An Industrial Approach to Breast Cancer Treatment

When a woman is diagnosed with breast cancer she is drawn into a series of examinations, tests and treatments with interdependent elements in several steps. Because the prognosis for recovery is tied to how quickly she gets help, it is important to minimize the time between the first doctor’s appointment and the commencement of treatment.

SICS conducted a feasibility study for Östra Götaland County Council in Linköping to assess opportunities for using planning to coordinate resources and create a more efficient treatment process for breast cancer.

The first part of the pilot study comprised an investigation stage in which the researchers learned about all aspects of the care process. The researchers then built a computer simulation model to better understand the workings of the process and to investigate which parts of the process were well-suited for more advanced planning. The model can handle many variables and provide insights that are otherwise difficult to gain. For example, it can detect that increasing resources in a particular step in the process might not result in time gains, because the patient still has to wait for other parts of the process to be completed.

The goal for the breast cancer team in Linköping is a lead time of less than 28 days from the first doctor’s appointment to the start of treatment. But the simulation showed that it is often impossible to achieve that goal using the current process and methods.

The simulation model was used to estimate how congested the different steps of the process are and to evaluate possible process changes. Being able to explore the process, and predict in advance how changes affect the lead time and the load curve, aroused great interest among the hospital staff.

Computer simulation gives a picture - planning gives a solution.

The purpose of the simulation is to investigate whether there is potential for shorter lead times, and if so, where to invest resources. Shorter lead times can be achieved with good planning. Naturally, sensitivity and flexibility are required in this context; a patient may need a few extra days to absorb the news that she has cancer before an operation can be scheduled. Nevertheless, SICS believes a more industrial approach to the planning process would benefit everybody involved.

"Health care is a perfect candidate for our planning methods” says Sara Gestrelius, Senior Researcher at SICS Swedish ICT . “I really wish that the health care system had better decision support tools. That would enable care that is more adaptable and coordinated, both for the patient and for health care professionals.”

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