Modelling a Radiation Oncology Outpatient Department for Emendo Limited


Ryan Geekie and Tanya Hoffmann 2009





Company Background

Emendo was established in 2002 to improve operational performance and patient care in hospitals. Emendo developed CapPlan, a system that improves operational performance while also enabling staff to deliver excellent standards of patient care. CapPlan accurately forecasts workloads covering long-term trends as well as short-term needs. This enables resources to be aligned efficiently.


This software is used by 8 hospitals in New Zealand, 6 in Australia, 1 in Britain and 2 in Canada and has helped these hospitals reduce their waiting lists and decrease their operating costs.


Originally starting as a small business, the company has expanded rapidly over the past few years and are now market leaders in reducing waiting lists and operational costs in health care.



Problem Situation

Currently, CapPlan has no way of tracking the patient journey through outpatient departments. Emendo feel that it is necessary to represent this system visually to identify problem areas.


The tasks involved in this project are to complete a literature review focusing on past simulation studies in health care; develop and design a conceptual model of the radiation oncology department at the CHDB; align the data from different sources to map a single patient’s journey through the system; and to finally apply Discrete Event Simulation (DES) to the model.


Emendo believe that the Radiation Oncology model will be the starting point for building a generic outpatient flow model which will be developed in the future and eventually added to Emendo’s outpatient application in their current CapPlan software.


This model will ultimately provide users with the ability to perform ‘what-if’ scenario simulation which will determine problem areas in the system and allow users to change variables with the purpose of reducing waiting time.  



Literature Review

A literature review was performed to investigate simulation in healthcare. The purpose of this was to understand projects that had been completed in the past. The main focus was on Discrete Event Simulation (DES) as applied to hospital outpatient departments; however Systems Dynamics (SD) applications were also reviewed as requested by Emendo. This enabled comparisons to be made and key literature was observed that would ultimately help with the modelling stage. 


Key findings from the literature review suggest that data may be difficult to obtain. Nearly all the models in the literature tend to focus on real-time patient flow within a single clinic. However, Emendo are more interested in seeing what work has been done at the higher level such as looking at the overall process, spanning weeks/months, rather than real-time patients within a particular facility. Other findings helped to determine the conceptual process of the radiation oncology outpatient department and the data required.




The following process flow diagram represents the main care paths for the radiation oncology department.


Figure 1: Flow diagram of radiation oncology

Note: follow-ups have been excluded from this model however may be added depending on the data available.


The software package chosen to model this flow diagram was Simul8 due to its visual nature and accessibility.




Ryan and Tanya would like to thank the support of their supervisors, Dr. Shane Dye and Dr. John Giffin, and the other members of the Department of Management for their feedback. Also, thank you to Andrae Gaeth and Bart Visscher of Emendo Ltd, for providing us with this project and for the time they dedicated to this project. And last but not least, Richard Floyd of the CDHB for providing us with the data for this project and for his assistance.