The Application of Model-Based Systems Engineering to Rural Healthcare System Disaster Planning: A Scoping Review

Abstract

Disasters and other emergency events have complex effects on human systems, particularly if the events are severe or prolonged. When these types of events happen in rural communities, the resources of the local public health, healthcare, and emergency response organizations can be quickly depleted or overwhelmed. Planning for emergencies can help to mitigate their impact. Model-based systems engineering (MBSE) methods, including computer simulations, can provide insight on how best to prepare for these events and to explore the effects of varying approaches and resource utilization. To best apply these methods for improving disaster management in rural settings, a synthesis of the current body of evidence in this field is needed. The objective of this scoping review was to provide a descriptive overview of the application of computer simulation based on MBSE approaches to disaster preparedness and response for rural healthcare systems. Six studies met inclusion criteria, and varied in terms of MBSE method used, healthcare setting, and disaster type and context considered. We identified a gap in the research regarding the application of MBSE approaches to support rural healthcare disaster preparedness planning efforts. Model-based systems engineering and systems thinking, therefore, represent novel methods for developing tools and computational simulations that could assist rural communities better prepare for disasters.

Keywords

Computer simulation / Disaster preparedness / Model-based systems engineering / Rural healthcare / Systems thinking

References

[1] Allen, M., A. Bhanji, J. Willemsen, S. Dudfield, S. Logan, and T. Monks. 2020. A simulation modelling toolkit for organising outpatient dialysis services during the COVID-19 pandemic. PLOS One 15(8): Article e0237628.

[2] American Hospital Association Rural hospital closures threaten access: Solutions to preserve care in local communities, 2022, Chicago, IL: American Hospital Association

[3] Arboleda CA, Abraham DM, Lubitz R. Simulation as a tool to assess the vulnerability of the operation of a health care facility. Journal of Performance of Constructed Facilities, 2007, 21(4): 302-312

[4] Arksey H, O’Malley L. Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 2005, 8(1): 19-32

[5] Benkacem, A., O. Kamach, S. Chafik, and Y. Frichi. 2022. Supervised machine learning to allocate emergency department resources in disaster situations. Paper presented at the 2022 14th International Colloquium of Logistics and Supply Chain Management (LOGISTIQUA), 25–27 May 2022, El Jadida, Morocco.

[6] Carmichael T, Hadžikadić M. Carmichael T, Collins AJ, Hadžikadić M. The fundamentals of complex systems. Complex adaptive systems: Views from the physical, natural, and social sciences, 2019, Switzerland: Springer 1-16.

[7] Ceferino, L., J. Mitrani-Reiser, A. Kiremidjian, G. Deierlein, and C. Bambarén. 2020. Effective plans for hospital system response to earthquake emergencies. Nature Communications 11(1): Article 4325.

[8] Chaffee MW, McNeill MM. A model of nursing as a complex adaptive system. Nursing Outlook, 2007, 55(5): 232-241

[9] Chatterjee P, Lin Y, Venkataramani AS. Changes in economic outcomes before and after rural hospital closures in the United States: A difference-in-differences study. Health Services Research, 2022, 57(5): 1020-1028

[10] Chovatiya, M., A. Dhameliya, J. Deokar, J. Gonsalves, and A. Mathur. 2019. Prediction of dengue using recurrent neural network. Paper presented at the 2019 3rd International Conference on Trends in Electronics and Informatics (ICOEI), 23–25 April 2019, Tirunelveli, India.

[11] Cliff, B. 2007. A study of disaster preparedness of rural hospitals in the United States. Ph.D. dissertation. Department of Interdisciplinary Health Studies, Western Michigan University, Kalamazoo, MI, USA.

[12] Coetzee C, Van Niekerk D, Raju E. Disaster resilience and complex adaptive systems theory. Disaster Prevention and Management, 2016, 25(2): 196-211

[13] Edwards JC, Kang J, Silenas R. Promoting regional disaster preparedness among rural hospitals. Journal of Rural Health, 2008, 24(3): 321-325

[14] Gul M, Guneri AF, Gunal MM. Emergency department network under disaster conditions: The case of possible major Istanbul earthquake. Journal of the Operational Research Society, 2020, 71(5): 733-747

[15] Haghpanah, F., K. Ghobadi, and B.W. Schafer. 2021. Multi-hazard hospital evacuation planning during disease outbreaks using agent-based modeling. International Journal of Disaster Risk Reduction 66: Article 102632.

