Development of a Proof-of-Concept Multi-Method Computer Simulation to Support Rural Healthcare Disaster Preparedness Planning

Due to a lack of resources,rural communities often face challenges when planning catastrophic events.This project involved applying systems thinking and model-based systems engineering to develop a proof-of-concept,multi-method computer simulation and then determining whether the simulation could be used to assess the efficacy of disaster planning approaches on health outcomes in rural communities,as a function of primary healthcare.The project focus was a rural or non-urban healthcare system experiencing a natural hazard.Both system dynamics and discrete event models were incorporated to represent subsystem operations,crucial disaster responses,as well as three key response systems:public health,emergency management,and healthcare.The subsystem models included several components:policies/procedures,communications,resources,exercises/drills/training,healthcare space and staff,and the flow of affected people into and through the system.The combined simulation can serve as a first step to a more comprehensive approach to helping rural communities achieve more efficient and effective healthcare planning for disaster responses.

The Application of Model-Based Systems Engineering to Rural Healthcare System Disaster Planning:A Scoping Review

Disasters and other emergency events have complex effects on human systems,particularly if the events are severe or prolonged.When these types of events happen in rural communities,the resources of the local public health,healthcare,and emergency response organizations can be quickly depleted or overwhelmed.Planning for emergencies can help to mitigate their impact.Model-based systems engineering(MBSE)methods,including computer simulations,can provide insight on how best to prepare for these events and to explore the effects of varying approaches and resource utilization.To best apply these methods for improving disaster management in rural settings,a synthesis of the current body of evidence in this field is needed.The objective of this scoping review was to provide a descriptive overview of the application of computer simulation based on MBSE approaches to disaster preparedness and response for rural healthcare systems.Six studies met inclusion criteria,and varied in terms of MBSE method used,healthcare setting,and disaster type and context considered.We identified a gap in the research regarding the application of MBSE approaches to support rural healthcare disaster preparedness planning efforts.Model-based systems engineering and systems thinking,therefore,represent novel methods for developing tools and computational simulations that could assist rural communities better prepare for disasters.

Revelation of Rural System of Medical Services in BRICS to China

In recent years, the great achievements of basic medical and healthcare services of BRICS have gained great attention and acknowledgement from the whole world. In their medical system reform, India, Brazil, Russia and South Africa have established their medical systems with their own characteristics. This provides valuable references for China in its critical stage of medical system reform. This paper explored the experience of BRICS＇ reform of medical system in order to offer some references and guidance for the establishment of basic medical and health services with Chinese characteristics and conforming to Chinese practice.

Integrated primary care-behavioral health program development and implementation in a rural context

Objective:Despite the known benefits of integrated primary care and behavioral health services,integrated behavioral health services have not been readily used in medical clinics in interior Alaska.With minimal resources,we recently developed an integrated primary care-behavioral health program in a medical clinic in interior Alaska to meet clinic and community needs.The objective of this study was to explore initial program outcomes and determine the feasibility of program development and implementation.Methods:We initially conducted a needs assessment for integrating behavioral health services into primary care.Program development was informed by specific clinic needs.Following program implementation,initial program outcomes were tracked with use of data from the electronic health record and patient and provider use and satisfaction surveys.The level of integration of primary care and behavioral health services was evaluated with the Practice Integration Profile.Results:A total of 188 patients were seen by behavioral health consultants during the initial pilot phase,including 44.0%referred for mental health symptoms,33.1%referred for physical health issues,and 22.3%referred for both mental and physical health issues.The initial program outcomes indicate modest clinical improvement(measured by the nine-item Patient Health Questionnaire)as well as patient and provider satisfaction with the model,and a moderate level of practice integration.Conclusion:On the basis of the initial findings,it appears that our integrated primary care-behavioral health program has the potential to serve an important role in addressing the behavioral health needs of the local population.Our implementation procedure and initial program outcomes suggest that such models are feasible in rural and small-scale settings with minimal overhead costs.