Sandia National Laboratories: CASoS Engineering Application Background: VA Healthcare

Application Background: VA Healthcare

To model the health care system of the VHA as a complex adaptive system of systems, assess the effects of threat scenarios of consequence, and develop appropriate mitigation strategies to counter those threats.

To decompose the VA health care system into the fundamental building-blocks of medical physics, organizational physics, and social physics
To develop a model that allows the investigation of how local policies affect the organization as a whole, and vice versa, developing a framework capable of analyzing organizational behaviors and constraints within complex hierarchical networks

Successful demonstration in September 2010 of an initial implementation of fundamental medical and organizational physics, both in steady-state and under perturbation (threat), for a single Medical Service Unit (MSU) and a network of MSUs
Next steps are to generate results for a network of healthcare facilities subjected to two types of surges in demand: 1) a spike, representing a natural disaster which introduces patients with acute trauma requiring immediate treatment, and 2) a steady increase in demand imposed by the increasing prevalence of hepatitis C, which can result in a population with a significantly increased burden of end-stage liver disease and hepatocellular carcinoma. Policy actions to be evaluated include striking the right balance between medical center-level policies and network-level policies (issues of multi-level selection), cost-effective resource utilization, and mediating resource conflicts.

To create a general framework for public health action that uses medical physics, organizational physics, social physics, perturbations, and uncertainty quantification as fundamental components
To contribute a flexible timer-based simulation mechanism, that supports both stochastic and deterministic execution, to the Loki toolkit

This framework for public health action could be extended to other health care networks, such as private health care systems and the Department of Defense(DoD) health care system
The framework could be extended to address issues of multi-level selection in any hierarchical organization

This application is funded by the Office of Public Health and Environmental Hazards (OPHEH) in the Veterans Health Administration (VHA) of the Department of Veterans Affairs (VA).