Listen to stakeholders, then build the model!

Even the best models are useless if they can’t be implemented to solve problems. One of the reasons why modern problems of society are so complicated is that consensus of stakeholders often comes after the solution is proposed and analyzed. The economics and systems models that we work on thus need stakeholder interaction and feedback to accurately identify and quantify incentives and risks. This past week, we interacted with two other projects that involve a wide variety of stakeholders.

On June 10th, our team had an extensive conversation with Pam Tenaerts, Director of the Clinical Trials Transformation Initiative (CTTI) at Duke University and an Expert Advisor to our project. For almost four hours without any break, we discussed how CTTI is aiming to improve the clinical trials process, along with current problems and proposed solutions. CTTI’s approach is to generate projects through its members who are stakeholders and/or individuals experienced with the clinical trials process. They then convene a meeting of the members who work through the problem and come up with proposed solutions. Their projects range from specific issues such as designing trials to help inform the safe use of extended-release and long-acting opioids to broader analyses such as looking at the state of clinical trials through ClinicalTrials.gov data.

While CTTI’s inside-out approach helps identify problems within the clinical trials system, we start from the outside and work our way in. Being non-experts, our systems models are inspired by interactions, incentives, and risks within and outside the system. Among our broader goals, we also hope to take CTTI’s work further using our own complementary methods. For example, CTTI has created an Aggregate Analysis of the ClinicalTrials.gov database in their state of clinical trials project, and we intend to mine this data to see if we can get system-wide insights as well as use the data in our models of risk and economics.

After being inspired by CTTI’s approach to integrate stakeholders, we experienced such an environment first hand at the New Models meeting organized by MIT Collaborative Initiatives. In the room were stakeholders from industry, academia, healthcare, patient advocacy, military, government, and many others to have a day-long discussion on new models for our healthcare system. The participants echoed calls for system-wide changes, tackling the risk and costs in the system, and making sure incentives were aligned in any proposed changes.

In our systems models, understanding the behaviour of the stakeholders and the culture they operate in is essential to accurate analyses. These two meetings helped us learn more than any dataset would ever have.

One thing that resonated with me was that healthcare was described as the civil rights issue of our time. This has inspired us to go out and do our best to tackle these problems. There is a lot at stake.

Sauleh Siddiqui