One user’s SIMUL8 20-year journey from the days of floppy disks to his latest project.

 

We recently had the pleasure of speaking with one of SIMUL8’s earliest users. It happened by complete coincidence, a call that came in at the end of the day from a user who was keen to get access to his SIMUL8 License number so he could use his floppy disk, yes that’s right a floppy disk!

 

This fascinated us, as it has been a long, long time since any of us at SIMUL8 had seen a floppy disk version. It got us wondering all sorts of things – what version was it, how long had he been using it for, and how many projects had he completed over the years?

Bob Harper qualified as a manufacturing engineer in the 1970’s and has a background working in both manufacturing and healthcare. After an undergraduate apprenticeship with Rolls Royce aero engines he worked in several manufacturing companies before starting his own businesses largely involved in healthcare and specifically diagnostics.

He spoke with us about his use of SIMUL8 on over 30 projects and why sometimes being ignorant of the process makes you a better consultant…
 

How many projects do you think you’ve completed over the years?

“Certainly we have used simulation in between 30 and 40 reasonably substantial projects for implementation of big systems in healthcare trusts.”

 

How long did your simulations take to build? Was it hours, days, weeks?

“All of the above! To start with it took a bit longer because we were learning as we were going, and occasionally simulations didn’t run as expected, but we learned our way through and the more familiar we got the faster and more dynamically we could build the models.

 

“We actually got to the stage where, if we did the groundwork in advance, then we could do the optimizing live in front of the customer; it was as quick as that. We knew well enough what the variables were, we knew well enough how they linked to real time and the real situation, so pretty quickly we became fluent with the system and we were able to fly with it and be very active and responsive to customer questions.”

 

What do you think your biggest success has been?

“That’s a tricky question! I think probably one of the most exciting projects was with the East Sussex Hospital Trust (at that time Hastings and Rother NHS Trust.) Right back in 1994 they were real pioneers in their use of technology and keen to progress with digital imaging systems. They had limited resources and were determined to get good results from quite inexpensive and lightweight systems when the big teaching hospitals were deploying very heavy and super expensive systems.”

 

“SIMUL8 helped us to perceive the real issues and make intelligent decisions that enabled us to achieve as much as our wealthier peers, and maybe more. We were able to perceive the potential issues and deal with them before they ever became a problem.”

 

But there are many other great successes, maybe especially in west London, where we were involved in hospital design. We found that hospital designers tended to produce a contemporary looking environment, but they didn’t necessarily understand changes in working practice that new technologies release, and how they affected design. Careful consideration of these factors and optimization was required.

 

In reality I don’t recall a single time when we used simulation in a project, which we did routinely after a while, where the outcome was not positive, because it brought people together so well.

 

Seeing things with fresh eyes is a great asset, especially if you have to tools to analyze what you see. I vividly recall the time when I went into a hospital and discussed some issues with the clinical director of Radiology. He decided that he would like to introduce me to the director and senior management team. This was a large gathering and he said “I have brought someone here who I’d like you to meet, this is Bob Harper, he is a consultant and his primary value to us is his profound ignorance of radiology”! It doesn’t sound a great introduction but I’ve never forgotten it because there was so much truth in his words. Fresh eyes can be a huge advantage.

He then took me down to meet the senior consultant in A&E and he showed me around his newly rebuilt facility. He was especially pleased with the spacious new waiting room and attendant facilities, and in a somewhat unguarded moment I asked “What do you want people to wait for?” My point was that it would be better to consider how to avoid a lot of waiting time, which is difficult to manage, expensive and inconvenient to everyone, than to build facilities (including car parks) to cope with it. This is what really drove me along the simulation line, because you can try out different options that lead to the real goal, not a coping mechanism, and that’s the way I like to think of things. It’s challenging, but it offers opportunity for a complete rethink and redesign of facilities so that they are comfortable and effective.”
 

It sounds like you used it a lot for customer engagement on your projects?

“Yes, that’s so right, we did use it for customer engagement, and that was a primary use. Customer interest soared when they understood that we were talking person to person with them about their work, what they spent their lives doing, something they were fundamentally interested in and felt a deep desire to contribute to. Then from that initial interest point we found that questions came pretty quickly about how new systems would work and what would be likely to go wrong and how they could be more secure and resilient.

 

“Customer input started to have a substantial impact on the design of the systems we were putting forward, and we could be much more confident that the work we were doing would be accepted and bring good result.”

 

But of course we also used SIMUL8 for ground up process and system design, and for system testing; we would never go to the customer without the understanding that repeated simulation runs can bring. This was not only for treatment paths in hospitals, we even used it to predict the capability of IT systems to handle data flows, which we determined to be a key factor when rapid access to very large diagnostic image files were required but processing and network technologies were of much lower capability that they are today.

 

Getting Started with SIMUL8

“I came across SIMUL8 as a result of a published study. At that stage I was working with hospitals and they were looking at taking on new computer systems to take the place of their old entirely manual systems within the field of diagnostics. We had to find a way to encourage people to take advantage of the new opportunities for better working rather than just computerizing what they were doing already.

Process analysis is necessary and worthy, but it’s just a tool, it isn’t interesting to most people, whereas animation and visual dynamics are involving and draw people into consideration about their working environment. I found a study which looked particularly at the way in which you could use simulation to bring processes to life, and I thought it was a very interesting approach.”

 

“Then I thought I’d never be able to use that effectively, it’s going to be too complex, but I looked at the published material at the time, and I spoke with SIMUL8 support staff in your offices. It seemed you were enthusiasts about the capability and applicability of simulation, and there were a number of simulations that had already been built which completely convinced me that that was the way to go, and that was how I initially made an investment in SIMUL8 back in the mid-1990s.”

