Stemming the tide - the lifesaving role of simulation

With its roots firmly entrenched in the manufacturing sector, the reach of simulation has gradually extended far beyond its manufacturing origins, becoming a vital business process in arenas as diverse as financial services and the oil & gas industry. Perhaps a little more surprising, is the trail that simulation is blazing through an altogether very different sector, by playing a key role in supporting the reduction of infectious diseases across the globe, highlighting the technology’s potential to assist huge improvements to healthcare in the developing world.

A shining example of the great work that simulation is underpinning, involves the Liverpool School of Medicine’s (LSTM) research project to support the scale-up of new Tuberculosis diagnostic tools. Better diagnostic tools that can provide results in minutes rather than days have the potential to ultimately reduce TB sickness and mortality, a vital reduction, particularly considering that TB is estimated to have killed 1.8 million people in 2015 alone, with TB now ranked alongside HIV as the leading cause of death worldwide.

The impact of WITNESS

Our WITNESS simulation solution was chosen with a view to projecting the impact of introducing these new diagnostics, modelling the processes which would not only maximise the use of the tools, but also providing clarity on how to implement them to optimum effect. By facilitating a better understanding of the processes involved in ramping up the roll-out, factoring in variables including resource requirements, patient impacts and operational characteristics of the health system, based on data gathered in Tanzania, WITNESS was able to identify potential process bottlenecks and inefficiencies, playing an important role in supporting the roll-out of new technologies in country.

In this instance, the detailed, exhaustive analysis afforded by simulation was highly influential. Given the significant levels of investment required to deliver the new diagnostics effectively, it was fundamental that the project team could demonstrate not only the impact on patients, the population and health system costs of the new tools, but could also confidently recommend the most cost-effective strategy to pursue to achieve the ultimate objective of improving healthcare and reducing mortality rates. WITNESS was able to ‘de-risk’ the project, helping to avoid unintended consequences while enabling better, more informed, controlled decision-making, grounded in scientific data, providing policy makers with hard evidence on which to base the optimum roll out strategy for the diagnostics.

Simulation as a key component in reducing mortality

What resulted from this initial project has had far reaching consequences. The research itself along with the actual model that was developed as part of the simulation process, are now being used by the TB programme to direct placement of the new diagnostic tools in Tanzania. And, after the results of the study were published in an international journal, three other countries in the developing world are now carrying out similar studies.

Such is the robust nature of the findings, national policy makers and organisations like the World Health Organisation (WHO) can draw on the study’s ultimate recommendations for the use of new tools. By using the results afforded by simulation to underpin and inform further international collaboration, it would seem that the ability to reduce morbidity and mortality from a whole host of infectious diseases throughout the developing world is a real possibility, with simulation as a key component.

The initial Tanzanian study was part of the TREAT TB initiative funded by United States Agency for International Development (USAID) and led by the International Union Against Tuberculosis and Lung Disease.