Healthcare Modelling is a relatively new concept for Counties Manukau DHB, so when the chance came to attend a workshop on the subject many jumped at the opportunity.

So what is healthcare modelling and why do we need it?

CMDHB like other health care organisations around the world are facing increasing demands on services, by a growing and ageing population. Faced with financial constraints and limited resources we need to work smarter and more creatively to rise to the challenges above. 

“It’s not just a case of cutting back at the edges and hoping for the best in the current financial climate”, says Prof Harper.  "We need to meet the challenge of transforming the quality of care through radically different processes and systems that will save money but also produce better outcomes.” 

This is where healthcare systems modelling can help and why Prof Harper's work and that of his team is growing in interest and popularity.

In simple terms modelling a healthcare system means capturing health processes, such as patent flow, and creating mathematical and/or computer simulation model representations of that system.  The developed mathematical models could for example explore the relationships between demand for service, service times, waiting times, patient choice and behaviours, and resource utilisation.  These models, utilising techniques such as queueing theory, game theory and simulation, then readily permit for scenario experimentation.  Health service planners can use these to evaluate the likely impact of change, gain understanding of systems behaviour and interaction, and re-design systems in an informed way. 

For example, work in the UK on modelling patients through Emergency Care has been able to help identify bottlenecks in the system, and what needs to be done to make the process more efficient, for example by better forecasting demand, working out how many hospital beds are needed, what the correct skill-mix of workforce is required to best meet that demand, and better schedule operating theatres.   Prof Harper and colleagues Dr Vincent Knight and Dr Jonathan Gillard (who also were visiting CMDHB) are working with the Welsh Ambulance Service to model ambulance capacity planning and location analysis to assist in where best to locate ambulances to meet response time targets and improve patient survival.

You can also apply the same modelling principles to examine the spread of diseases or care-pathways of longer term-conditions, and the impact of different screening and treatment policies.  This has been successfully used in the UK to inform health policy on screening for Chlamydia, as well as evaluating the frequency and age to screen for the UK breast cancer screening programme. 

“The key to achieving these goals lies in better design and management of service at all levels, supported by the appropriate tools, methods, and approaches. It’s about trying to best deploy resources in the most efficient and effective way to improve patient outcomes,” says Prof Harper. 

The Operational Research group at Cardiff University has a long tradition of healthcare modelling and forms part of the wider pan-Wales university initiative, the Wales Institute of Mathematical and Computational Sciences (WIMCS), which is a joint collaboration between Aberystwyth, Bangor, Cardiff, Glamorgan and Swansea universities. That initiative created the Health Modelling Centre Cymru (hmc²) which was launched last year and is directed by Prof Harper, bringing together mathematicians, computer scientists, operational researchers and statisticians from across Wales to work on healthcare related research and applications. 

For more information about Professor Harper’s work go to www.profpaulharper.com/