Toward Simulation-Based Real-Time Decision-Support Systems for Emergency Departments Yariv N. Marmor, Segev Wasserkrug, Avraham Shtub. 2009 Winter Simulation Conference (WSC’09), December 13-16, Austin, TX, USA

Emergency Departments (EDs) require advanced support systems for monitoring and controlling their processes: clinical, operational, and financial. A prerequisite for such a system is comprehensive operational information (e.g. queueing times, busy resources,…), reliably portraying and predicting ED status as it evolves in time. To this end, simulation comes to the rescue, through a two-step procedure that is hereby proposed for supporting real-time ED control.
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A Modern Simulation Approach for Pharmaceutical Portfolio Management Kirk Solo and Mark Paich. International Conference on Health Sciences Simulation (ICHSS'04), January 18 - 21, 2004, San Diego, California, USA

By creating an integrated simulation environment that models the underlying structure of a pharmaceutical enterprise portfolio it becomes possible to identify the optimal longitudinal allocation of finite resources across the constellation of available investment opportunities. The implementation of a hybrid approach that integrates multiple modeling techniques and analytic disciplines allows for a comprehensive environment that captures the underlying dynamics that drive observed market behavior. The implementation of an object oriented model structure constrains the models complexity by supporting dynamic re-use of both structure and logic.
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Agent Modeling of Hispanic Population Acculturation and Behavior Lyle Wallis, Mark Paich, and Andrei Borshchev. The 3rd International Conference on Systems Thinking in Management (ICSTM 2004), May 19 - 21, 2004, Philadelphia, Pennsylvania, USA

In recent US Census data widely reported in the press “Hispanics” have become the largest minority group in the US. Using simulation modeling technology we look at some of the structural forces that shape the characteristics of the Hispanic population. The model creates a simulated Hispanic population whose level of acculturation to the broader population of which it is a part dynamically varies according to individual choice. The modeling technique used draws on both System Dynamic and Agent based paradigms both supported by innovative AnyLogic software. The representative Hispanic population is disaggregated down to the individual level as individual agents. Each agent makes choices stochastically as modulated by its current state and the outside environment that it is in.
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Geographically-Enhanced Mathematical Models of HIV Dynamics Bobashev G.V., Zule W., Root E.D., Wechsberg W.M., Borshchev A. V., and Filippov A.E. NIDA Symposium on AIDS, Cancer and Related Problems, May 26, 2004, St. Petersburg, Russia

Mathematical modeling is a relatively new but fast developing area of HIV studies providing researchers with an additional dynamical dimension in epidemiological work that allows scientists to simulate the consequences of various intervention and prevention scenarios. We illustrate these concepts by presenting a model that describes Injecting Drug Users (IDU) networks, injecting behavior and HIV/HCV spread within the networks. This individual-based (also called agent-based) model is used to investigate the impact of the introduction of Integralcannula syringes (ICS) instead of commonly used Detachable Needle syringes (DNS). Laboratory experiments have shown that ICS retain approximately 1000 times less residual blood (<.001 ml vs. 1ml) following injection and rinsing than DNS thereby decreasing risk of HIV/NCV transmission by nearly 100 times after 2 rinses.
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Scalable Mathematical Models for Substance Use: From Social Networks to the Whole Populations Georgiy V. Bobashev, William A. Zule, Elizabeth D. Root, Wendee M. Wechsberg, Andrei V. Borshchev, and Alex E. Filippov. The College on Problems of Drug Dependence 66th Annual Meeting, June 12–17, 2004, San Juan, Puerto Rico

