|February 3, 2018:
CHEPS students Anna Learis, Riley McKeown, and Justin Rogers attended the Great Lakes IISE Regional Conference at the Ohio State University from February 2nd to February 3rd, 2018. The conference gave attendees the chance to network with and listen to speakers from industries, take plant tours to learn about processes and potential employers and start forming their own professional networks with other up-and-coming students.
The group won one of the competition awards for an assembly line competition. They were also awarded best dressed at the conference.
Anna Learis said, “What I enjoyed about the conference was the opportunity to network with other IOE students from different schools in the region, such as Wayne State and OSU. Additionally, there were speakers from many industry sectors and learning about their different career paths and histories was a very engaging opportunity.”
||February 2, 2018:
Center for Healthcare Engineering and Patient Safety (CHEPS) Associate Director Amy Cohn traveled to the University of Wisconsin – Madison to give a lecture on CHEPS and the research taking place at the University of Michigan at the intersection of healthcare and engineering on February 2, 2018. She was hosted by Gabriel Zayas-Caban, formerly a post-doctorate research fellow at CHEPS and now an assistant professor of Industrial and Systems Engineering at the UW – Madison. He works with the Wisconsin Institute for Healthcare Systems Engineering (WIHSE), an institute similar to CHEPS.
In addition to delivering a talk, Professor Cohn was able to meet up with graduate students in the WIHSE program. She also met with Maicen Stuart, a student interested in pursuing graduate studies at the University of Michigan, as well as two University of Michigan alums, Jinshan Li and Shiyu Zhou, both of whom are now on the faculty at UW – Madison. The visit was a valuable opportunity to compare notes about CHEPS and similar programs happing at the UW – Madison, where a lot of work integrating healthcare and systems engineering is taking place, just as it is here at The University of Michigan.
WIHSE is hosting the 2018 WIHSE Conference, a day-long event bringing together practitioners and researchers in healthcare and engineering to conduct research, create new knowledge, and design better systems in healthcare, on May 2, 2018. If Professor Cohn is able to attend, she looks forward to spending time in Madison when there isn’t a -10 degree windchill.
|January 15, 2018:
Donald Richardson and Bassel Salka were honored at the North Campus Deans’ MLK Spirit Awards Ceremony & Reception on Monday, January 15, 2018. The Martin Luther King Spirit Awards are given to students, student organizations, and faculty members at the University of Michigan North Campus who exemplify the leadership and vision of Dr. King through their commitment to social justice, diversity, and inclusion.
Donald has supervised several undergraduate and master’s students conducting research at the Center for Healthcare Engineering and Patient Safety (CHEPS). He’s served as a mentor to students in both CHEPS and The Department of Industrial and Operations Engineering (IOE). He serves as a graduate student coordinator in IOE and also assists with the IOE Diversity Initiative which strives to both recruit and retain underrepresented groups in the department.
Recently, Donald organized and led an on-campus event for eighty 10th and 11th-grade students from the Ypsilanti and Detroit area. The students took part in multiple on-campus lab tours and participated in various STEM-focused actives. During the summer of 2016, he worked as a graduate student assistant with the Summer Research Opportunity Program (SROP) where he oversaw multiple program activities as well as mentored over 40 underrepresented undergraduate students throughout their summer research experience while continuing his own research.
“I really wasn’t expecting any recognition for mentoring both high school and undergraduate students or my various leadership roles at UM. To me this is just one of my passions to do whatever I can to make sure other students interested in STEM, especially underrepresented minorities, can be afforded similar opportunities as myself,” said Donald. “One quote/proverb I always think about when it comes to service is ‘To whom much is given much is required.’”
Bassel often serves as a resource for new CHEPS students. Fellow CHEPS student Anna Learis said, “During project meetings, he would ensure that everyone had a chance to input their ideas and oftentimes made a point to introduce new members to the rest of the staff. I noticed that whenever a prospective new IOE student approached our supervisor Amy Cohn, she would habitually put them in touch with Bassel so that he could answer their questions and show off our work.”
Bassel is the co-founder of UMICH MLC, the first Lean consulting group on campus. He’s also part of PhiDE, the only pre-medical fraternity on campus, and works as an Orgs Study Group Facilitator for Science Learning Center. During his Freshman and Sophomore year, Bassel twice raised over $1,500 and participated in Alternative Spring Break trips to Camp For All in Burton Texas, a camp dedicated to providing assistance to children with physical and mental disabilities. He organized and lead the trip, choosing applicants from the Muslim Student Association (MSA). In addition, as Social Chair of the University’s MSA, he has continuously worked to build a sense of community on campus.
Bassel is also the president of the Arab Student Association and, in his two years as leader, has taken the annual cultural show from 400 guests to over 1300. In addition, he started the Middle Eastern and North African Consortium (MENA Consortium), a group of students that are leaders in their respective MENA organizations who meet regularly to assist one another and build community. One of the projects they are working on is establishing a Middle Eastern/North African box on all University applications so that more students can have representation in the University.
“It feels great being recognized for work on campus that I am so passionate about,” said Bassel of his MLK Spirit Award.
Congratulations to both Bassel and Donald for the much-deserved recognition!
||January 12, 2018:
On Friday, January 12, 2018, CHEPS welcomed students, returning and new, to campus in a cozy meeting that marked the official kickoff of CHEPS activities in Winter 2018. Amy Cohn, associate director of CHEPS, extended her warmest welcome to the growing family of CHEPS students. She discussed important policies, procedures, and expectations of CHEPS and CHEPSters. She, also, introduced Julia Warner who joined the CHEPS family in December 2018 as a project manager. Ms. Warner will be working along with students to ensure that their research is well managed.
Jim Bagian, CHEPS director, on his part too welcomed all the excited students, reminding them of the CHEPS spirit and giving them some advice on professional conduct.
And, as usual, this semester CHEPS students come from very diverse academic backgrounds, covering almost all the different majors offered at U of M in engineering, computer sciences, and medicine. Students who have experienced working at CHEPS before return because of the unparalleled opportunities. We are incredibly proud of our growing family.
After the meeting, CHEPSters enjoyed a delicious dinner arranged by the CHEPS administrative assistant, Gene Kim. They enjoyed, too, some traditional sweets from Kuwait that Hanan Al-Awadhi, an IOE graduate student and a returning CHEPS student, brought in. Everything was in place for socializing, mingling with new friends and catching up with old ones. It was the perfect setting to play trivia together.
Now, with a successful kickoff, CHEPSters are ready to write a new chapter including research breakthroughs, interdisciplinary collaboration, and friendship while improving the safety and quality of healthcare delivery! Welcome, 2018!
|January 9, 2018:
CHEPS Director Dr. James Bagian, along with Douglas Paull, a VA surgeon and co-director of VA’s Ann Arbor-based National Center for Patient Safety (NCPS), wrote an invited editorial titled “Handovers During Anesthesia Care: Patient Safety Risk or Opportunity for Improvement?” which is published in the January 9, 2018 issue of The Journal of the American Medical Association (JAMA) as a response to a study published in the same issue by Jones et al.
Jones et al describe how complete handovers among anesthesiologists were associated with significantly poorer patient outcomes and conclude that complete handovers should be minimized.
Instead of minimizing complete handovers and viewing handovers as a vulnerability, Bagian and Paull recommend in their editorial to address underlying root causes – especially the use of explicit communication techniques and tools, in order to turn handoffs from a potential patient safety risk into an opportunity for improvement.
||January 5, 2018:
On Friday, January 5th, CHEPS hosted two alums, Joanna (Fleming) Blackmer and Jason Card, now working at the Johns Hopkins University Applied Physics Lab (JHU/APL). The two shared a presentation and held a discussion during a lunch and learn event. “One of my favorite things about CHEPS is our alums’ willingness to come back and mentor current students,” said CHEPS Associate Director Amy Cohn.
Joanna worked as a graduate research assistant for CHEPS and earned an MSE and BSE in Industrial & Operations Engineering from the University of Michigan. Since graduating in 2014, she has contributed to multiple projects in the National Health Mission Area as a health systems engineer at the Johns Hopkins University Applied Physics Lab. She has supported the Patient Centered Medical Home, Value Based Care, Trauma Center Verification and Designation, Dental Enterprise Patient Safety and developed the Medical Home Port Management Tool (acuity-based forecasting tool).