[16] Hassan, E.M., and H. Mahmoud. 2020. An integrated socio-technical approach for post-earthquake recovery of interdependent healthcare system. Reliability Engineering & System Safety 201: Article 106953.

[17] Hassan, E.M., and H.N. Mahmoud. 2021. Orchestrating performance of healthcare networks subjected to the compound events of natural disasters and pandemic. Nature Communications 12(1): Article 1338.

[18] Heady HR. A delicate balance: The economics of rural health care delivery. Journal of the American Medical Association, 2002, 287(1): 110-110

[19] Hoard M, Homer J, Manley W, Furbee P, Haque A, Helmkamp J. Systems modeling in support of evidence-based disaster planning for rural areas. International Journal of Hygiene and Environmental Health, 2005, 208(1): 117-125

[20] Homer JB, Hirsch GB. System dynamics modeling for public health: Background and opportunities. American Journal of Public Health, 2006, 96(3): 452-458

[21] HoseinDoost S, Adamzadeh T, Zamani B, Fatemi A. A model-driven framework for developing multi-agent systems in emergency response environments. Software & Systems Modeling, 2019, 18(3): 1985-2012

[22] Hyde J, Kim B, Martinez LS, Clark M, Hacker K. Better prepared but spread too thin: The impact of emergency preparedness funding on local public health. Disaster Management & Response, 2006, 4(4): 106-113

[23] Jackman AM, Beruvides MG. Nembhard HB, Cudney EA, Coperich KM. The emergence of industrial and systems engineering principles and practices in disaster management. Emerging frontiers in industrial and systems engineering, 2019, Boca Raton, FL: CRC Press 189-204

[24] Jacques CC, McIntosh J, Giovinazzi S, Kirsch TD, Wilson T, Mitrani-Reiser J. Resilience of the Canterbury hospital system to the 2011 Christchurch Earthquake. Earthquake Spectra, 2014, 30(1): 533-554

[25] Kapucu, N., and F.I. Rivera. 2020. Rural resilience: Disaster preparedness for communities off the beaten path. Geneva: United Nations Office for Disaster Risk Reduction. https://www.preventionweb.net/news/rural-resilience-disaster-preparedness-communities-beaten-path. Accessed 11 Mar 2023.

[26] Kapucu N, Augustin M-E, Garayev V. Interstate partnerships in emergency management: Emergency management assistance compact in response to catastrophic disasters. Public Administration Review, 2009, 69(2): 297-313

[27] Kasturi, S.N., J. Park, D. Wild, B. Khan, D.A. Haggstrom, and S. Grannis. 2021. Predicting COVID-19-Related health care resource utilization across a statewide patient population: Model development study. Journal of Medical Internet Research 23(11): Article e31337.

[28] Manley WG, Furbee PM, Coben JH, Smyth SK, Summers DE, Althouse RC, Kimble RL, Kocsis AT, Helmkamp JC. Realities of disaster preparedness in rural hospitals. Disaster Management & Response, 2006, 4(3): 80-87

[29] Mason DJ. Rethinking rural hospitals. Journal of the American Medical Association, 2017, 318(2): 114-115

[30] Moher, D., L. Shamseer, M. Clarke, D. Ghersi, A. Liberati, M. Petticrew, P. Shekelle, L.A. Stewart, and P.-P. Group. 2015. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Reviews 4: Article 1.

[31] Moore, T.W., P.D. Finley, J.M. Linebarger, W.E. Beyeler, V.J. Davey, and R.J. Glass. 2011. Public health care as a complex adaptive system of systems. Paper presented at the Eigth International Conference on Complex Systems, 26 June–1 July 2011, Quncy, MA, USA.

[32] Mostafavi A, Ganapati NE. Toward convergence disaster research: Building integrative theories using simulation. Risk Analysis, 2019, 14(7): 1078-1086

[33] Patvivatsiri, L., E.J. Montes, and X. Ouyang. 2007. Modeling bioterrorism preparedness with simulation in rural healthcare system. Paper presented at the 2007 Winter Simulation Conference, 9–12 December 2007, Washington, DC, USA.

