A Human-Centric Engineering Discipline

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[vc_row type=”in_container” full_screen_row_position=”middle” scene_position=”center” text_color=”dark” text_align=”left” top_padding=”30″ overlay_strength=”0.3″ shape_divider_position=”bottom”][vc_column column_padding=”no-extra-padding” column_padding_position=”all” background_color_opacity=”1″ background_hover_color_opacity=”1″ column_shadow=”none” column_border_radius=”none” width=”1/1″ tablet_text_alignment=”default” phone_text_alignment=”default” column_border_width=”none” column_border_style=”solid”][vc_column_text][nectar_dropcap color=”#3452ff”]T [/nectar_dropcap]he title of this blog post is stolen from this great article on the future of Artificial Intelligence by Michael I. Jordan from Berkeley. I highly recommend reading it not just for understanding what artificial intelligence is and where we need progress, but also how engineering principles can help cultivate the future of our infrastructure.

The aspect I appreciated most was the eloquence with which he describes the need for a new type of engineering, and carefully outlines its purpose and goals. One of the challenges we have always faced at the Center for Systems Science and Engineering is defining what we mean by systems. Not only has the word already been used different disciplines, but has taken on a broader context that has sometimes been detrimental because it feels like there is no concreteness to what the discipline aims to do. One of my colleagues has joked that they should just call “systems thinking,” which is what researchers in systems admittedly practice, as just “don’t be stupid.” Another colleague has described the faculty in systems at our university as the “island of misfit toys;” researchers who have taken an interdisciplinary angle to their work so that they don’t really belong anywhere. One of the best ways I have seen systems defined is by Andreas Hieronymi [Hieronymi, A. (2013). Understanding systems science: a visual and integrative approach. Systems research and behavioral science, 30(5), 580-595.], whose Figure 2 I reproduce below:[/vc_column_text][/vc_column][/vc_row][vc_row type=”in_container” full_screen_row_position=”middle” scene_position=”center” text_color=”dark” text_align=”left” overlay_strength=”0.3″ shape_divider_position=”bottom” shape_type=””][vc_column column_padding=”no-extra-padding” column_padding_position=”all” background_color_opacity=”1″ background_hover_color_opacity=”1″ column_shadow=”none” column_border_radius=”none” width=”1/1″ tablet_text_alignment=”default” phone_text_alignment=”default” column_border_width=”none” column_border_style=”solid”][image_with_animation image_url=”6354″ alignment=”center” animation=”Fade In” img_link_large=”yes” border_radius=”none” box_shadow=”small_depth” max_width=”100%”][/vc_column][/vc_row][vc_row type=”in_container” full_screen_row_position=”middle” scene_position=”center” text_color=”dark” text_align=”left” overlay_strength=”0.3″ shape_divider_position=”bottom”][vc_column column_padding=”no-extra-padding” column_padding_position=”all” background_color_opacity=”1″ background_hover_color_opacity=”1″ column_shadow=”none” column_border_radius=”none” width=”1/1″ tablet_text_alignment=”default” phone_text_alignment=”default” column_border_width=”none” column_border_style=”solid”][vc_column_text]Credit: Hieronymi, A. (2013). Understanding systems science: a visual and integrative approach. Systems research and behavioral science, 30(5), 580-595.[/vc_column_text][/vc_column][/vc_row][vc_row type=”in_container” full_screen_row_position=”middle” scene_position=”center” text_color=”dark” text_align=”left” overlay_strength=”0.3″ shape_divider_position=”bottom”][vc_column column_padding=”no-extra-padding” column_padding_position=”all” background_color_opacity=”1″ background_hover_color_opacity=”1″ column_shadow=”none” column_border_radius=”none” width=”1/1″ tablet_text_alignment=”default” phone_text_alignment=”default” column_border_width=”none” column_border_style=”solid”][vc_column_text]But Michael I. Jordan goes a step further and clearly defines what type of engineering discipline is needed:

“Whether or not we come to understand “intelligence” any time soon, we do have a major challenge on our hands in bringing together computers and humans in ways that enhance human life. While this challenge is viewed by some as subservient to the creation of “artificial intelligence,” it can also be viewed more prosaically — but with no less reverence — as the creation of a new branch of engineering. Much like civil engineering and chemical engineering in decades past, this new discipline aims to corral the power of a few key ideas, bringing new resources and capabilities to people, and doing so safely. Whereas civil engineering and chemical engineering were built on physics and chemistry, this new engineering discipline will be built on ideas that the preceding century gave substance to — ideas such as “information,” “algorithm,” “data,” “uncertainty,” “computing,” “inference,” and “optimization.” Moreover, since much of the focus of the new discipline will be on data from and about humans, its development will require perspectives from the social sciences and humanities.” [Michael I. Jordan]