Jason Card is a CHEPS alum with MSE and BSE degrees in Industrial & Operations Engineering from the University of Michigan. Since graduating in 2013, he has supported health systems optimization projects through performance improvement techniques, database design, population health analysis, simulation modeling, and change management. He is part of the Health Systems Engineering Group at APL with experience supporting a variety of clinical and ancillary services.
Joanna and Jason weren’t the only alums at the event. Eli Sherman was in attendance and said, “As a CHEPS and UM alum is was great to come back to visit and see that CHEPS is doing better than ever, continuing to lead the way in innovation in healthcare through its own work and by educating those that will drive change in the years to come.”
Jason and Joanna provided an overview of APL and its history as an advisor to the U.S. Government. They discussed APL’s Research and Exploratory Development Department, which oversees the health initiatives, and talked about life as an APL health systems engineer and analyst. They presented a high-level overview of current and past projects.
Donald Richardson, a CHEPSter and IOE PhD student in attendance, enjoyed learning more about the history of APL. “I didn’t realize (1) JHU/APL was initially started to help support the military in WWII by finding a way to better protect ships from air attacks. (2) Ever since they have been contracted with the government as a support lab and not focused on selling their services/products like a consulting firm. This complements the healthcare application projects very well by avoiding being salesmen and just focusing on helping the patients/medical professionals,” he said.
IOE undergraduate student, Riley McKeown, appreciated learning more about Joanna and Jason’s day to day work. He said, “It was great to learn from Jason and Joanna about projects they are working on to improve communication between multiple doctors treating the same patients, as well as the challenges they have faced during the implementation process.”
“I thought the Lunch and Learn was great,” said Michael Kalmus, also an IOE undergraduate. “I enjoyed learning more about the broad scope of the APL, value-based care and the interesting projects Joanna and Jason are currently working on. I also enjoyed hearing their insights on challenges in healthcare and how they are using analytics and systems engineering to solve them (i.e. creating a dashboard that allows different providers to access a patient’s medical records easily).”
Thank you to Joanna and Jason for returning to CHEPS and offering such an interesting lunch and learn presentation!
|December 11, 2017:
Our final talk of the Fall 2017 Providing Better Healthcare through Systems Engineering seminar series featured Dr. Sung Won Choi from the University of Michigan Medical School presenting a talk titled “Multi-dimensional, Highly Time-resolved Big Data Approach for Disease Prediction.”
Dr. Sung Won Choi is an Associate Professor of Pediatrics and Communicable Diseases at the U of M Medical School and, in 2017, she was named the inaugural Edith S. Briskin / Shirley K Schlafer Research Professor of Pediatrics. She has a research interest in translational medicine, more specifically in the field of blood and marrow transplantation (BMT). She is recognized for her work in translating the use of histone deacetylase inhibition in BMT patients for prevention of a devastating complication known as graft-versus-host disease (GVHD).
In her presentation, Dr. Choi spoke about one of the major unmet challenges in today’s care, individualized prediction of disease and disease-related events. In traditional care settings, disease-identification is symptom-based and unidimensional. For many patients with no evident symptoms or symptoms that are common across many diseases, this means a late onset of treatment. Patients with GVHD, a complication following the receipt of donor tissues (blood and marrow transplants) from a genetically different person, for example, suffer most from the late diagnosis. GVHD patients exhibit similar symptoms to other diseases such as skin rash, shortness of breath, weight loss and general fatigue, yet due to a unique condition. In GVHD, the donor immune cells attack the host body’s cells, including lungs, liver, and skin cells. Disease identification is only possible with the use of biomarkers.
So, in order to offer more patient-centered, more personalized care for blood and marrow transplantation patients, Dr. Choi in a joint effort with collaborators from machine learning (Dr. Wiens), medical oncology (Dr. Tewari), computational biology (Dr. Li) and mechanical engineering (Dr. Kurabayashi) at the U of M is using complex computational methods to collect multi-parameter, highly time-resolved data that would enable her and her team to make accurate short-term disease predictions, and then to start the medical intervention as early as possible (pre-symptoms state).That would make, she said, the intervention more effective, more personalized, and more patient-centered!
Now, as we adjourn this season, we wish you and your dear ones a very happy and a warm holiday. We will be looking forward to seeing you again for next year’s Providing Better Healthcare through Systems Engineering seminar series. Happy Holidays!
||December 4, 2017:
This December, the Providing Better Healthcare through Systems Engineering seminar series started off the month with a talk on “Block Scheduling for Medical Residents” featuring Dr. Amy Cohn, Dr. Garth Strohbehn, & Mr. William Pozehl.
Dr. Cohn is a professor of Industrial & Operations Engineering at the University of Michigan and the Associate Director for the Center for Healthcare Engineering and Patient Safety (CHEPS). Her primary research interest is in robust and integrated planning for large-scale systems, predominantly in healthcare and aviation applications.
Dr. Strohbehn is a general internist and chief medical resident at the U of M Health System. He has been a member of the Internal Medicine Residency Program since 2014 and, along with three colleagues, chief resident since June 2017, where his major shared responsibilities include scheduling, training, mentoring and advocating for resident well-being. His primary research interest is in medical education, more particularly in educational systems redesign, novel educational methods (visual arts and mindfulness), and clinical research education.
Mr. Pozehl is a researcher at CHEPS. His work focuses on enhancing care delivery through building models to schedule care providers with the goals of improving schedule quality and reducing the burden of constructing these schedules.
In a joint talk, the speakers explained how scheduling medical residents to appropriate medical shifts remains a challenge to many academic health centers, including Michigan Medicine. These schedules must balance between institutional, professional, and educational requirements, in addition to individuals’ preferences (e.g. day-off requests). Many of these schedules are constructed manually, a time-consuming and error-prone process. Furthermore, manually-developed schedules tend to exhibit some degree of bias. Thus, in order to maintain the highest morale and well-being of the residents, and to enhance quality of patient care, the team developed a customized linear programming model that is capable of capturing the competing needs and the ever-evolving requirements of numerous residency programs at U of M, constructing schedules for more than 400 residents and 150 services annually. The automated scheduling significantly reduces time spent to construct a single schedule and improves schedule quality. The lecture concluded with a very thought-provoking discussion on how linear programming models could positively impact clinical practice while developing deep knowledge of complex systems in healthcare.
We look forward to seeing you in our last seminar for this season, Monday December 11, 2017 with a talk on “Multi-dimensional, Highly Time-resolved Big Data Approach for Disease Prediction” by Dr. Sung Won Choi from the University of Michigan Department of Pediatrics.
|November 27, 2017:
On November 27, 2017, Dr. Sachin Kheterpal spoke as part of the Providing Better Healthcare through Systems Engineering seminar. Dr. Kheterpal is an Associate Professor of Anesthesiology and Associate Dean for Research Information Technology at the University of Michigan Medical School. His career has been focused on the novel use of IT and electronic health records for patient care, quality improvement, and research. He is recognized as a national leader in perioperative large dataset clinical research and has published numerous articles, editorials and book chapters regarding intraoperative management and long-term postoperative outcomes. Using innovative techniques to integrate administrative, EHR and registry data across institutions, he leads the Multicenter Perioperative Outcomes Group, a research and quality improvement consortium of more than 40 anesthesiology and surgical departments.
In his presentation, titled “From Big Data to Small Decisions: Fulfilling the Potential of Precision Health,” Dr. Kheterpal discussed the new precision health initiative that the University of Michigan launched. It’s an initiative that spans all the schools and colleges of the U of M campus and brings together different disciplines to advance the prevention, diagnosis, and treatment of disease. This initiative works to support the university’s mission and commitment to research, education, and service. He then spoke about the five work streams: Research, Cohort development, Data & Analytics/IT, Health Implementations, and Education & Training. He next spoke about how the initiative is still in its infancy and has planned over the next several years for growth.