[34] Possik J, Asgary A, Solis AO, Zacharewicz G, Shafiee MA, Najafabadi MM, Nadri N, Guimaraes A An agent-based modeling and virtual reality application using distributed simulation: Case of a COVID-19 intensive care unit. IEEE Transactions on Engineering Management, 2022

[35] Preiser, R., R. Biggs, A. De Vos, and C. Folke. 2018. Social-ecological systems as complex adaptive systems: Organizing principles for advancing research methods and approaches. Ecology and Society 23(4): Article 46.

[36] Ramos, A.L., J.V. Ferreira, and J. Barceló. 2012. Model-based systems engineering: An emerging approach for modern systems. IEEE Transactions on Systems, Man, and Cybernetics, Part C (Applications and Reviews) 42(1): 101–111.

[37] Rogan, E., and J. Lewis. 2020. Rural health care: Big challenges require big solutions. https://www.aha.org/news/insights-and-analysis/2020-01-28-rural-health-care-big-challenges-require-big-solutions. Accessed 8 May 2023.

[38] Rural Health Informaton Hub. 2022. Rural healthcare payment and reimbursement. Grand Forks, ND: Rural Health Information Hub. https://www.ruralhealthinfo.org/topics/healthcare-payment. Accessed 11 Mar 2023.

[39] Sablik, T. 2022. The rural nursing shortage. https://www.richmondfed.org/publications/research/econ_focus/2022/q1_feature_1. Accessed 6 May 2023.

[40] Savitsky LM, Albright CM. Preventing COVID-19 transmission on labor and delivery: A decision analysis. American Journal of Perinatology, 2020, 37(10): 1031-1037

[41] Schlidt, E., and C. Wilkinson. 2021. Medicare reimbursement in rural America. In National Rural Health Association policy brief. Washington, DC: National Rural Health Association.

[42] Simonovic SP. Systems approach to management of disasters: Methods and applications, 2010, Hoboken, NJ: Wiley

[43] Skryabina, E.A., N. Betts, G. Reedy, P. Riley, and R. Amlôt. 2020. The role of emergency preparedness exercises in the response to a mass casualty terrorist incident: A mixed methods study. International Journal of Disaster Risk Reduction 46: Article 101503.

[44] Smith SW, Portelli I, Narzisi G, Nelson LS, Menges F, Rekow ED, Mincer JS, Mishra B, Goldfrank LR. A novel approach to multihazard modeling and simulation. Disaster Medicine and Public Health Preparedness, 2009, 3(2): 75-87

[45] Soyler, A., and S. Sala-Diakanda. 2010. A model-based systems engineering approach to capturing disaster management systems. Paper presented at the 2010 IEEE International Systems Conference, 5–8 April 2010, San Diego, CA, USA.

[46] Swain N. Enhancing the disaster resilience for rural communities through better disaster preparedness and improved emergency response, 2012, Washington, DC: National Institute of Food and Agriculture, U.S. Department of Agriculture

[47] TariVerdi M, Miller-Hooks E, Kirsch T, Levin S. A resource-constrained, multi-unit hospital model for operational strategies evaluation under routine and surge demand scenarios. IISE Transactions on Healthcare Systems Engineering, 2019, 9(2): 103-119

[48] Toerper MF, Kelen GD, Sauer LM, Bayram JD, Catlett C, Levin S. Hospital surge capacity: A web-based simulation tool for emergency planners. Disaster Medicine and Public Health Preparedness, 2018, 12(4): 513-522

[49] Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, Moher D, Peters MDJ PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Annals of Internal Medicine, 2018, 169(7): 467-473

[50] Trucco P, Nocetti C, Sannicandro R, Carlucci M, Weinstein ES, Faccincani R. Assessing hospital adaptive resource allocation strategies in responding to mass casualty incidents. Disaster Medicine and Public Health Preparedness, 2022, 16(3): 1105-1115

[51] van Dis J. Where we live: Health care in rural vs urban America. Journal of the American Medical Association, 2002, 287(1): 108-108

[52] Yaylali E, Ivy JS, Taheri J. Systems engineering methods for enhancing the value stream in public health preparedness: The role of Markov models, simulation, and optimization. Public Health Reports, 2014, 129(Suppl 4): 145-153

[53] Zehrouni, A., V. Augusto, T. Garaix, R. Phan, and X. Xie. 2017. Health care emergency plan modeling and simulation in case of major flood. In Proceedings of the 2017 Winter Simulation Conference, 3–6 December 2017, Las Vegas, NV, USA.