 

Did you get a demo of the software or any training?

“I didn’t get a demo as such, I saw pictures online to start with, but once I bought the software there were demonstration models on the disks so I was able to work with those. It was a really good lead in and I found the models really helpful.

I didn’t have any formal training either, I just started using it and my skills developed as I went. What we were doing was essentially quite simple. I started off with a process map, and the instant anyone’s eyes fell on one of those you could see them go glassy. You knew they weren’t going to work through it. So the first thing we did was turn the process map into something that looked like their plan or layout and introduce something visually interesting. People could see things happening – it was a process but one which was interesting for them to engage with.

 

“Pretty quickly we started to find that you could go so much further because you could start to see whether the processes would actually work in real time, and find out what the sensitivities are.”

 

For example, if you’ve got two people in a defined role with defined responsibilities and one of them isn’t there because they’re taking a break or have been called away, what’s going to happen? Or if the process requires someone to enter a 16 digit number into a computer and they keep entering it wrong, what will the outcome be and what can we do about it? This is the sort of silly thing that can cause a process to fail, and snatch defeat from the jaws of victory!

We found SIMUL8 easy to take on, it drew us into detail through the questions clients asked, it just wasn’t a difficult thing to do. The best part was it gave us the ability to play with the whole situation and test changes, and that was just so useful. You could almost get the audience to design the process themselves; they’d sit and watch a model run attentively and ask “what would happen if such and such occurred?” – and this from the very people who wouldn’t get near a process map!”

 

When you called you mentioned you were getting ready to use SIMUL8 again, what made you come back to it?

“Although I moved out of consultancy to start a diagnostics business some years ago I’ve tried to keep abreast of simulation and changes in the technology, and now I am looking at some new opportunities which I think simulation could really help with. So I thought I’d take a look around and see what’s new.

Reviewing the market was an interesting exercise in itself because simulation has developed and changed. Some products from competitive companies look very competent, indeed some of the concepts that are being used are absolutely staggering, but when I analyzed it we still needed a simulation product that is process linked. We really don’t need a complex and expensive multimethod approach to simulation.

 

Furthermore I found that some of the packages separate out the simulation itself from the animation, but one of the things that I really valued about SIMUL8 is you could look at the two together, you didn’t have to build two models one to demo the simulation and the next to build something that made it acceptable to a potential customer. And so I asked myself “Can I just use what I used before?”

 

And so I scurried around to see if I still had the SIMUL8 software, and I found that I did – on two floppy disks! But somehow I’d managed to lose the license number, and that’s when I called the SIMUL8 team.”

 

What are you currently working on?

“I’m looking at the development of a software product. It doesn’t really fit in with either of the businesses we have, so we will be starting afresh, new name, new structure, new challenges, so it’s drawing board stuff really, very exciting – well, I’m excited!”

 

So simulation will be used in your new venture?

“Most definitely yes! At this point in time we have an embryo proposition of the sort that’s likely to lift a lot of eyebrows. People are going to say that we already have systems that do what yours is intended to do, which is true, but we perceive that the way in which systems are deployed and information is exchanged has moved on. We’re seeing an increased reluctance to use the old systems which are often slow and demanding, but despite that proposals for change often encounter resistance.”

 

We have to be very clear about exactly what the new proposition is and make it as compelling as possible and as right as possible, so SIMUL8 – yes! I’m itching to get my hands on it because we absolutely do need to develop, test and cement the principles behind this advance and make sure they’re as right as they can be, and demonstrably so.”

 

How will SIMUL8 be used as part of this?

“In the early stages it won’t be used in a customer facing way. I need to convince myself through analysis that the concept is right and optimum to start with. So initially SIMUL8 will be used to guide the innovative process and I think that’s a really good way of using it. We can go a long way down the development road and have a good level of confidence in the product even though it has never been used “in anger” because we identify what requires change or improvement and put it right there and then. That’s exactly what I have always done with SIMUL8 and it’s a great way to develop.

 

“SIMUL8 can be used to demonstrate to the potential customer that there’s something there that has the capability to really make a difference to their operations.”

 

In healthcare my motive is never primarily commercial; I look to provide solutions that provide benefit to all parties – in this case making hard pressed clinicians’ lives better and easier, making the patient journey quicker, better, safer and easier, and saving NHS resources – manpower, space and money. I absolutely believe that there’s scope for putting a tick in all those boxes and that’s why we want to subject solutions to careful testing, the sort of testing that SIMUL8 is so effective for. If you develop something that confers genuine advantage and you can communicate it well, commercial success usually follows.

And there’s something very particular about healthcare; it’s quite different to manufacturing. If I go into a manufacturing plant I only really have to convince one senior person about the benefits of simulation, however, if I go into a hospital I can persuade the Chief Executive but if the clinical staff aren’t on board too it simply isn’t going to happen.

 

“You’ve got to engage persuasively with a lot of people and that’s where it is so helpful to sit down with them and show them a simulation. If you say “let’s look at what’s really going on” it makes people feel part of the process and that’s so valuable in initiating change in a healthcare environment.”

 

Working together in the future

“It’s been a pleasure over the years and I’m sure you’ve picked up from what I’ve said it’s been tremendous working with you from the very start. As soon as I had the first call with you as an organization I was excited because I could sense you were enthusiasts and people who could make things happen. I’m delighted that you’ve moved on and got to the position you’re in at the moment and I look forward to continuing the relationship.”