The work that Dr. Kheterpal and those involved with the initiative will do has amazing implications for the future of healthcare at the University of Michigan
Please join us on Monday, December 4th, 2017 as Dr. Amy Cohn, Billy Pozehl, and Dr. Garth Strohbehn speak on “Block Scheduling for Medical Residents.”
|November 20, 2017:
On November 20, 2017, the Providing Better Healthcare through Systems Engineering seminar had the pleasure to welcome Dr. Geoff Barnes to come talk to us about Health Systems Engineering and Implementation Science: Using the Best of Both Worlds to Standardize Periprocedural Anticoagulation.
Geoffrey Barnes, MD, MSc, is a cardiologist and vascular medicine specialist at the University of Michigan. He completed his undergraduate degree in Biomedical Engineering at Washington University in St. Louis, followed by medical school, residency and fellowship training at the University of Michigan. He has been on faculty at the University of Michigan since 2014. He co-directs the Michigan Anticoagulation Quality Improvement Initiative (MAQI2), a collaborative of six health center anticoagulation clinics aimed at improving care for patients across the state of Michigan. Informed by his undergraduate engineering degree, he strives to use logical models to understand and improve healthcare delivery systems. His current research is focused on improving the delivery of anticoagulation care for patients undergoing surgical procedures.
In his presentation, Dr. Barnes introduces challenges in regard to the use of blood thinners for different health conditions. Blood thinners are used because a patient has a higher risk of blood clots in the heat or arteries. As blood clots, it can lead to heart attacks or even a stroke. However, there are challenges when it comes to using blood thinners. As blood thins, blood clots less which poses difficulty when it comes to possible surgeries while on blood thinners. For patients who are on blood thinners and need surgery, doctors advise patients to stop taking blood thinners a few days before because the effect of the drug does not start and stop immediately. Doctors have introduced medicine to bridge the gap between taking blood thinners to surgeries and back to taking blood thinners. However, the authors think that the new medicine will instead create an urgent need for an expansion as well as an evolvement of those traditional clinics, as there are three major purposes the new clinic could serve.
Join us next week for a talk on “From Big Data to Small Decisions: Fulfilling the Potential of Precision Health” by Sachin Kheterpal, MD, MBA.
|November 13, 2017:
On November 13, 2017, the Providing Better Healthcare through Systems Engineering seminar featured Center for Healthcare Engineering and Patient Safety Director, James Bagian. In addition to his position as Director here at CHEPS, Dr. Bagian is a Professor in the Department of Anesthesiology in the Medical School and in the Department of Industrial and Operations Engineering in the College of Engineering at the University of Michigan. Previously, he served as the first Director of the VA National Center for Patient Safety (NCPS) and the first Chief Patient Safety Officer for the Department of Veterans Affairs from 1999 to 2010 where he developed numerous patient safety related tools and programs that have been adopted nationally and internationally. Presently, he is applying systems engineering approaches to the analysis of medical adverse events and the development and implementation of systems-based corrective actions that will enhance patient safety primarily through preventive means.
In his presentation on “Patient Safety: Challenges and Ways to Overcome Them,” Dr. Bagian discussed how patient safety has become a commonly recognized challenge among not only care providers but also among patients throughout the world. Its rise to prominence was spurred by the Institute of Medicine’s (now called the National Academy of Medicine) landmark report titled ‘To Err Is Human.’ While initially, there was a good deal of denial in the medical profession that the level and frequency of harm to patients was not as high as the report contended, 44,000 to 98,000 annually, there was general agreement that the number by any accounting was too high. More recently, there have been reports that put the annual number of deaths as high as 250,000 making it the 3rd leading cause of death in the USA. This increase in the reported number of patients harmed may be more a result of the methods used in the counting process rather than an increase in the risk of harm due to care but reinforces the reality that the risk is still one that can benefit from corrective action.
Dr. Bagian discussed some of the barriers to improvement. Obstacles to improvement range from a failure to acknowledge that the problem exists, to who is responsible, to an over-simplistic and superficial perspective that seldom goes past the determination of proximate cause and implementation of siloed symptom-based corrective actions. The failure to routinely take a systems-based approach to the identification of vulnerabilities that place the patient at risk and failure to formulate and implement corrective actions that address these foundational vulnerabilities are the principal challenges that the patients and healthcare faces today. Dr. Bagian ended his seminar with a discussion of potential approaches to overcome the barriers to improvement.
Please join us on Monday, November 20th, 2017 to hear Dr. Geoffrey Barnes discuss “Health Systems Engineering and Implementation Science: Using the Best of Both Worlds to Standardize Periprocedural Anticoagulation.”
||November 6, 2017:
On Monday November 6th, 2017 over 120 guests gathered for the annual Healthcare Engineering and Patient Safety Symposium. Posters were on display representing a variety of research and projects from inside and outside of the university. Attendees came from throughout the university, representing Engineering, the School of Public Health, the Health System, the Medical School, the School of Nursing, and the Institute for Healthcare Policy and Innovation. Several, like returning alumni and local corporate representatives, also attended from outside the university. Attendees mingled throughout the poster rooms, learning about the research students and faculty are doing, and connecting with new and old friends.
This year’s poster winner was “A Dynamic Approach to Improve Chemotherapy Pre-mix Policies” presented by Donald Richardson, Hwon Tak, Matthew See, and Amy Cohn. Lauren Steimle also took home some treats after winning the raffle for tweeting about the symposium!
For the second time this year, alumni didn’t just attend the symposium and the traditional reunion dinner held the Friday before, several also took the time to hold a panel discussion for current CHEPS students. The panel focused on allowing participants to share their experiences in the healthcare field and answer questions about the industry.
One of the best parts of the symposium is seeing how big the CHEPS community has grown over the past year, and this year we had quite an impressive crowd. The energy and passion for collaboration and healthcare improvement was evident throughout the night. Thank you to everyone who joined us!
|October 30, 2017:
On October 30, 2017, Dr. David Burke presented a seminar titled, “‘Deep Monitoring’ Chronic Disease in Underserved and Remote Populations” as part of the Providing Better Healthcare through Systems Engineering seminar series. His seminar reviewed initiatives led by University of Michigan faculty and external partners to address the growing challenge of chronic disease throughout the world, an issue exacerbated by a global healthcare workforce shortage.
Dr. Burke discussed how his team is co-opting technologies to aid in monitoring and patient education of chronic disease, especially in underserved populations. His team uses parallel technology strategies that rely on high-volume manufacturing of digital electronics and standardized transportation. Dr. Burke provided examples of applications, including coopting digital cameras and a video game system to use in remote health monitoring, as well as a renovated shipping container that can be used as a setting for providing vision or dental exams. His team’s impressive work is already making a difference in several areas including Jamaica; a short video about the team’s innovative eye clinic can be found here: https://www.youtube.com/watch?v=_qfhuoYZoIY.
The work of Dr. Burke and his colleagues is providing great value to the University of Michigan, as well as external communities, through their impact on service, education, and research.
Please note: There will be no seminar on Monday November 6. In its place, please join us from 5-7:30PM in the 3rd and 4th floors of the Robert H. Lurie Engineering Center for the 2017 Healthcare Engineering & Patient Safety Symposium, RSVP here!
||October 25, 2017:
The Center for Healthcare Engineering and Patient Safety (CHEPS) made a strong appearance at the Institute for Operations Research and the Management Sciences (INFORMS) Conference in Houston, Texas from October 22 – 25, 2017. This conference is one of the largest for those in operations research.
CHEPS brought a dedicated healthcare research presence, with each attendee presenting their research, either orally or by poster. Specifically, the CHEPS presentations at the conference were as follows:
Rachel Moeckel, a second year Master’s student at CHEPS, stated the following of her experience: “I feel so grateful to have been able to attend INFORMS this year! It was exciting to be a part of this event, surrounded by thousands of people who are excited by some of the same things I am. It felt connecting relationally to spend time with those who attended from CHEPS. I also thought my poster presentation went well. I intentionally started conversations with those who would glance at my poster, hoping to make it easier to transition into presenting. Through engaging with people, I received many suggestions, possible connections, related research, and pertinent questions.”
Students gained exposure to companies looking for candidates with industrial engineering education and to a great deal of research that others were doing in this field. They also participated in networking/social events held on Monday evening: “Michigan Nite” and the Women in OR/MS Social.