Mathematical modeling is a relatively new but fast developing area of substance use field providing researchers with additional dynamical dimension in epidemiological work and allowing scientists to simulate the consequences of various intervention and prevention scenarios. We illustrate these concepts by presenting two models. The first model describes Injecting Drug Users (IDU) networks, injecting behavior and HIV/HCV spread among the networks. The size, structure of the networks as well as frequency of injecting and HIV risks were obtained from published literature on urban IDU networks. This individual-based model was used to investigate the impact of introduction of Integral-cannula syringes (ICS) instead of commonly used Detachable Needle syringes (DNS).
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Spatial Dynamics of Social Network Evolution Sara Metcalf and Mark Paich. The 23rd International Conference of the System Dynamics Society, July 17 - 21, 2005, Boston, USA

This paper explores the problem of fragmenting social networks enabled by spatial distancing between distinct socioeconomic classes. Such fragmentation is evidenced by the experience of urban sprawl without population growth. We develop a prototype model to examine the spatial dynamics of social network evolution in the face of neighborhood migration. This model draws upon the small world analogy by using an initial template of connections that are “rewired” over time. Spatially, connections are established for neighborhood proximity. Socially, connections are added based upon similarity of economic class.
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Decreased length of stay after addition of healthcare provider in emergency department triage Theodore Eugene Day, Abdul Rahim Al-Roubaie, Eric Jonathan Goldlust; EMJ Online First, August 22, 2012

The objective of this paper was to determine the effects of adding a healthcare provider in triage on average length of stay (LOS) and proportion of patients with >6 h LOS. The other goal was to assess the accuracy of computer simulation in predicting the magnitude of such effects on these metrics.
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A multi-paradigm, whole system view of health and social care for age-related macular degeneration Joe Viana, Stuart Rossiter, Andrew A. Channon, Sally C. Brailsford, Andrew Lotery, WSC-2012, Berlin

This paper presents a hybrid simulation model for the management of an eye condition called age-related macular degeneration, which particularly affects the elderly. The model represents not only the detailed clinical progression of disease in an individual, but also the organization of the hospital clinic in which patients with this condition are treated and the wider environment in which these patients live (and their social care needs, if any, are met). The model permits a ‘whole system’ societal view which captures the interactions between the health and social care systems
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Hybrid simulation with loosely coupled system dynamics and agent-based models for prospective health technology assessments Anatoli Djanatliev, Reinhard German, Peter Kolominsky-Rabas, Bernd M. Hofmann, WSC-2012, Berlin

Due to the ageing of the world population, the demand for technology innovations in healthcare is growing rapidly. All stakeholders (e.g., patients, healthcare providers and health industry) can take profit of innovative products, but the development degenerates often into a time consuming and cost-intensive process. Prospective Health Technology Assessment (ProHTA) is a new approach that combines the knowledge of an interdisciplinary team and uses simulation techniques to indicate the effects of new innovations early before the expensive and risky development phase begins. In this paper, we describe an approach with loosely coupled system dynamics and agent-based models within a hybrid simulation environment for ProHTA as well as a use-case scenario with an innovative stroke technology
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The service productivity learning cockpit – a business-intelligence tool for service enterprises Prof. Dr. Torsten Eymann, Universität Bayreuth, Lehrstuhl für Wirtschaftsinformatik

Computer simulation is a way to imitate business processes based on reality. Due to the fact that the environment in hospitals is highly dynamic with local autonomy of stakeholders participating in the business processes, we found an agent–based modeling and simulation (ABMS) approach to be most suitable and it is therefore applied in this context. From an inception to a running simulation, followed by an analysis of the output, we need to keep in mind our user’s physical problem as well as their capability of digesting the results. An interface between a computer modeler/programmer’s deliverable and a user like a hospital manager who learns from the simulated behavior of physical reality, is a visualization tool. We call this tool a “Learning Cockpit” (LC). Although a manager has experience in managing their business and they use personal qualities to positively drive their organization in challenging business environments, a simulation provides them additional support in decision process. With the help of simulation, they should be able to clearly and concisely grasp the information about the current operations, the resources involved and the inherent costs to get an output. They should be able to measure the performance of the current setup, and if necessary, make some changes and bring more value to the organization
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