Healthcare Systems

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This book is centered around the development of agile, high-performing healthcare institutions that are well integrated into their environment. The aim is to take advantage of artificial intelligence, optimization and simulation methods to provide solutions to prevent, anticipate, monitor and follow public health developments in order to intervene at the right time, using tools and resources that are both appropriate and effective.<br /><br />The focus is on the people involved – the patients, as well as medical, technical and administrative staff – in an effort to provide an efficient healthcare and working environment that meets safety, quality and productivity requirements.<br /><br /><i>Heathcare Systems</i> has been written by healthcare professionals, researchers in science and technology as well as in the social sciences and humanities from various French-speaking countries. It explores the challenges and opportunities presented by digital technology in our practices, organizations and management techniques.

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Chapter written by Cléa MARTINEZ, Maria DI MASCOLO, Marie-Laure ESPINOUSE and Jérôme RADUREAU.

2

Home Healthcare Scheduling Activities

2.1. Introduction

Home healthcare (HHC) is a field of research which, due to its complexity in terms of organization and diversity of players, not to mention in the medical and social specificities of patients, opens up several fields of investigation. We can identify the optimization challenges inherent to the management of the HHC structure, which in turn leads to significant research activity on problems concerning nurse rostering and drug deliveries. The optimization problem in HHC must take into account several constraints related to the organization of the structure, the patient, road traffic, emergencies, etc. The purpose is to ensure visits to patients according to their care plans. One of the major constraints in the organization of care is taking into account emergencies as well as uncertainties such as changes in the duration of care and also the disturbances caused by the external environment (road traffic, for example).

In this chapter, we present a solution for the HHC planning problem by integrating uncertainties and dynamic rescheduling. We first present a literature review with recent works that have focused on HHC planning. Section 2.3focus on the proposed approach, which is based on a genetic algorithm with the consideration of real-time disturbances and uncertainties. Section 2.4presents the experiments and the obtained results. We finish this chapter with a conclusion and some perspectives.

2.2. State of the art

The increase of the number of elderly people in France has led to a substantial increase in the demand for HHC services (e.g. home support structures, home hospitalization, etc.). This demand is due to two main causes:

– home care is less expensive for health insurance companies and helps to relieve congestion in hospitals;

– people who are still autonomous want to stay at home and benefit from HHC services (cleaning, reading, meal delivery, etc.).

HHC structures play an important role in the development of the silver economy and offer better well-being for elderly people. However, the organization of HHC is complex and difficult to control due to the multiplicity and diversity of players, their status (private or public), as well as their function (medical, paramedical, social, administrative). Moreover, each treatment is specific and must be personalized insofar as it relies on the patient’s level of dependency.

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