Online Workshop: Improving Patient Care Pathways
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Transcript of Online Workshop: Improving Patient Care Pathways
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Improving Patient Care Pathways
Claire Cordeaux: Executive Director, Healthcare
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SIMUL8 Corporation | SIMUL8.com | [email protected]
Presenter
Claire Cordeaux
Executive Director, Healthcare SIMUL8 SIMUL8 Corporation
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SIMUL8 Corporation | SIMUL8.com | [email protected]
• Understanding patient care through pathways• How simulation can help• Examples• Standard of Care• Sharing across a community• How you can get involved
Agenda
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Patient Care Pathways
Routinely used to understand and improve practice• Services • Clinical practice• Disease
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Patient Care Pathways: Services
Process flow through services
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Patient Care Pathways: Clinical Practice
Used to show best clinical practice.
Map of Medicine
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Patient Care Pathways: Disease Progression
Show progression through disease states over time.
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Our Approach to Simulating Pathways
Combining disease state transitions with best practice and service access.
Why?• Test impact of service redesign on disease
progression• Genericized – can be used and localised by any
group interested improving pathways for patients with the same condition
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SIMUL8 Corporation | SIMUL8.com | [email protected]
Disease Transitions: State Charts
• Define all disease states patients can transition to.
• Input the transitions between states. (Rates, %, Time)
• As simulation runs patients will transition to an from states based on the inputted rules.
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SIMUL8 Corporation | SIMUL8.com | [email protected]
Service Model
The disease transition model is linked to a service or treatment model.
As patients transition into different states they use different service. They trigger events in a DES model.
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SIMUL8 Corporation | SIMUL8.com | [email protected]
Best Clinical Practice
New interventions, best clinical practice, service redesign can all be tested for impact on:
Cost, Resource, Activity, Waiting times
AND
Disease Progression
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SIMUL8 Corporation | SIMUL8.com | [email protected]
Case Study 1: HIV
What is the impact of screening?
What is the impact of increasing frequency of attendance to improve adherence?
• on future burden of disease • projected treatment costs for the service
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SIMUL8 Corporation | SIMUL8.com | [email protected]
Age-banded population projections
Age-banded disease
prevalenceDemand
1.23m x HIV 0.465% = 2531
Simulating Demand
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SIMUL8 Corporation | SIMUL8.com | [email protected]
Simulated Demand: Catchment Population
The projected population is decreasing
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SIMUL8 Corporation | SIMUL8.com | [email protected]
25% of patients are undiagnosed and use this pathway.
Undiagnosed patients can infect others.
Late diagnosis leads to becoming symptomatic and very sick.
Diagnosis (Current State)
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SIMUL8 Corporation | SIMUL8.com | [email protected]
Diagnosis (Current State)
Successful ART leads to near normal life expectancy
Cost per year if symptomatic and AIDs
75% of patients are diagnosed and use this pathway.
Diagnosed but untreated can infect others
Late diagnosis leads to becoming symptomatic and very sick
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SIMUL8 Corporation | SIMUL8.com | [email protected]
Costs (indicative only)
Cost $Diagnosis 100Follow up Appointment and Drug therapy every 6 months
9,000
HIV symptoms (annual) 25,000AIDS (1 year only) 50,000
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SIMUL8 Corporation | SIMUL8.com | [email protected]
Activity Results
These results represent no change for next 5 years.
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new infectionsARTFollow ups
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SIMUL8 Corporation | SIMUL8.com | [email protected]
What if screening reduces undiagnosed to 15%?
Costs decrease over time as fewer patients develop HIV Symptoms and Aids and fewer are infected, although follow ups increase.
1 2 3 4 50
50000000
100000000
150000000
200000000
250000000
Screening CostsCosts
1 2 3 4 50
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Screening AidsAidsScreening HIV SymptHIV sympt
1 2 3 4 50
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Follow upsScreeningFollow ups
Scenario 1 Results
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SIMUL8 Corporation | SIMUL8.com | [email protected]
What if we see patients every 3 instead of very 6 months and this increases successful ART?
Scenario 2
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SIMUL8 Corporation | SIMUL8.com | [email protected]
Scenario Results: Increasing Treatment Frequency
Costs increase but infections reduce. Symptomatic patients reduce in years 4 and 5
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50000000
100000000
150000000
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250000000
Screening CostsCostsSupported ART Costs
1 2 3 4 50
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New infection baselineNew Infection ScreeningNew infection Supported ART
1 2 3 4 50
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2500
Baseline HIV symptScreening HIV SymptSupport ART HIV Sympt
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SIMUL8 Corporation | SIMUL8.com | [email protected]
What Resources are Required?
1 2 3 4 50
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Baseline follow upsSreening Follow upsSupport ART Follow ups
Follow ups increase in each scenario – with 100 weekly appointments wait times are unacceptable.
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SIMUL8 Corporation | SIMUL8.com | [email protected]
Resource requirements
Increasing weekly appointments to 250 brings wait times in line with requirements
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SIMUL8 Corporation | SIMUL8.com | [email protected]
Template Simulations
What are the key features of any disease pathway?
Share your thoughts via our survey monkey and we will report back.
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SIMUL8 Corporation | SIMUL8.com | [email protected]
Standard of Care
Imagine a simulated pathway including:• Expected demand from population health predictions and
disease progression• Evidence-based best clinical practice• Localizable to individual providers and populations
Answering questions:• What if I implement best practice?• What will this look like in 3-5 years time?• What resources will I need?• How much will it cost/what income will I earn?• Will I have patients waiting if I don’t increase staffing?• What will patient outcomes be?
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SIMUL8 Corporation | SIMUL8.com | [email protected]
Share and Manage Pathways on the Web
Have multiple user logins to access a suite of simulation models.
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SIMUL8 Corporation | SIMUL8.com | [email protected]
Create Simulation Suites
Upload multiple models which user can run, change, SAVE and EXPORT results from. These users can also share these with others.
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SIMUL8 Corporation | SIMUL8.com | [email protected]
Manage Access
Create localized simulations and assign them so that only specific users can view particular simulations.
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SIMUL8 Corporation | SIMUL8.com | [email protected]
Do Once and Share
Our offer to you
Help us build pathways we can share.
Send us your pathway suggestions and we will choose one to build and share using our new technology
Email to [email protected]
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SIMUL8 Corporation | SIMUL8.com | [email protected]
QUESTIONS
Please forward any topics you would like to see covered to [email protected]
Continue the discussion on SIMUL8 in Health – LinkedIn Group
September Workshop – “Optimizing Outpatient Operations – Staffing & Scheduling”.