And in the midst of all this, the group was able to enjoy Houston, exploring the underground tunnel system connecting many of the skyscrapers and visiting Space Center Houston for a tram tour of NASA Johnson Space Center.
|October 9, 2017:
On October 9, 2017, our Providing Better Healthcare through Systems Engineering seminar featured Dr. Lisa Prosser from the Department of Pediatric and Communicable Diseases as well as the Department of Health Management and Policy at the University of Michigan. Dr. Prosser is also the director of the Child Health Evaluation and Research Center (CHEAR). Here, her research focuses on measuring the comparative effectiveness and cost-effectiveness of childhood health interventions using methods of decision sciences and economics.
In her presentation on “Using Decision Modeling to Inform Newborn Screening Policy Decisions for Pompe Disease: A Case Study,” Dr. Prosser introduced the audience to the applications and advantages of using decision analysis in healthcare, specifically determining various newborn screening policies. She highlighted how these models allow for an extension of the time horizon beyond any clinical trials, allow the researcher to simulate both actual and hypothetical scenarios, as well as require that all assumption be explicitly defined and agreed on by experts in the field. Subsequently, these models also result in identifying sources of uncertainty which help prioritize future research.
Next, she introduced her case study on the process for introducing newborn screening for infantile Pompe disease. Any new condition suggested for screening must first be approved by the Advisory Committee on Heritable Disorders in Newborns and Children. While this committee has met since 2004, decision modeling has only been incorporated in the last 5 years to better inform the committee on which conditions to approve for newborn screening. Dr. Prosser stressed the importance of avoiding the use of very complex models due to them being perceived as a “black box” and therefore disregarded by policymakers.
She then presented her decision model for infantile Pompe disease screening and clinical identification. Focusing on a 3-year time horizon, the model projected the key health benefits and harms if the newborns were screened for a particular condition. Considering the predicted 4 million US newborns each year, her model projected that screening methods will identify 134 cases of the Pompe disease and anticipated 13 averted deaths with 26 additional children who will not require invasive ventilation. While life-saving for the onset cases, there is also the consideration of overdiagnosis for a patient who would have never shown symptoms otherwise. Even with no symptoms, these children potentially can be denied by certain life or health insurances due to their pre-existing condition on record. Dr. Prosser uses this point to motivate her future research by expanding the 3-year time horizon to a lifetime model. This will allow her to capture the potential harms of a late onset diagnosis. She also plans to perform a cost-effectiveness analysis which includes both the cost of screening as well as long-term treatment cost.
Following the presentation, Dr. Prosser continued the discussion over Q&A on her decision analysis model as well as challenges posed by the nature of a problem involving federal policymakers, pharmaceutical companies, patients, providers, and insurances companies.
Please come back and join us on Monday, October 30th, 2017 to hear Dr. David Burke discuss his work on “Deep Monitoring Chronic Disease in Underserved and Remote Populations.”
|October 2, 2017:
Our first Providing Better Healthcare through Systems Engineering seminar in the month of October took place on October 2, 2017 and featured Dr. Xi Jessie Yang from the Department of Industrial & Operations Engineering at the University of Michigan. Dr. Yang joined U of M in 2016 as an assistant professor after completing a postdoctoral fellowship at MIT. She earned a PhD (2014) and a MEng (2009) in Human Factors Engineering and a BEng from Electrical and Electronic Engineering (2006), all from Nanyang Technological University, Singapore. Her research interests include human-robot interaction and human factors in healthcare. Please refer to http://icrl.engin.umich.edu/ for more information.
In her presentation on “Robotic Assistance in Coordination of Patient Care,” Dr. Yang introduced three studies that investigated the use of automated, embodied systems in healthcare settings in order to enhance efficiency and reduce cost. The first study evaluated the degree of trust of robotic assistance on bed allocation and personnel the healthcare providers have in comparison to a computer-based program. The study found higher rates of trust in the assistive device recommendation when the device is more sociable (in this case the robot) and when the proposed recommendations are of quality.
The second study, on the other hand, investigated the irrationality in trust assessment. Dr. Yang explained that trust in automated decision support systems is not rational as people are more likely to trust a decision support system if the decision is more difficult for them to make on their own. She added that the study found that the magnitude of trust loss is larger than the magnitude of trust gain.
She strengthened her earlier findings with a final study that investigated trust evolution & stabilization. The study had participants pilot drones and showed them two displays to aid in threat detection: a binary display and a likelihood display. They then used benchmark surveys and questionnaires to quantify the trust levels, which showed that trust evolves over time, eventually stabilizes, and can be modeled as a first-order LTI system.
The lecture concluded with a very thought-provoking discussion as research in healthcare automation continues to pose engaging questions. Of main interest were social behaviorism and technology, ethics, and regulations.
Join us next week for a seminar on “Using Decision Modeling to Inform Newborn Screening Policy Decisions for Pompe Disease: A Case Study” by Lisa Prosser on October 9, 2017.
|September 25, 2017:
The third lecture in the 2017 Providing Better Healthcare through Systems Engineering Seminar Series took place on September 25, 2017 and featured Dr. Grisselle Centeno, an Associate Professor in the Department of Industrial and Management Systems Engineering at the University of South Florida. Her research and teaching interests include optimization-based modeling for the planning and control of operations in healthcare, transportation, and manufacturing industries. She possesses experience in working with large-scale mathematical programming models and building decision support systems. Her research work has been supported by the National Science Foundation (NSF), the Florida Department of Transportation (FDOT), and the Office of Naval Research (ONR), among other sources. Dr. Centeno is also highly involved in conducting research in engineering education and promoting the growth of a diverse engineering workforce. Dr. Centeno’s talk titled “The Bloodmobile Routing Problem” delved into how blood centers must determine on a daily basis a set of locations among a group of potential sites to route bloodmobiles for blood collection so as to avoid shortages for health interventions.
Dr. Centeno began her talk with some general background on blood donations in the US by asking the audience a few questions:
Considering how blood is such a scarce commodity, Dr. Centeno then spoke about the differences between a traditional supply chain and a blood supply chain and noted that the structure is in reverse since platelets, red blood cells, and plasma are all extracted separately. She also noted the potential threat to human life if a shortage were to occur.
Dr. Centeno then when on to discuss the integer programming models used to model the problem in a way to incorporate variable durations in bloodmobile visits, uncertainty in blood potentials and multiple bloodmobile types. She demonstrated how small instances of the problem (up to 30 locations to visit) were solved to optimality using the branch-and-price algorithm, and CPLEX was used to solve larger-scale settings of the problem.
The study showed that as demand increases, a higher number of bloodmobiles must be operated but if there are more donation locations to select from, fewer bloodmobiles are required and the distance traveled to satisfy the blood demand is shorter. It also showed that the total distance traveled is highly dependent on random donation locations.
Please join us on Monday, October 2 to hear Xi Jessie Yang present on “Nurses’ Trust in Robotic Assistance on the Labor Floor.”
|September 20, 2017:
On Wednesday September 20th, after a long day of classes, the old and the new students of the Healthcare Engineering and Patient Safety (HEPS) Masters program came together for a nice dinner at Cardamom, a casual eatery serving up modern & traditional Indian cuisine. While eating delicious curry, students got to know each other a lot better as they conversed and shared stories about their own undergraduate experiences. Some even realized that they shared the same classes together! Needless to say, it was a great time for everyone.
|September 18, 2017:
The second lecture in the 2017 Providing Better Healthcare through Systems Engineering Seminar Series featured Dr. Sharon Johnson, a Professor of Operations and Industrial Engineering in the Foisie School of Business at Worcester Polytechnic Institute (WPI). Dr. Johnson recently served as Faculty Director of the Healthcare Delivery Institute (HDI) at WPI and is currently a member of HDI’s Faculty Steering Committee. She is also currently a visiting professor at the University of Michigan. Dr. Johnson’s talk titled, “Secure Messaging and Patient Portals: Designing Customer-Facing Processes,” explored process impacts and design guidelines for patient-facing, secure messaging (SM) systems.
