Program Overview
08:45 Opening Remark (Maria Pia Fanti, Cristian Mahulea, Xiaolan Xie)
08:50 Cristian Mahulea “A model-based approach for the specification and verification of clinical guidelines”
09:35 Xiaolan Xie “Dynamic surgery scheduling”
10:20 Coffee Break
10:35 Kristofer Bengtsson “Event based information architecture for healthcare”
11:20 Maria Pia Fanti “A Clinical Decision Support System for Improving Self Consciousness of Health Conditions”
12:05 Closing Remark (Maria Pia Fanti, Cristian Mahulea, Xiaolan Xie)
Healthcare systems are highly computerized large-scale distributed systems. To manage the increasing demand and financial pressure, radically new planning and control approaches are needed. Future planning and control requires better integration of various subsystems and advanced algorithms for information handling, prognosis and optimization. It also needs to be useful and understandable by healthcare personnel and patients as well as shifting from a reactive care to proactive and patient-centered care. This workshop intends to discuss actual problems of healthcare systems related to planning and management. The focus of the workshop is on the logistics and planning of patient activities and resource utilization. Since the application domain is very complex, the workshop will discuss how new models describing the healthcare system behavior and new algorithms can be implemented using advanced Information and Communications Technology. The topics of the workshop are very related to the topics of the CASE series, for example a special session on “Automation in Health Care Management” has been organized last year, while two have been proposed at the actual edition “Stochastic and simulation Modeling in Healthcare Management and Theory” and “Application of Data and Process Mining in Healthcare Systems”.
List of topics
A model-based approach for the specification and verification of clinical guidelines
Cristian Mahulea
This presentation shows a modeling methodology for clinical guidelines and medical protocols used in hospitals and in primary healthcare. The clinical guidelines and medical protocols are assumed to be given in a graphical form in a structure obtained by combining few elements. It is shown how the clinical guidelines represented with this syntax can be automatically converted into a mathematical model represented as Petri nets. The main advantage of the new model is the inclusion of resources and patient flow in the same model, which makes possible its use in analysis and verification of the guidelines using some of the already known results from the PN literature. Moreover, if many clinical guidelines or medical protocols are considered, the models can be used for resource optimization and performance evaluation. Some case studies from a primary care team in Zaragoza and from the ”Lozano Blesa” University hospital in Zaragoza are presented.
Dynamic surgery scheduling
Xiaolan XIE
In this talk, I will first give an overview of my research activities with both French and Chinese hospitals. I will then focus on daily surgery scheduling in a multi-OR setting where OR stands for Operating Rooms with random surgery durations.
We first address the dynamic assignment of a given set of surgeries with planned surgeon arrival times also called appointment times. Surgeries are assigned dynamically to ORs at surgery completion events. The goal is to minimize the total expected cost incurred by surgeon waiting, OR idling, and OR overtime. We first formulate the problem as a multi-stage stochastic programming model. An efficient algorithm is then proposed by combining a two-stage stochastic programming approximation and some look-ahead strategies. A perfect information-based lower bound of the optimal expected cost is given to evaluate the optimality gap of the dynamic assignment strategy. Numerical results show that the dynamic scheduling and optimization with the proposed approach significantly improve the performance of static scheduling and First Come First Serve (FCFS) strategy.
We then address the optimization of surgeon appointment times for a sequence of surgeries. Surgeries are assigned to ORs dynamically on a FCFS basis. It materially differs from past literature in the sense that dynamic assignments are proactively anticipated in the determination of appointment times. A discrete-event framework is proposed to model the execution of the surgery schedule and to evaluate the sample path gradient of a total cost incurred by surgeon waiting, OR idling and OR overtime. The sample path cost function is shown to be unimodal, Lipchitz continuous and differentiable w.p.1 and the expected cost function continuously differentiable. A stochastic approximation algorithm based on unbiased gradient estimators is proposed and extensive numerical experiments suggest that it converges to a global optimum. A series of numerical experiments are performed to show the significant benefits of Multi-OR and properties of the optimal solution with respect to various system parameters such as cost structure and numbers of surgeries and ORs.
Event based information architecture for healthcare
Kristofer BENGTSSON
It is challenging to get an overview and understanding of the activities and their relations at an emergency department (ED). This is due to the complicated relations among activities, many concurrent activities and the always-changing system behavior. A key enabler to get this overview is the transformation of real-time events into understandable information. This presentation demonstrates an event-based information architecture for healthcare (EVAH) that gathers state changing events in real-time at an ED and visualizes them in a user interface.
A Clinical Decision Support System for Improving Self Consciousness of Health Conditions
Maria Pia FANTI
In this contribution we present a clinical Decision Support System devoted to monitor and suggest diet, physical exercises, medical analysis, medical checks and possible treatments in order to help the individual with the self-managing of lifestyle and disease. It analyses the data, alerts the individual about the actions that should be taken, in the case that additional information is needed it asks to the individual, and makes recommendations regarding lifestyle changes or contacting care providers.
The DSS bases the recommendations, suggestions and disease evaluation on historical data, patient records, clinical guidelines, existing and improved predictive models as well as on ICT information coming from suitable sensors, medical instruments, the individuals and the environmental data. To this aim remote monitoring of medical equipment installed at home may be provided and the relative outputs are integrated in the DSS in a holistic way.
Moreover, the DSS improves the knowledge of a particular disease by collecting new data about the patients in order to help the hospitals to realize new people screening to identify common and prevalent data that are connected to a specific pathology.
