
  for modelling
• Broad validation of the approaches suggested in
  MASHnet proposal

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Future Activities
Web Resources new site under development Smaller
targeted events Specific themes/Specific
groups Building on outputs from events to
date Collaboration NHS Confederation, Westfocus,
The Operational Research Society, Institute of
Mathematical Applications etc. Future Conference
2007
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MASHnet Organisation - Phase 2
PROGRAMME/EVENTS
BIBLIOGRAPHY
PRACTITIONERS DIRECTORY

Activity
LINKS
Greater role for internet Website Focused of
achieving early goals.
Sub-groups
CASE STUDIES LISTING
INFO DISSEMINATION (website, newsletter etc)
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Find Out More
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Invitation to participate !

• Practitioners Directory
• Case Study Listing
• www.mashnet.org.uk