In her talk, Dr. Johnson discussed two different studies. The first centered on the characteristics of SM use at two Veterans Health Administration (VHA) facilities, while the second dealt with patient portal use at a multi-specialty clinic. Dr. Johnson began her talk by getting audience members to think about the role of patient-facing technologies in healthcare, before presenting them with examples of real messages encountered by clinics and asking them to think about the steps and workflow involved in resolving the issues at hand.
Dr. Johnson then further discussed the purpose of her project in the context of garnering a greater understanding of the types of messages flowing through a secure messaging system as well as the tasks, activities, and resources involved in addressing patient needs through this medium. To this end, Dr. Johnson and her team analyzed a total of 1000 message threads from ten different patient care teams from different parts of the country. Messages were analyzed for content, and team workflow in addressing secure messages was also captured. Site visits were then performed and semi-structured interviews conducted in order to gain a richer understanding of how SM was used within a particular care team and how the technology was perceived among team members. Dr. Johnson and her team then created a process map of how decisions were made when messages were received and identified major workflow patterns around SM use. Future work aims to better understand variation in flow through the system with the ultimate goal of influencing design processes. Future work aims to better understand variation in flow through the system with the ultimate goal of influencing design processes.
The second study Dr. Johnson highlighted concerned patient portal use in a multi-specialty group medical practice. Dr. Johnson and her team collected clickstream data, encounters, and patient surveys for 632 patients over the course of two years, looking for patterns and predictors in portal use and health status. She found portal usage to be proportional to clinical encounters and that patients with poorer health tended to use the portal more. Additionally, perceived ease of use and perceived usefulness of the patient portal were found to have a significant effect on perceived health management.
From this study, Dr. Johnson and her team drew broad conclusions about process design guidelines for the creation of patient portals and other patient-facing technologies.
Please join us on September 25th for a talk titled, “The Bloodmobile Routing Problem,” presented by Dr. Grisselle Centeno.
|September 11, 2017:
The Providing Better Healthcare through Systems Engineering Seminar Series kicked off on Monday, September 11, featuring a talk from Joseph Cicchese titled, “Identifying Optimal Antibiotic Regimens Regimens for Tuberculosis Tuberculosis Treatment.” Joseph is a PhD candidate in Chemical Engineering at the University of Michigan and works with Dr. Jennifer Linderman. The seminar was attended by members from across the University community, including the College of Engineering, Medical School, and School of Public Health.
In his talk, Joseph shared an optimization-driven approach to modeling tuberculosis (TB) antibiotic treatment. He first provided background on TB, including its global impact of 1.8 million deaths per year and review of how TB interacts with granulomas in the body. Joseph also discussed inherent challenges in investigating TB treatment, like insufficient animal models and an extremely wide range of potential therapies for consideration.
When considering how to model TB, Joseph introduced the basic multi-scale model used to understand granuloma formation and function. This multi-scale model links an agent-based model, a receptor trafficking/signaling model, and a soluble molecule diffusion model. Joseph demonstrated this model’s functioning using a simulation to model infection and granuloma development.
Joseph then discussed how he is using an optimization model to incorporate pharmacokinetic and pharmacodynamic elements of antibiotic therapy. The key question of this optimization model is to understand “what is the best antibiotic regimen for TB?” by investigating the regimen design space. Joseph compared a genetic algorithm versus surrogate-assisted optimization to understand each method’s accuracy and efficiency. He presented the results of this optimization model for isoniazid and rifampin, with emphasis on results from surrogate-assisted optimization.
Following the presentation of his work, Joseph entertained several questions from the crowd on drug interactions and modeling methods.
Please join us on September 18 for a talk titled “Secure Messaging and Personal Health Records: Designing Customer-Facing Processes” by Sharon Johnson.
||September 7, 2017:
As the new semester starts, CHEPS is welcoming students, old and new, back to campus. This past Thursday, September 7th, the annual fall kickoff meeting took place at the SI North CHEPS office. As usual, Associate Director Amy Cohn sat down with a full room of excited students to extend the warmest welcome to all of them.
Additionally, we are glad to be hosting Professor Sharon Johnson from Worcester Polytechnic Institute at CHEPS this year. Professor Johnson said hi to all the students and says she is looking forward to working with the team. During the meeting, important policies, processes, and expectations were discussed. For the past several years, CHEPS has continued growing at a healthy pace and standards have been gradually established for more efficient operations of the center.
After the official meeting, the CHEPSters had time to socialize and mingle with new friends and catch up with the old over delicious Mexican food kindly arranged by Gene Kim. CHEPSters had a great time playing board-games as the evening went on. Sharing cheerful laughs and board-game victories, students at CHEPS definitely knew how to get the semester off to a great start!
This semester, CHEPS students come from a diverse academic background again, ranging from Chemical Engineering senior to IOE PhD. Many students have conducted research with CHEPS during the summer and decided to continue their work in the fall because of the unparalleled opportunities and awesome people. Several students were away for summer internships but were glad to re-join the CHEPS family.
Wesley Chen, a new HEPS master student, has been with CHEPS since last summer and was in Jacksonville this summer. “My internship was nice this summer but there is nothing quite like working on a meaningful project with these cool kids,” he said. Bill Zhang, a third- year HEPS master student, was delighted to be back as well after a summer interning at Cleveland Clinic. Bill said, “It was a privilege to work at the #2 hospital in the country and learn so much about healthcare operations. However, coming back to CHEPS is special to me because this is where I feel at home.”
With a great kickoff event in the book, the CHEPS family is definitely ready for another semester of improving the safety and quality of healthcare delivery!
|September 1, 2017:
Congratulations to CHEPS collaborator and Associate Professor in The Department of Industrial and Operations Engineering, Mariel Lavieri, who has been named the IOE Department Richard Wilson Faculty Scholar for a two-year period beginning September 1, 2017. She is an outstanding teacher, researcher, mentor, and colleague. This honor follows several other major awards that Mariel and her students have won in the past 12 months.
|August 1, 2017:
On Tuesday, August 1st, students and faculty gathered to hear from Adam VanDeusen, a new IOE PhD student. Adam walked us through his post undergrad adventures and shared some insights from his multidisciplinary experiences. After completing his bachelors in IOE from the University of Michigan, Adam went on to get his MPH in Chronic Disease Epidemiology from Yale School of Public Health. His research work and professional career took him from Ghana to Washington DC, and then to Minnesota before returning home to Ann Arbor. Throughout the last few years he’s worked on a variety of projects, including cost-effectiveness research, healthcare leadership consulting, and ED operations analyses. Adam described some benefits and challenges of sometimes being the only engineer in a healthcare setting and provided concrete advice to students entering the workforce. Adam brings a range of skills and experiences to the CHEPS team, and we are looking forward to working with him this fall!
||July 28, 2017:
CHEPS Associate Director Amy Cohn as well as several students who collaborate with CHEPS attended the 2017 INFORMS Healthcare Conference in Rotterdam, Netherlands from July 26th to the 28th. The theme of this year’s conference was “optimizing operations and outcomes.”
Amy Cohn chaired a panel and presented a talk titled “Multi-objective Criteria Scheduling in Healthcare.” She said of the panel, “I particularly liked that there were people from all over the world and so we weren’t just focusing on the rules and the customs of the U.S. healthcare system but we could hear how other countries had similar or different problems.” Both her talk and panel generated a lot of good questions and lively discussion. In addition, she enjoyed getting the chance to catch up with colleagues. “I really liked getting to see folks from INFORMS and healthcare that I only see every so often. I got to get caught up with Julie Ivy and Harriet Nembhard,” she said, mentioning that they even had a little time to enjoy exploring the city.
Lauren Steimle, and IOE PhD student who attended presented a talk titled, “Optimizing Medical Treatment Decisions For The Prevention Of Heart Attack And Stroke.” Her session was chaired by IOE PhD student, Selin Merdan, who presented a talk on “Robust Optimization Framework to Account for Prediction Errors for Cancer Diagnosis.”
Lauren said, “I particularly enjoyed Dimitris Bertsimas’ plenary talk ‘Personalized Medicine: A Vision for Research and Education.’ He argued that using models that are interpretable by physicians, even if they do not perform quite as well as more complex models, is worth it if this makes the results more likely to be adopted in practice. Also, before the conference, I attended the Healthcare Operations Research summer school put on by the Center for Healthcare Operations and Improvement Research at the University of Twente. The summer school was a great opportunity to learn more about current methods and meet other students using operations research to solve problems in healthcare.”
