Healthcare complexity: redesigning care with systems modeling

Abstract

This paper proposes a conceptual modeling approach based on qualitative system dynamics modeling to help unveil the dynamic behavior of complex systems when implementing process changes and policy decisions. As cited in the literature, most IT projects result in substantial changes to current organizational processes but not all IT projects deliver the expected outcomes. The proposed approach is applied to the healthcare application domain, which exhibits significant adjustments to existing information systems’ portfolios given the efforts to cope with rising cost structures or other ongoing process changes and improvements. The proposed approach has the potential to highlight the key issues to consider when undertaking information system projects, including identifying undesirable or inadvertent consequences of policy changes on stakeholders. The paper proposes the use of a qualitative system dynamics modeling approach as a framework to detect likely undesirable outcomes in systems analysis and design context. We illustrate the approach with the help of a case study (Madlabana and Petersen, 2020) which reports the experiences of nursing staff during process changes as part of a “performance management system” implementation which is deployed within broader healthcare reforms context.