Aim : To develop a patient-based simulation model (SimCare) designed to reproduce complex patient situations and capture physician thinking and decision making activity necessary to manage hypertension.
Background : Hypertension is a challenging disease for physicians because of the complexity of the underlying physiology and the cognitive processes and tasks that are required to provide optimal management.
Methods : SimCare is a learning tool designed to teach optimal care management by providing feedback to the user related to actions taken or overlooked. Feedback is provided after each patient encounter and is implemented using an open source Business Rules Engine from JBoss called Drools. SimCare was developed in a JEE software application hosted on a Weblogic cluster running on Linux with an Oracle database backend running on AIX. The model includes a collection of “patient state predictors” that are stacked in a predefined way and is configurable in a plug and play fashion. The model simulates relevant “patient states”, which are broadly categorized into vitals (bp), labs (e.g. LDL), and behavioral factors (adherence and lifestyle). The user can then perform clinical functions and view effects of their decisions on patient states. Formulas derived from published literature and clinical experience is used to compute patient physiological responses.
Results and Conclusions : SimCare uses a complex systems approach to capture hypertensive physiology and care required in routine clinical settings. It has great potential to be used as a web-based teaching application for optimal hypertensive care, and could be translated to a multitude of other chronic conditions.