Another IOE PhD student in attendance, Emily Tucker, presented a talk titled “Incentivizing Supply Chain Resiliency To Prevent Drug Shortages.” She said of her conference experience, “I spent about 2 weeks in the Netherlands and had a great experience at the Healthcare Operations Research Summer School (hosted by CHOIR) and the INFORMS Healthcare conference. I met folks from all over the world, and based on a group project at the summer school, a group of us (currently PhD students in the Netherlands, Denmark, Germany, Canada, and the US) are planning to start piloting a project to teach herd immunity. It was also great to discuss and present my work – I connected with several researchers interested in drug shortages (my dissertation topic), and I look forward to future conversations with them. And of course, the Netherlands is a beautiful country! It was fun to see windmills, museums, and eat lots of cheese.”
||July 28, 2017:
On Thursday and Friday July 27-28th, students between the 8th and 10th grade were given the opportunity to learn more about different engineering majors at the annual Michigan Discover Engineering event. CHEPS Junior Bassel Salka took the lead in organizing and instructing the IOE session of the program by introducing students to Industrial and Operations Engineering, discussing examples of IOE in the real world, completing the Resident Shift Scheduling Game, and giving a mini lesson on optimization methods. CHEPSters Dale Mallette and Anna Learis also helped out with the event by guiding the students through the Resident Shift Scheduling Game and answering any questions they may have. When asked what the most satisfying part of the event was, Anna replied, “I loved seeing how excited the kids became when they learned about the different aspects of IOE and saw its effect on their daily lives.”
||July 21, 2017:
Karmel Shedah, CHEPS and IOE PhD student, and Billy Pozel, CHEPS Research Area Specialist, traveled to Quebec from July 17 – 21, 2017 for The International Federation of Operational Research Societies (IFORS) Conference.
“This was my first opportunity to attend and present at an international conference,” Billy said. “I am so fortunate that CHEPS affords me the opportunity to travel to experience a different culture and share our work with a global audience.”
IFORS was also Karmel’s first international conference with CHEPS. In addition to enjoying the beauty of Quebec City, she said she was amazed by the quality of the conference, research presentations, and educational sessions.
“A large body of professionals, from academic and industrial backgrounds, attended our research presentation on developing a decision support tool to optimize colonoscopy appointment scheduling (for colorectal cancer screening),” said Karmel. “There was a consensus among the audience that our approach will improve the quality of colonoscopy appointment scheduling and procedure, and is of significant theoretical contribution as well. Additionally, some research groups, who work on closely related problems, shared research experience and discussed opportunities for future collaboration. It was rewarding to have professionals, from different backgrounds, confirming the impact of the work we do at CHEPS in improving the safety and quality of healthcare delivery.”
In addition to the conference, Karmel and Billy had the chance to visit some historical places in Quebec City. Both agree the trip was a wonderful experience.
|July 11, 2017:
Young-Chae Hong successfully defended his PhD thesis, titled “Using Dominance in Solving Complex, Combinatorial Optimization Problems: Applications from Healthcare Provider Scheduling and Vehicle Routing,” on Tuesday, June 11. Young-Chae’s dissertation focused on the study of healthcare provider scheduling with multiple conflicting metrics and a column generation approach to solving vehicle routing problem based on dynamic programming. In his research, he utilized dominance to generate Pareto-dominant solutions for the multi-criteria optimization problem. Also, he analyzed the role of dominance in the column generation approach to solving the vehicle routing problem. He developed the mathematical approach to finding a Pareto point and mathematically proved that the approach can find the complete Pareto Frontier. He demonstrated both the tractability and the practicality of our approach as applied to the University of Michigan Pediatric Emergency Department. Congratulations, Dr. Hong!
|July 11, 2017:
Brian Lemay’s paper titled, “New Methods for Resolving Conflicting Requests with Examples from Medical Residency Scheduling” was awarded the 2017 Murty Prize for being the best research paper on Optimization by an IOE student. The paper proposes an optimization based method that identifies maximally-feasible and minimally-infeasible sets of time-off requests which can then be used by decision makers to select their preferred schedule. Although the paper focuses on a residency scheduling problem, the proposed method is applicable to any problem involving conflicting requests. A version of the paper co-authored by Prof Amy Cohn, Prof Marina Epelman, and Dr. Stephen Gorga was recently accepted for publication in the Production and Operations Management (POM) Journal.
Brian earned his Ph.D. in May after successfully defending his dissertation titled, “Addressing Challenges in Healthcare Provider Scheduling.” During his time at Michigan, Brian worked closely with CHEPS students and faculty members for his research, with Prof Amy Cohn serving as his advisor and dissertation chair. Currently, Brian is working as the Analysis, Assessments, and Lessons Learned Division Chief for Air Force Special Operations Command.
|June 29, 2017:
On Thursday, June 29th, Stephanie Castaing, a registered nurse and CHEPS alum, and Jeremy Castaing, a PhD in Industrial and Operations Engineering and also a CHEPS alum, spoke to CHEPS students and staff about their work. As described in the June 1, 2017 section, Stephanie and Jeremy developed a tool to create even patient assignments for nurses. Stephanie had the vision for the tool after she recognized that patient assignments created by hand by the charge nurse were incredibly time-consuming and inefficient. She partnered with Jeremy, who coded the Patient Assignment Tool, or PAT.
Stephanie and Jeremy showed CHEPS students and staff a demo of the PAT as well as the code behind the scenes of the tool. They also discussed several problems that they faced throughout the process of implementing the PAT and their subsequent tips in dealing with those situations. Stephanie described the difficulties in getting people on board with the new tool, specifically due to the fact that “people were comfortable with the old system of making the assignments by hand.” In working to convince her coworkers and managers of the advantages of the PAT, Stephanie stressed the importance of being prepared to highlight the tool’s major benefits, and in showcasing the tool by playing around with it at work.
Stephanie and Jeremy also discussed the importance of being persistent throughout the process with management and the nurses. When collecting pre and post-implementation surveys from the nurses, they said persistence was key. Stephanie made sure to relay the fact that the sooner the pre-implementation surveys were collected, the sooner the PAT could assist the charge nurses and other floor nurses in creating balances patient assignments.
Now that the PAT has been implemented, the time to create patient assignments has drastically reduced from over an hour to just minutes. It was received very well by Stephanie’s coworkers and management, as well as other departments in the hospital and the nursing dean. Jeremy may be busy in the future adjusting the PAT for other nursing programs!
|June 28, 2017:
On Wednesday June 28, 2017, students and staff gathered at CHEPS for a lunch and learn with Dr. Vikram Tiwari. Dr. Tiwari is an Assistant Professor of Anesthesiology & Biomedical Informatics at the Vanderbilt University’s School of Medicine. He is also the Director of Surgical Business Analytics at the University Hospital. Dr. Tiwari’s two roles provide the ideal environment to research real problems, with real data, and apply solutions to operations within the health system.
He presented two recent projects, one focused on predicting surgical volume by day and another, managing operating room capacity at the physician level. Through statistical models and linear programing tools, Dr. Tiwari uses science to better manage processes and capacity within the health system. While the science is fascinating, the most valuable lesson from the day was how important visual analytics and presentation tools are. No matter how good an analysis is, if the analysis is not communicated effectively, the results do not matter. This lesson must be kept in mind as we strive to achieve our mission at CHEPS; to improve the safety and quality of healthcare delivery, we must remember the necessity of strong visual and communication skills.
|June 23, 2017:
On June 23rd, several CHEPS students were able to help out with the Girls in Science and Engineering (GISE) summer day camp here at the University. The GISE program is a week long day camp for girls that have completed the 7th or 8th grades and that are interested in science and engineering. Participants meet women engineers and scientists at the University and engage in exciting activities to learn about the science fields.
