Systemic Design Approach to a Real-Time Healthcare Monitoring System: Reducing Unplanned Hospital Readmissions.

Faisal Alkhaldi,Ali Alouani

doi:10.3390/s18082531

Abstract

Following hospital discharge, millions of patients continue to recover outside formal healthcare organizations (HCOs) in designated transitional care periods (TCPs). Unplanned hospital readmissions of patients during TCPs adversely affects the quality and cost of care. In order to reduce the rates of unplanned hospital readmissions, we propose a real-time patient-centric system, built around applications, to assist discharged patients in remaining at home or in the workplace while being supported by care providers. Discrete-event system modeling techniques and supervisory control theory play fundamental roles in the system’s design. Simulation results and analysis show that the proposed system can be effective in documenting a patient’s condition and health-related behaviors. Most importantly, the system tackles the problem of unplanned hospital readmissions by supporting discharged patients at a lower cost via home/workplace monitoring without sacrificing the quality of care.

Highlights

The quality of care (QOC) and cost of care (COC) of healthcare services provided by healthcare organizations (HCOs) has become a front-and-center issue in the United States [1,2]
In reference [4], we introduce the other portion of universal patient model (UPM) for patients inside automata, patient automata (PAio) : healthcare organizations, for a different use
To avoid generating the numbers of events manually, which could be cumbersome given the potentially large number of concurrent patients in transitional care periods (TCPs) [34] and holons involved, we show, in Appendix B, a systematic way to create the number of each event which appears in the holons of all patient automata (PAio ) in the electronic companion care (eCC)

Summary

Introduction

The quality of care (QOC) and cost of care (COC) of healthcare services provided by healthcare organizations (HCOs) has become a front-and-center issue in the United States [1,2]. The POC have a direct impact on the following seven major system outcomes inferred from [3,5,6]: (1) timeliness (e.g., patient waiting time); (2) degree of utilization of healthcare services (e.g., overutilization, underutilization); (3) effectiveness of interventions and care provisions (e.g., health improvements, pain containment/management, etc.); (4) (avoidance/occurrence of clinical) adverse events; (5) patients’. For a real-time operational approach, improvements in COC and QOC require measurable components to be acted upon, for example, by (reducing) rates of unplanned hospital readmissions related to targeted outcomes, e.g., unplanned hospital readmissions. Attempts to alter these components subsequently take place through interventions taken on certain relevant system state variables. This paper, which is an extension of work that originally appeared in reference [7], takes

Objectives

Discussion

Conclusion