The Big Issues
Can simulation models improve decision-making in healthcare?

Improving healthcare, while also cutting costs, can demand a wholesale redesign of services and infrastructure use. But the process - developing the business case and involving multiple stakeholders - can be difficult and risky. The relationships between technology, services and infrastructure are complicated, with potential benefits poorly evidenced. Additionally, today's preference for 'local solutions' means decision-makers often lack expertise in tackling such tricky issues. The result can be an aversion to innovation.

That's why HaCIRIC is studying ways to test possible scenarios for healthcare change. We are assessing whether modelling, simulation and visualisation (MSV) can successfully involve stakeholders - predicting impacts on them and the system as a whole - and facilitate successful innovation.

Our research has international implications as health systems seek greater efficiency but struggle to optimise the combination of technology, care and infrastructure.

Demonstrating better building layout and design?

The need to remodel infrastructure to support changing services is paramount to effective healthcare. We are using MSV techniques to help architects and planners to take account of diverse stakeholders, new treatments and medical advances. They are benefiting from new evidence-based strategies, practical guidance, good practice and new tools for improving the design of healthcare space and layout. In another project, we are using Building Information Modelling (BIM) and environmental simulation to improve the therapeutic design of new and existing healthcare facilities. This project involves collaboration with the Department of Health, Central Office of Information, Leicester and Rutland PCTs and universities in the US and Sweden. We have enhanced the BIM approach by developing purpose-built models and digital mock-ups, helping to reduce the cost and time required for various aspects of healthcare building design and the development process.

Showing improved ways to deliver care?

HaCIRIC is using modelling and simulation to test new ways to deliver stroke care in the UK and the United States. The two countries have contrasting approaches and outcomes, offering important lessons for each and potentially major improvements in disability and mortality rates, as sought by the UK government. In collaboration with MIT and the Harvard Medical School, we are exploring how disruptive innovations could make a difference in cost effectiveness and outcomes, and modelling the impact of new approaches and technologies.

Increasing the use of simulation tools in complex decision making?

Despite strong academic research pointing to their potential benefits, modelling and simulation tools in healthcare are insufficiently employed. HaCIRIC is examining how simulation is actually used in real-life settings involving NHS primary and secondary trusts. We are studying how it is used for representing reality more effectively, for experimenting with policy options, supporting communication, learning as a group, and capturing expert knowledge. We hope to show what works best in practice in terms of choice of simulation technique, facilitation approach and visual representation. From our detailed understanding of modelling practice, we are developing recommendations for more effective use of MSV in healthcare planning.