A Dynamic Model for a Cyber-Physical Healthcare Delivery System with Human Agents

The traditional monolithic hospital focused health-care system organically developed to address acute conditions. In recent years, healthcare needs have shifted from treating acute conditions to meeting an unprecedented chronic disease burden. Chronic disease healthcare is based on continued delivery outside healthcare facilities, deep understanding of individual health state, managing individualized health needs and coordination between many medical specialities. Classic healthcare dynamic models based on production systems and applicable to acute healthcare inadequately address chronic disease. A new dynamic model paradigm is needed to capture the dynamics of providing healthcare for individuals with chronic disease based on clinical need rather than patient throughput. This paper develops a healthcare dynamic model for personalized healthcare delivery and managed individual health outcomes. It utilizes a hetero-functional graph theory rooted in Axiomatic Design for Large Flexible Engineering Systems and Petri nets. The dynamics of the model builds upon a recently developed systems architecture for healthcare delivery which bears several analogies to the architecture of mass-customized production systems. At its essence, the model consists of two synchronized Petri nets; one for the healthcare delivery system and another for individuals' health state evolution. Such a model allows for the transparent description of health outcomes and links them to the evolution of the healthcare delivery system and its associated costs.