Ventana software support forum

Posted: **Fri Dec 05, 2003 6:39 pm**

I heard on the news tonight that we (in the United States) are out of flu
vaccine and there will nothing to replace it until the next flu season. I
also heard that the pharmaceutical companies alone decide how much vaccine
they will make. Last year they made 13 million doses too much. This year
they cut back based on last years figures. I may be dense but that sure
sounds like the beer game to me -- only this time its the flu game.

Has anyone in modeled all this? Could anyone? Should anyone? It strikes
me as an almost perfect post-grad or post-doc project. Its probably a
money-maker too.

Hey! What can SD contribute to the resolution of this problem?

Regards,

Fred Nickols, CPT
nickols@att.net
www.nickols.us

Posted: **Sat Dec 06, 2003 5:25 pm**

Yeah, its a classic for SD and its also an example of one of Demings
"rules of the funnel" where "tampering" with the system (making decisions
about the future based on what happened to your just-past decision) just
increases the variability of the system. Its fairly common knowledge that
you dont do this -- but its also fairly common practice to do it anyway.
Are we stubborn, or just stupid?

From: "John Gunkler" <jgunkler@sprintmail.com>

Posted: **Sun Dec 07, 2003 7:15 am**

Fred Nickols suggestion of The Flu Game is a nice example of the dilemma of
managing mismatches in supply and demand of any health intervention in time
(and, of course, space)
It could also be a specific form of The Vaccine Game which could address why
some vaccines of less cost benefit to a community are adopted faster than
others that are "proven" more cost-effective, across various countries.
Indeed, what system features (especially financing/insurance, market forces
and regulation) combine with individual interactions, perceptions, choices
and behaviors of consumer/patients and health providers to produce the
ongoing pattern of overuse, under-use and mis-use of treatments.
Hey ! Who decides what is overuse, anyway?
Clarify this, and you can take on the US Health System..(or any other)
next.

A great idea...I wish Id thought of it, Fred....but beware of scope creep

regards
geoff
Dr Geoff McDonnell
Director Adaptive Care Systems
Research Fellow Centre for Health Informatics UNSW
gmcdonne@bigpond.net.au