One of these activities, the Emergency Department (E.D.) simulation, is a fun and active way for the girls to learn about the basics of Industrial and Operations Engineering (I.O.E.). CHEPS students, along with other engineering student volunteers, helped run the simulation and talk to the campers about engineering. The activity began with a brief presentation that gave the girls a broad definition of what an engineer is and provided some examples of real-world cases in which engineering is used. The girls were also introduced to a few basic I.O.E. terms, such as “objective,” “constraint,” and “bottleneck.”
With this engineering background in place, the E.D. simulation was underway! The girls were given roles: a triage nurse, an E.D nurse and physician, a lab technician, a hospitalist, a transporter, and of course the patients. They were then told the rules and objective of the E.D. simulation, the latter being to get as many healthy patients as possible leaving the E.D. in five minutes.
During the first round, the girls quickly became acclimated to their roles and were eager to have a well-running E.D. However, it became apparent that the current setup of the hospital had major drawbacks and was extremely chaotic. The girls paused to brainstorm ways to get more patients through the emergency department in the next round. They then voted on the change they thought would have the greatest impact on their E.D. and set off on round two to beat their previous number of discharged patients.
The campers grew very committed to making their E.D. run smoothly and effectively. The second round of the simulation ran much better than the first, and the third was the best. Each time, more healthy patients were discharged from the hospital and the girls were proud for beating their previous record. Not only did the campers have a blast and feel rewarded for their work in the E.D. simulation, they learned several fundamental principles of I.O.E. and saw how they were used in a real-world example. One camper noted “I didn’t realize that industrial operations engineering could be used in so many different scenarios, like in a hospital. This game was fun, too!”
|June 8, 2017:
On Thursday, June 8th, CHEPS hosted four healthcare executives for a panel event, facilitated by James Molloy, a managing director at Citi Global Markets and IOE alumnus. The panel included Todd Hofheins, Former CFO at Providence Health & Services, Michael Hulefeld, COO at Ochsner Health System, Elliot Joseph, CEO at Hartford Healthcare, and Scott Nordlund, EVP Partnership, Growth & Innovation at Select Medical Corporation. Students, faculty, and industry professionals gathered to discuss issues currently challenging the healthcare industry and how industrial and operations engineering skills can be applied to the healthcare space.
The conversation began with some stage setting as the panelists discussed the history of the US’s reimbursement scheme and how this has driven operations and strategies of our healthcare systems. In a fee for service model, cost of services, value, quality, and consumer desires are not the motivators; organizations have been financially rewarded for volume, increasing throughput as much as possible. However, there has been a shift away from volume, towards value. Insurance companies are restructuring payment models to reimburse for services that are high quality and appropriate. Irrespective of political party, the industry agrees that healthcare is too expensive and the focus must be on keeping people healthy. These basic truths are encouraging organizations to focus on no-regret strategies, those that will support the business regardless of current policy changes. As Michael Hulefeld said, “Despite federal uncertainty, there are things that are just the right thing to do… we have to get costs down and improve safety, supporting patients across their care continuum.”
The conversation then shifted into variation across states and even within different local markets as Todd Hofheins discussed the variations he has seen through Providence’s markets. Provider recruitment, Medicare and Medicaid reimbursement models, the commercial plans’ market shares, even the density of consumers will have geographical differences. To be successful, an organization must understand these differences and adapt their strategies accordingly. Health systems must also react to the increasing consumer empowerment and organizations must deliver on cost and quality transparency demands.
As the event came to a close, the executives discussed the utility of a degree from the University of Michigan and provided advice to students as they entered their careers. Jim Molloy emphasized the importance of process-oriented thinking and how crucial sound statistics are. Scott Nordlund said, “There’s a ton of data, but no one knows how to use it effectively and strategically. Managing data and information is going to be just as important as managing patients.”
Each panelist stressed the importance of teamwork. As engineers, we will never be as knowledgeable about the clinical aspect of care as the clinical providers; therefore, it’s really important to work with the clinicians to understand the processes before putting together solutions. Luckily that’s one thing we do really well at CHEPS, working with multidisciplinary teams to develop innovative solutions! Elliot Joseph left the audience with one last piece of advice, something that we don’t often touch upon in our engineering curriculum as much as we should. He said, “Learn the art and science of change management. You can have all of the insights but without the softer, change management skills, you may never be able to effect change.”
As the participants filed out of the lecture hall, moving over to the reception area, you could feel the excitement in the air. At the reception, many project teams shared their research on posters which generated a great deal of discussion and excitement.
On Friday, panelists from the Healthcare Summit were invited back to the Lurie Engineering Building to speak with CHEPS students and staff. While enjoying the delicious breakfast, attendees happily discussed the previous day’s Summit and the panelists were given the opportunity to learn more about CHEPS and its ongoing projects. Scott Nordlund, one of the panelists, couldn’t help but comment on how great of an opportunity CHEPS is for University of Michigan students to get involved in healthcare management. After the breakfast, Bassel Salka, a pre-med student in IOE commented, “It was such a privilege to spend quality time with such accomplished professionals. I have never been more enthused about healthcare.”
Healthcare may be complicated, but it is full of opportunity. Those with an ability to systematically work through the complexities have a chance to make a real contribution to the industry, ultimately impacting people during their most vulnerable moments. Students at the University of Michigan have so many resources to cultivate the skills necessary to be successful within the healthcare industry. It will be exciting to see what the next generation of Wolverines is able to accomplish!
|June 5, 2017:
On Monday, June 5, 2017, the Center for Healthcare Engineering and Public Safety (CHEPS) hosted a Lunch and Learn for Dr. Geoff Barnes to discuss his project, “Anticoagulation and Endoscopy – Making Logic from Chaos.” For many patients who take long-term anticoagulants, undergoing procedures (such as colonoscopy) requires complex management of their medications. In his talk, Dr. Barnes explored the current process for managing these medications and how IOE principals can be applied to design a better system.
Dr. Barnes received his undergraduate degree in biomedical engineering from Washington University in St. Louis in 2003, followed by medical school and fellowship at the University of Michigan. His areas of research include anticoagulation, venous thromboembolism, quality improvement, and shared decision making. Currently, Dr. Barnes co-directs the Michigan Anticoagulation Quality Improvement Initiative (MAQI2).
Attendees listened intently to the presentation from Dr. Barnes. One talk attendee, Diana, who is a rising sophomore starting her journey in IOE this coming fall, said, “I have always been interested in both math and biology, and research like this seems like the best of both worlds.”
Thank you to Dr. Barnes for an interesting an informative talk!
|June 1, 2017:
Stephanie Castaing, CHEPS alum and registered nurse, was named a finalist in the University of Michigan’s 2017 President’s Staff Innovation Awards for her work on a tool that helps charge nurses create balanced patient assignments.
Stephanie saw charge nurses taking a significant amount of time creating assignments, making them unavailable to assist with patients during this time. Designed by Stephanie and coded by Jeremy Castaing, another CHEPS alum, the Patient Assignment Tool (PAT) was developed to balance patient assignments and save time. The tool includes an input tab that allows users to type-in patient variables such as acuity and isolation precautions and an output tab that reports the optimized patient assignments given those variables.
In addition to saving time and creating more balanced patient assignments, the tool allows charge nurses to visualize the location of patients and patient sets from the outputs. Additionally, sets are more balanced, meaning nurses do not have to come early to pick their patient assignments in fear of getting a heavy patient assignment. There has been nothing but positive feedback from the charge nurses using the tool since implementation in October 2016. Not only charge nurses have noticed a change, but staff nurses have also seen an improvement in terms of pre-assigned patients, distance between patients in a given set, and overall assignment fairness.
|May 12, 2017:
On Friday, May 12, 2017, the CHEPS team had their annual summer kickoff meeting. CHEPS Associate Director Amy Cohn sat down with the students and staff, old and new, to talk about policies, projects, and expectations for the summer. After the meeting, the CHEPSters had the opportunity to bond and get to know one another over pizza, wings, and salad provided by Gene Kim. With the mouthwatering smell of pizza and cheerful laughs of CHEPSters filling the halls of SI North, it was clear that the summer was off to a great start.
When asked what she will miss most about CHEPS when moving on to medical school, Anna Munaco, a recent graduate and CHEPS veteran, replied saying “I am going to miss the people the most, they are such an amazing group from all different backgrounds, there is no other place like this.” Anna’s sentiment is shared by many others here at CHEPS.
