Agent based modeling of "crowdinforming" as a means of load balancing at emergency departments

Abstract

This work extends ongoing development of a framework for modeling the spread of contact-transmission infectious diseases. The framework is built upon Agent Based Modeling (ABM), with emphasis on urban scale modelling integrated with institutional models of hospital emergency departments. The method presented here includes ABM modeling an outbreak of influenza-like illness (ILI) with concomitant surges at hospital emergency departments, and illustrates the preliminary modeling of 'crowdinforming' as an intervention. 'Crowdinforming', a component of 'crowdsourcing', is characterized as the dissemination of collected and processed information back to the 'crowd' via public access. The objective of the simulation is to allow for effective policy evaluation to better inform the public of expected wait times as part of their decision making process in attending an emergency department or clinic. In effect, this is a means of providing additional decision support garnered from a simulation, prior to real world implementation. The conjecture is that more optimal service delivery can be achieved under balanced patient loads, compared to situations where some emergency departments are overextended while others are underutilized. Load balancing optimization is a common notion in many operations, and the simulation illustrates that 'crowdinforming' is a potential tool when used as a process control parameter to balance the load at emergency departments as well as serving as an effective means to direct patients during an ILI outbreak with temporary clinics deployed. The information provided in the 'crowdinforming' model is readily available in a local context, although it requires thoughtful consideration in its interpretation. The extension to a wider dissemination of information via a web service is readily achievable and presents no technical obstacles, although political obstacles may be present. The 'crowdinforming' simulation is not limited to arrivals of patients at emergency departments due to ILI; it applies equally to any scenarios where patients arrive in any arrival pattern that may cause disparity in the waiting times at multiple facilities.

Keywords: Agent Based Models; Contact Graphs; Infection Spread Models.

Fig. 1

The ABM framework encompassing various data sources.

Fig. 2

A screenshot of the ABM input.

Fig. 3

The emergency department individual based model.

Fig. 4

Simulated Surges at Winnipeg Hospitals during an Outbreak

Fig. 5

Day of Week Variations at Winnipeg Hospitals during an Outbreak

Fig. 6

Surges at Winnipeg Hospitals with ‘crowdinforming’.

Fig. 7

Surges at Winnipeg Hospitals and Clinics with ‘crowdinforming’.

Fig. 8

Hospital Loads without averaging.