How to represent complex healthcare systems?

East of EnglandGeneric Health Relevance
Published Date: 20 Aug 2014

Co-Design of an Integrated Diagrammatic Systems Modelling Language (iDSML) to Facilitate Effective communication and problem solving in Healthcare Systems


The aim of this research is to design an integrated diagrammatic systems modelling language for describing healthcare systems. This is to facilitate communication and problem-solving in healthcare systems.

In order to achieve this aim, the following objectives would be addressed:

  1. A review of the academic literature and current practice for approaches to and theories for developing diagrammatic visual languages.
  2. Identify categories in the healthcare domain appropriate for representation in a diagrammatic language.
  3. Define collections or elements of graphical objects appropriate for representing the defined categories based on theory and empirical observations
  4. Define combinations of graphical objects to form the syntax of the diagrammatic language.
  5. Conduct case-studies to test efficacy of a new language based on defied measures of assessment.
  6. Develop a modelling process toolkit for using the language.
  7. Disseminate result in appropriate healthcare journals and conferences

The basic assumption in this research is that healthcare practitioners and managers require a better approach to diagrammatically describing healthcare systems and processes. This leads to the question;

Will a better diagrammatic modelling language help improve the design, quality and safety of healthcare delivery?


This research is, in a broad sense, a Mixed Method Research. The design will adopt a two-phase methodology employing a semiological framework (see figure 1) with a strong focus on design by the use of the inclusive design process at key stages.

Phase one

This will comprise of three elements:

  1. A focused review of literature on approaches to systems modelling and representation and related theories
  2. The categorisation of the healthcare domain through the collection and analysis of healthcare process maps and focus groups with stakeholders.
  3. The development of the graphic objects (graphemes) and the “semantics” of the language.
  4. The formulation/development of the “syntactics” of the language using psychological experimentation.

Phase two

This will focus on language validation, the “pragmatics”. This will involve the application of the outcome of phase one (the developed language) in three NHS services and in-depth case-study interviews with the stakeholders. The services are:

  1. A community Learning Disabilities Service – North East Essex
  2. A group of five mental health services – East of England
  3. An Accident and Emergency Department – Addenbrookes
  4. Theatre processes in Addenbrookes
Dr Alexander Komashie