Consensus Forming in Clinical Pathway Development: Norm Based Modeling and Simulation

摘要

Clinical pathway (CP) defines the optimal sequencing and timing for the treatment of a given diagnosis. Its aims include controlling healthcare expenses, improving care quality and some others. CP development team needs consensus about a preferable sequence against the alternatives, in conformity to those sometimes controversial targets. This paper suggests that the team faces a Multi-Objective Combinatorial Optimization problem. A norm based approach is proposed to model the problem, in which feasible solutions are represented as set of norms. A computer simulation system maps a solution to objective variables, then the team can intuitively see what will happen if this set of norms applies. The development team has opportunity to revise the norms and test them again. An artifact example shows how this approach could harnesses efficient from formalized definition and computer simulation, with full regard to human judgment.