Expected participants and their background: The tutorial is targeted at PhD students and researchers interested in the problem of healthcare systems management using mathematical based approaches. Since the application domain is very complex, new models of healthcare organization based on advanced ICT systems and services should be proposed with the participation of academic, hospitals and ICT companies. The main emphasis of the workshop will be given to the applications related to the care of older patients and the involvement of the citizen in the decision-makings.
Organizers:
Maria Pia Fanti, Polytechnic of Bari, Italy
Cristian Mahulea, University of Zaragoza, Spain
Xiaolan Xie, Ecole Nationale Supérieure des Mines de Saint Etienne, France and Centre for Healthcare Engineering, Shanghai Jiao Tong University, P.R. China
List of speakers and their biographical sketch:
1. Kristofer BENGTSSON received the PhD degree in September 2012 from Chalmers University of Technology. The title of his thesis was Flexible design of operation behavior using modeling and visualization. He is founder of Sekvensa AB, a spin-off company based on research results from the automation research group related to tools and methods for modeling healthcare systems and activity behavior. Dr. Bengtsson spends much of his time in collaboration with hospitals. He has a background in the automation industry with a focus on user interface development, project management and control design.
2. Maria Pia FANTI received the Laurea degree in electronic engineering from the University of Pisa, Italy in 1983 and was a visiting researcher at the Rensselaer Polytechnic Institute of Troy, New York, in 1999. Since 1983 she is with the Department of Electrical and Information Engineering of the Polytechnic of Bari (Italy) where now she is full professor of System and Control Engineering and Chair of the Laboratory of Automation and Control.
Her research interests include discrete event systems, Petri net, consensus protocols, management and modeling of complex systems such as automated manufacturing systems, automatic guided vehicle systems, railway and traffic networks, supply chains, and healthcare systems. She has published around 230+ papers and two textbooks on these topics. She was General Chair of the 2nd IFAC Workshop on Dependable Control of Discrete Systems, of the 2010 IEEE Workshop on Health Care Management, and of the 2011 IEEE Conference on Automation Science and Engineering.
Prof. Fanti is Editor of IEEE Trans. on Automation Science and Engineering and Associate Editor of the IEEE Trans. on Systems, Man, and Cybernetics: Systems. She is member at large of the board of governor of the IEEE SMC Society, Co-Chair of the Technical committee on Discrete Event Systems of the IEEE SMC Society, Chair of the Central & Southern Italy SMC Chapter, Chair of the Technical committee on Automation in Logistics of the IEEE Robotics and Automation Society.
3. Cristian MAHULEA is currently an Assistant Professor at the Department of Computer Science and Systems Engineering of the University of Zaragoza, Spain. He received the B.S. and M.Sc. degrees in control engineering from the Technical University of Iasi, Romania, in 2001 and 2002, respectively, and the Ph.D. degree in systems engineering from the University of Zaragoza, Spain, in 2007. His research interests include discrete event systems, hybrid systems, automated manufacturing, Petri nets, mobile robotics and healthcare systems. He has participated in the development and implementation of Petri Net Toolbox and SimHPN, two MATLAB packages for simulation, analysis and synthesis of discrete-event systems modeled with Petri nets. He has been a Visiting Professor at the University of Cagliari, Italy, and a Visiting Researcher at the University of Sheffield, U.K., and Boston University, MA, USA and currently he serve as Associate Editor for IEEE Transactions on Automation Science and Engineering.
4. Xiaolan XIE received his Ph.D degree from the University of Nancy I, Nancy, France, in 1989, and the Habilitation à Diriger des Recherches degree from the University of Metz, France, in 1995.
Currently, he is a distinguished professor of industrial engineering, the head of the department of Healthcare Engineering of the Center for Health Engineering and the head of IEOR team of CNRS UMR 6158 LIMOS, Ecole Nationale Supérieure des Mines (ENSMSE), Saint Etienne, France. He is also a chair professor and director of the Center for healthcare engineering at the Shanghai Jiao Tong University, China. Before Joining ENSMSE, he was a Research Director at the Institut National de Recherche en Informatique et en Automatique (INRIA) from 2002 to 2005, a Full Professor at Ecole Nationale d’Ingénieurs de Metz from 1999 to 2002, and a Senior Research Scientist at INRIA from 1990 to 1999. His research interests include design, planning and scheduling, supply chain optimization, and performance evaluation, of healthcare and manufacturing systems. He is author/coauthor of over 250 publications including over 90 journal articles and five books. He has rich industrial application experiences with European industries. He is PI for various national and international projects including ANR-TECSAN HOST on management of winter epidemics, NSF China key project on planning and optimization of health care resources, French Labex IMOBS3 project on home health cares, FP6-IST6 IWARD on swarm robots for health services, FP6-NoE I*PROMS on intelligent machines and production systems, the FP5-GROWTH-ONE project for the strategic design of supply chain networks, the FP5- GRWOTH thematic network TNEE on extended enterprises.
Dr. Xie is a fellow of IEEE. He has been an associate editor for IEEE Transactions on Automation Science & Engineering, IEEE Transaction on Automatic Control, IEEE Transactions on Robotics & Automation and International Journal of Production Research. He has a Guest Editor of various special issues on healthcare engineering and manufacturing systems. He is general chair of ORAHS’2007 and IPC chair of the IEEE Workshop on Health Care Management WHCM’2010.