Architecting a System Model for Personalized Healthcare Delivery and Managed Individual Health Outcomes

In recent years, healthcare needs have shifted from treating acute conditions to meeting an unprecedented chronic disease burden. The healthcare delivery system has structurally evolved to address two primary features of acute care: the relatively short time period, on the order of a patient encounter, and the siloed focus on organs or organ systems, thereby operationally fragmenting and providing care by organ specialty. Much more so than acute conditions, chronic disease involves multiple health factors with complex interactions between them over a prolonged period of time necessitating a healthcare delivery model that is personalized to achieve individual health outcomes. Using the current acute-based healthcare delivery system to address and provide care to patients with chronic disease has led to significant complexity in the healthcare delivery system. This presents a formidable systems' challenge where the state of the healthcare delivery system must be coordinated over many years or decades with the health state of each individual that seeks care for their chronic conditions. This paper architects a system model for personalized healthcare delivery and managed individual health outcomes. To ground the discussion, the work builds upon recent structural analysis of mass-customized production systems as an analogous system and then highlights the stochastic evolution of an individual's health state as a key distinguishing feature.