Improving Access to Medical Care for Patients in Need of Augmentative and Alternative Communication Using Systems Engineering and Optimization Models
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Augmentative and Alternative Communication (AAC) is a set of tools and strategies used to support or replace speech or writing for individuals with communication impairments. Several barriers currently exist preventing the access of AAC tools for patients in need which include: (1) AAC assessment is a complex process that involves many professionals to effectively serve patients with complex communication need; (2) There is a substantial gap between the need for and the provision of assistive technology assessment available; and (3) Selection of an unsuitable AAC device can result in abandonment of the device which can lead to loss in revenue, time and effort. Therefore, pairing the competencies of the AAC user with a fitting communication system and providing a method of access are crucial.
This thesis addresses two specific aims as a first step towards achieving the goal of improving access to AAC devices. The first thesis aim looks at developing optimization models and solution algorithms that can help in recommending the best-suited devices to consider for a patient based on a disability profile. The optimization model and algorithm developed in this thesis administer the decision-making process by matching the conforming attributes of the patient’s diagnostic profile with the devices’ attributes to select the devices with the highest fitting score to be recommended for the patient. The computational study in the thesis demonstrates that the overall device satisfaction score is always equal for the optimization model and the algorithm. Several factors contribute to the overall device satisfaction score; the factors include ‘Patient condition’, ‘Number of devices available’, ‘Assessment weight distribution’ and ‘Minimum level of assessment satisfaction’.
The second thesis aim is to derive a healthcare mobile facility concept for patients needing AAC using the systems engineering life cycle model. The high-level conceptual design of the system was carried out in three phases of needs analysis, concept exploration, and concept definition. To fulfill the system requirements, the mobile assessment vehicle will have seven subsystems: the assessment vehicle, electrical system, network and audiovisual system, medical equipment, AAC devices, AAC device assignment tool, and human resource team. The design of an AAC mobile assessment vehicle can have a global impact and can revolutionize medical service delivery in different parts of the world.