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Modeling a better health system
NC State health systems engineers make your health care more organized, efficient and cost-effective.
Dr. Julie Ivy wants everyone to spend less time and money on their health care.
So when she learned that hospitals were having a difficult time deciding how much medication to order — and sometimes ending up with more than they needed — she knew there had to be a better way to manage the inventory. Without a solution, hospitals could continue to spend lots of money on medication that wound up in trash bins or, even worse, become inundated with sick people and not enough drugs to treat them.
Ivy is one of about 20 NC State faculty members and graduate students in the Edward P. Fitts Department of Industrial and Systems Engineering working in the emerging field of health systems engineering. These researchers strive to make health care more organized, efficient and cost-effective — results that keep patients healthy and save everybody money.
These engineers think of health care as an interconnected system, rather than as individual components, and they focus on health care delivery and medical decision-making. They’re advising doctors on the right times to prescribe medication; finding the most efficient cancer-screening methods; and, thanks to a $1.6 million grant from the Centers for Disease Control and Prevention, improving North Carolina’s Health Alert Network, a system that keeps health workers on the same page during statewide health emergencies.
Students interested in the field are gaining hands-on experience in the department’s health systems engineering concentration, which was established in 2009. This certificate program, led by Dr. Stephen Roberts, the A. Doug Allison Distinguished Professor in Industrial and Systems Engineering, provides students with a paid mentored internship at a sponsoring health organization.
The field is emerging as US health care costs for prescription medication, hospital care, doctors’ fees and other services continue to rise; they accounted for more than 17 percent of the national gross domestic product in 2009. As these costs go up, health systems engineers look for ways to give patients, doctors and hospitals the most bang for their health care buck.
That’s where quantitative modeling, a method using mathematical equations to predict behavior and simulate health care-related situations, plays a major role.
“With simulation, we try to create a computer model of the particular system, whether it’s a pharmacy or a laboratory,” Roberts said. “Then we experiment with it to find a better system.”
Ivy’s work with NC State alumna Dr. Anita Vila-Parrish, teaching assistant professor and director of undergraduate programs in the department, holds promise for improving inventory management policies at hospitals. This would allow hospital staff to order medication with more certainty and limit purchases that don’t fit the budget.
“You can get what you need, at the best possible price, when you need it,” said Ivy, associate professor of industrial and systems engineering.
The engineers are also interested in the early detection of different types of cancer. Ivy, Roberts and Dr. Brian Denton, associate professor of industrial and systems engineering, are comparing screening methods for breast cancer, colorectal cancer, and prostate cancer, respectively. They’re looking at screening times, frequencies and costs, all geared toward finding the most efficient way to catch the diseases early, when treatment is more likely to work.
Denton is also using modeling to show how heart disease progresses in patients affected by a condition that causes more deaths per year than breast cancer and AIDS combined — diabetes.
“We look at the optimal time to begin treatment,” Denton said. “And that means trying to figure out which treatment to use first, when to use it, at what age, and how things like gender, for example, affect treatment.”
Denton’s research with Jennifer Mason, a PhD student in the department, focuses specifically on patients living with type 2 diabetes, the most common form of the chronic disease. Their recent work revealed that only 48 percent of patients who were prescribed statins — medication that lowers cholesterol levels and reduces the risk of heart disease and stroke — were taking the prescribed dose on a regular basis after one year.
For diabetics, who are at particularly high risk for heart attack and stroke, the findings let them know how important it is to stick to their medications.
These types of results give patients, policy makers and hospital staff important information as they make decisions that can save time, money and lives.
“There’s going to be an increasing need for people who look at these systems of health care,” Roberts said. “And NC State engineers will be prepared for the job.” 