System barriers to the appropriate, timely, and equitable use of biomedical innovations have led to slow and inconsistent adoption, limiting their full potential impact on patient outcomes. For 16 years NEWDIGS has worked with key stakeholders to help the system catch up with the science of biomedical innovation. Current efforts focus on improving our ability to get the right treatments to the right patients at the right time in ways—and doing this not simply one product, stakeholder, or organization at a time, but rather in ways that are scalable and sustainable for the system.
System barriers include flawed and misaligned incentives, the lack of systematic data collection to generate real-world evidence, imperfect information systems for decision making, policy constraints, system capacity gaps, and social influences on health, among others.
Designing solutions for the complex, dynamic US healthcare system is hard, and implementation is even more challenging. We have come to recognize the importance not only of what we innovate, but also how we innovate.
NEWDIGS is pleased to announce the next step in the evolution of our collaborative design methods. This year we will incorporate System Dynamics Modeling into our Design Lab methodology. We will begin by applying it to our ongoing Alzheimer’s Disease project where fully leveraging the clinical potential of emerging life science products will require re-engineering of care to be more primary care centered.
Enriching our proven design methodology with system dynamics modeling
One of our working groups is now applying the concepts of systems dynamics modeling (SDM) to help visualize a “map” of the current system of Alzheimer’s Disease (AD) care as context for anticipated diagnosis and treatment innovations. The SDM considers:
- Patient pathway from initial cognitive concerns through diagnosis to treatment
- Diagnostic testing workflows (cognitive assessment, biomarker testing)
- Treatment decision-making and monitoring
- Provider capacity, workflows, referral pathways, and location
- Patient and caregiver engagement dynamics
- Impact of policy, payment, and other potential incentives/factors
The team will build on the care map to develop a dynamic simulation model intended to:
- Identify high-leverage intervention points that could significantly improve the detection, diagnosis, and treatment of early Alzheimer’s disease in primary care settings
- Provide a platform for stakeholders to test different intervention strategies and observe system-wide impacts
- Support exploration of incentive alignment among diverse healthcare stakeholdersEnable the development of implementation roadmaps that account for complex system dynamics
- Create a template architecture for modeling other disease pathways (beyond AD) within primary care
Where are we in this journey?
- Many model elements have been identified
- Casual loops between system components are now being explored
- Conceptual model mapping of current diagnosis and treatment processes is nearly complete
- A colleague with expertise in qualitative and quantitative model construction has been engaged
What’s next?
The vision and initial prototype of the dynamic simulation model will be presented and discussed at our next invitational Design Lab (September 10 & 11, Boston). We look forward to sharing our progress there on model development including:
- Validating and refining the conceptual model with input from NEWDIGS consortium members
- Identifying gaps and inefficiencies in the system
- Populating model for running simulations
- Partnering with other communities in solution generation
- Socializing the results
- Identifying broader policy initiatives to enhance the effort
- If resources permit, advancing the model into an open access dynamic simulation platform for use across the Alzheimer’s Disease ecosystem to support adaptive change management in the rapidly evolving marketplace.
Want to get involved?
We would love to have you and/or other members of your organizations consider being involved in this process—no SDM experience required, just an interest in helping to find better ways to improve the delivery of care for Alzheimer’s disease. Contact us
Resources to learn more
Health Affairs Forefront: Bringing Systems Thinking to Drug Value Assessment
BioCentury commentary: Biomedical Innovation Requires Health System Innovation