What can computer simulation offer?
The last half century has witnessed remarkable advances in computing power, machine intelligence, and emergence of novel means of measurement that have led to new and cheaper technologies, advances in science and industry, and more powerful tools to support the efficient functioning of societies. Over many decades, private industry and public sectors alike have harnessed these advances in numerous ways, not least of which is the use of computer simulation, artificial intelligence and supporting technologies to better understand complex systems, solve challenging problems, optimize the allocation of resources, and improve system efficiency, performance, and public safety. For example, complex technological exploits such as space and planetary exploration may not have been attempted without the use of computer simulation. It is difficult to estimate how many lives have been saved globally by our ability to model, simulate and forecast the path, severity and duration of significant weather events before they hit (NASA hurricane simulation system).
Computer simulation is used extensively in disciplines including nuclear physics, astronomy, climatology and meteorology, evolutionary biology, ecology, earth science, materials science and engineering. However, its use to support scientific advances and inform policy and planning decisions in the health and social sectors has lagged behind. For the most part, these sectors rely on comparatively rudimentary decision analytic approaches which, for complex problems, fail to meet decision support needs of policy makers and regional planners. This can lead to investment in interventions that ‘seem like a good idea at the time’ or ‘comprehensive’ approaches where investments are made in a wide a range of ‘possibly effective’ solutions. Such comprehensive strategies often lack focus, result in service systems that are crowded and difficult to navigate, lack sufficient actual investment in time, resources and capacity to implement programs and services effectively, and act to spread finite resources too broadly; diluting the potential impact of investments. What often results are strategies and reforms that produce little or no impact despite significant investments (Box 1), or adverse unintended consequences (Box 2). Further investments and reforms often follow, and the ad hoc trial and error pattern repeats over.
Developing computer simulation models that represent the complexity of health and social systems, and using them to simulate policy and intervention scenarios (before they are implemented in the real world), can be undertaken in ways that offer significant value to decision makers and researchers including their capacity to:
- Leverage the tremendous growth of available evidence and data
- Better understand causal pathways that lead to our most persistent health and social problems
- Avoid ‘flying blind’ when determining how best to address complex problems with limited available resources
- Support and nurture learning ecosystems that leverage data, expert and local knowledge and modelling insights to learn more quickly, reliably and deeply how best to improve population health and well-being.
Funding for capacity building in health sector applications of computer simulation is being provided sporadically in Canada, UK, Europe, and the US, including by the Centers for Disease Control and Prevention (CDC) and National Institutes of Health (NIH). But there is a long way to go. Nothing but a sustained, coordinated, global approach to capacity building will accelerate the development of the workforce and infrastructure needed to replicate the evolution seen in other sectors within our current generation. CSART is an alliance of existing centres of excellence in the application of computer simulation and advanced research technologies in health, with deep knowledge, long experience, a history of successful collaboration, and have the building blocks in place that have served as the hallmarks of success in other sectors. CSART is perfectly placed to coordinate global capacity building efforts to deliver more sophisticated decision tools to support health and social policy and catalyze systemic and sustainable improvements in population health and wellbeing. In turn, CSART is in a position to leverage its innovation networks to use generated improvements and insights to shape the design, implementation and refinement of future cutting edge technology frameworks.