From the site of the Rippel Foundation, which runs the ReThink Health project:
For years, John Sterman, head of MIT’s System Dynamics Lab, had been working with industrial and business leaders, as well as with members of the energy sustainability movement. As a system dynamics modeler, he developed board games and computer simulations that helped leaders see the consequences of their actions – intended and unintended – in complex systems like factories or climate change.
For John, fixing health and healthcare in the US was no more complicated than the decision of whether or not to defer maintenance on pumps and pipes in a major manufacturing facility. How do leaders – the bosses who run the facility – decide to invest their resources?
Their choices are simple – invest in routine maintenance or defer main maintenance until there is an imminent need for a repair. With competing demands for resources within the company and pressure to produce bottom line results, deferring maintenance often seems like an attractive option.
But system dynamics models trace the impact of that decision over time. Deferring maintenance actually drives significantly higher costs and results in greater down time over the long term.
The parallels to health and healthcare are clear. Moving health upstream, focusing on social determinants and prevention, and strengthening our communities can reduce costs and demand on the healthcare system. Yet lack of system insight and failure to understand the true consequences often lead to poor decisions and the misallocation of resources.
The Foundation seeded an experiment to see if the lessons and tools of system dynamics could be brought to regional health systems – ones that involve all major stakeholders to focus on both health and healthcare. There were other health models in existence that focused on national policies, specific diseases, and targeted interventions, but none looked at regional health systems, and none allowed the critical stakeholders in a region to play out their own “what if…?” scenarios for system redesign. An award-winning team of MIT-trained system modelers, including Dr. Sterman, developed what has now become the ReThink Health Dynamics Model. First piloted in Pueblo, Colorado in 2010, it has been refined over the years through work with numerous regional health collaboratives and educational institutions.
Today, the Model is used by communities and colleges across the country to rethink the definition, design, and approach to investing in a new health system – one that embraces routine maintenance and health as much as repairs and healthcare.