Justin Rogers, a student that just recently joined CHEPS last week says he can relate to Anna’s thoughts. Justin says the thing he is most excited about CHEPS is “Getting to know the people better. In my short time here they have all been amazing.”
The CHEPS family is ready for another productive summer!
|May 4, 2017:
Brian Lemay successfully defended his PhD thesis, titled “Addressing Challenges in Healthcare Provider Scheduling”, on May 4, 2017. Brian’s dissertation focused on the study of several applications of assigning healthcare providers to various types of schedules (such as rooms, locations, services, and rotations) with the common goal of satisfying healthcare provider preferences. In his work, he examined specific examples from the healthcare industry including building surgical OR and clinic room schedules, assigning medical residents to block schedules, and scheduling medical residents with conflicting requests for time off. He developed several mathematical approaches to solving these problems and illustrated that there are trade-offs in each type of modeling. His work showed that adjusting the mathematical model to match the specifics of a scheduling problem can improve the generated schedules and lead to reduced solve times. Reduced solve times can then, in turn, allow schedulers to examine “what-if” scenarios in order to determine the schedule that works best for them and their personnel.
Congratulations, Dr. Lemay!
|April 13, 2017:
HEPS masters student Andrea McAuliffe was recently awarded an AAMI-HSEA Health Systems Engineering Scholarship. This new annual scholarship, established by the AAMI Foundation in partnership with the Health Systems Engineering Alliance (HSEA), is intended to help build competencies and promote educational opportunities to support the adoption of a systems approach to healthcare technology and to support talented young professionals entering healthcare.
“I’m honored to receive the AAMI-HSEA scholarship,” Andrea said. “As a dual degree student, I hope to merge the fields of engineering and public health to pioneer solutions to improve healthcare delivery. Support from AAMI and HSEA will allow me to focus on my education and research while at the University of Michigan, and I am very grateful for this opportunity.”
|April 7, 2017:
On Friday, April 7, 2017, CHEPS students joined BME students in a guest lecture of BME 499: Clinical Observation and Needs Finding led by Jonathan Cohn. Jonathan is a well-known journalist who is an expert in U.S. healthcare policy. In his lecture, he covered a brief history of the US Healthcare System to show how our system got to where it is today. Jonathan emphasized that in any decision involving healthcare, there are always tradeoffs that should be considered.
After the lecture, BME students and CHEPsters headed right next door to CHEPS for a reception of socializing and snacking. Multidisciplinary collaboration remains a strength of the CHEPS program and helps expose students to a broader range of knowledge and experience!
|February 22, 2017:
On Feb 22nd 2017, the Center for Healthcare Engineering and Patient Safety (CHEPS) had the pleasure of hosting Dr. Jarir Chaar for a lunch and learn talk. Dr. Chaar graduated from the University of Michigan with a PhD in Electrical Engineering and Computer Science in 1990. He then moved on to work at IBM where he leads multiple teams, executed research projects, and is currently working as the Director of IBM Watson Health.
During his talk, Dr. Chaar focused on how IBM research plays an important role in interfacing between the industry – whose business requirements are constantly evolving and academia – with whom they work collaboratively to answer some of the most complex questions and come up with disruptive technologies. The fact that IBM holds more patents than all the tech giants combined lays a testament to the huge push for innovation at IBM.
For the faculty, staff, and students at CHEPS, this was a great opportunity to learn about the forefront of today’s technology being used to carry out predictive analytics in healthcare and a multitude of its applications in areas like DNA sequencing, personalized drug recommendation, optimizing recovery and brain-inspired computer systems.
The students used this opportunity to understand Dr. Chaar’s view on some of the questions we’ve all been asking ourselves “What are some of the disruptive technologies one can expect in healthcare over the next couple of years”, “What is IBM Watson Health’s growth strategy?” , “Is the Bitcoin system going to gain substantial backing from tech companies?” etc.
Dr. Chaar ended the session by expressing his strong interest to continue engaging with CHEPS, work collaboratively on healthcare projects, and aid seamless transfer of the right talent into IBM.
|February 14, 2017:
On Tuesday, February 14, 2017, Jim Bagian, CHEPS Director and Joe DeRosier, CHEPS Program Manager, presented a workshop on human factors, patient safety, and root cause analysis (RCA) for attendees from the University of Michigan Hospital as well as a few CHEPS students. Root Cause Analysis is a patient safety improvement activity that is focused on identifying and eliminating or controlling system vulnerabilities that can result in patient injury. Investigative tools such as flow diagramming, cause and effect diagramming, triggering questions, the five rules of causation, and the action hierarchy were covered in the workshop.
|January 13, 2017:
Jeremy Castaing successfully defended his PhD thesis, titled “Scheduling Under Uncertainty: Applications to Aviation, Healthcare, and Aerospace,” on January 13, 2017. Jeremy’s dissertation focused on the study of several problems related to scheduling tasks under uncertainty of processing times or resource availability. In his work, he considered examples from the airline industry (gate assignment optimization and recovery from delay), healthcare (patient appointment scheduling) and aerospace (satellite download scheduling). He developed mathematical approaches to solve exactly or find good approximations to these complicated problems. The work showed that considering uncertainty in when scheduling projects can significantly increase the performance of the created plan by decreasing expected delays, costs and completion time of the project.
Jeremy, who is now working full time at LLamasoft as an applied research scientist in their Ann Arbor office, says his defense was a great experience. “I felt proud to share my work with my committee and many CHEPS students,” he said. He hopes to continue to stay involved in the CHEPS community.
“I entered the PhD program in 2012 and immediately joined CHEPS,” he said. “Over the past four and a half years, I had the chance to work on many projects including aviation, satellites, and chemo. I feel extremely lucky to have had the opportunity to interact with so many brilliant people. One of my favorite highlights is my first summer spent at CHEPS. We got so much work done while having a lot of fun!”
|January 9, 2017:
Sung Won Choi, M.D., a CHEPS collaborator and Associate Professor of Pediatrics and Communicable Diseases, has been recognized as the first Edith S. Briskin and Shirley K. Schlafer Foundation Research Professor of Pediatrics. Dr. Choi, who has been working in the University of Michigan Department of Pediatrics and Communicable Diseases since 2006, was recognized at an event on January 9, 2017. Congratulations, Dr. Choi!
Dr. Choi is studying how to better prevent and treat acute GVHD, and currently is investigating the role of histone deacetylase inhibition in GVHD prevention and translating exciting laboratory insights into a novel, proof-in-principal clinical trial. A member of the Blood and Marrow Transplantation (BMT) Program at the U-M, she is working to lower rates of GVHD to improve overall patient outcomes. She is also exploring innovative health information tools in the inpatient BMT setting to improve health care safety and outcomes.
|January 6, 2017:
On Friday, the CHEPS team had their kick off meeting for the Winter 2017 semester. Thanks to a scheduling miracle and over 35 students and staff attended! Students greeted each other after the holiday break, and the ever-expanding group welcomed 8 new CHEPSters. The team discussed policies, procedures, and standard work for the semester and then bonded while scheduling a kick off meeting for every project with Amy Cohn for the following week, a much more challenging task than you’d imagine! With over 25 projects, it’s going to be a busy and exciting semester.
Following a great kickoff for the winter 2017 semester, a group of CHEPSters watched the movie Hidden Figures at Rave Cinemas. The movie reveals the little-known story of three brilliant African-American women mathematicians: Katherine Johnson (Taraji P. Henson), Dorothy Vaughan (Octavia Spencer) and Mary Jackson (Janelle Monáe). While working in the segregated West Area Computers division of Langley Research Center at NASA, the trio was instrumental in the United States catching up to and passing the Soviet Union in the Space Race, culminating in one of the greatest operations in history: the launch of astronaut John Glenn into orbit. The movie inspires individuals of all genders and races to dream big and work hard to achieve their aims. As an advocate for diversity, teamwork, and a big supporter for talented individuals, Professor Amy Cohn encouraged everyone to join her and watch movie following the kickoff event. A group of 15 enjoyed the movie with candies from the kickoff events and, motivated by the movie, are ready to resume the great work they do at CHEPS!