The paragraph above shows that the building blocks for such a discipline are already there, we just need a nice framework to put it in. He goes on to describe that discipline:

“Let us conceive broadly of a discipline of “Intelligent Infrastructure” (II), whereby a web of computation, data and physical entities exists that makes human environments more supportive, interesting and safe. Such infrastructure is beginning to make its appearance in domains such as transportation, medicine, commerce and finance, with vast implications for individual humans and societies.” [Michael I. Jordan]

And the part that resonated with me the most was the call to link markets with infrastructure, it’s such an overlooked aspect of the possibilities of AI specifically, but broader interdisciplinary engineering research:

“Finally, and of particular importance, II systems must bring economic ideas such as incentives and pricing into the realm of the statistical and computational infrastructures that link humans to each other and to valued goods. Such II systems can be viewed as not merely providing a service, but as creating markets. There are domains such as music, literature and journalism that are crying out for the emergence of such markets, where data analysis links producers and consumers. And this must all be done within the context of evolving societal, ethical and legal norms.” [Michael I. Jordan]

The article lays out a really good plan for a “human-centric engineering discipline,” and also challenges us to think beyond our siloes of practice to realize our potential. More importantly, by the story of his daughter’s birth describing the disconnect between statistical research and technological innovation, the article also highlights the dangers of not developing such a human-centric engineering discipline. As scientists, we ignore the future at our own and society’s peril.[/vc_column_text][/vc_column][/vc_row]

Many outpatient facilities with expensive resources, such as infusion and imaging centers, experience surge in their patient arrival at times and are under-utilization at other times. This pattern results in patient safety concerns, patient and staff dissatisfaction, and limitation in growth, among others. Scheduling practices is found to be one of the main contributors to this problem.

We developed a real-time scheduling framework to address the problem, specifically for infusion clinics. The algorithm assumes no knowledge of future appointments and does not change past appointments. Operational constraints are taken into account, and the algorithm can offer multiple choices to patients.

We generalize this framework to a new scheduling model and analyze its performance through competitive ratio. The resource utilization of the real-time algorithm is compared with an optimal algorithm, which knows the entire future. It can be proved that the competitive ratio of the scheduling algorithm is between 3/2 and 5/3 of an optimal algorithm.

This work was performed with the MIT/MGH Collaboration.

In many healthcare services, care is provided continuously, however, the care providers, e.g., doctors and nurses, work in shifts that are discrete. Hence, hand-offs between care providers is inevitable. Hand-offs are generally thought to effect patient care, although it is often hard to quantify the effects due to reverse causal effects between patients’ duration of stay and the number of hand-off events. We use a natural randomized control experiment, induced by physicians’ schedules, in teaching general medicine teams. We employ statistical tools to show that between the two randomly assigned groups of patients, a subset who experiences hand-off experience a different length of stay compared to the other group.

This work was performed with the MIT/MGH Collaboration.

Primary care is an important piece in the healthcare system that affects the downstream medical care of patients heavily. There are specific challenges in primary care as healthcare shifts from fee-for-service to population health management and medical home, focuses on cost savings and integrates quality measures. We consider the primary care unit at a large academic center that is facing similar challenges. In this work we focus on the imbalance in workload, which is a growing regulatory burden and directly concerns any staff in primary care. It can result in missed opportunities to deliver better patient care or providing a good work-environment for the physicians and the staff. We consider the primary care unit at the large academic center and focus on their challenge in balancing staff time with quality of care through a redesign of their system. We employ optimization models to reschedule providers’ sessions to improve the patient flow, and through that, a more balanced work-level for the support staff. 

This work was performed with the MIT/MGH Collaboration.

Perioperative services are one of the vital components of hospitals and any disruption in their operations can leave a downstream effect in the rest of the hospital. A large body of evidence links inefficiencies in perioperative throughput with adverse clinical outcomes. A regular delay in the operating room (OR), may lead to overcrowding in post-surgical units, and consequently, more overnight patients in the hospital. Conversely, an underutilization of OR is not only a waste of an expensive and high-demand resource, but it also means that other services who have a demand are not able to utilize OR. This mismatch in demand and utilization may, in turn, lead to hold-ups in the OR and cause further downstream utilization. We investigate the utilization of operating rooms by each service. The null hypothesis of this work is that the predicted utilization of the OR, i.e., the current block schedule, matches completely with the actual utilization of the service. We test this hypothesis for different utilization definitions, including physical and operational utilization and reject the null hypothesis. We further analyze why a mismatch may exist and how to optimize the schedule to improve patient flow in the hospital.