Things I Learned from Facebook:Network Science Applied to Access to Care.

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1 Things I Learned from Facebook:Network Science Applied to Access to Care. Puget Sound VA Health Care system, University of Washington Dept of Anesthesiology and Pain Medicine. October 23, 2016

2 Motivation VA access to care. Veterans Access, Choice and Accountability Act, 2014.

3 Networks - brief introduction Game of Thrones Tywin Lannister Jamie Lannister Pyter Balysh Sandor Clegane Cersi Lannister Tyrion Lannister Sansa Stanrk Arya Stark Jorah Mormont Jon Snow Daenerys Targaryen

4 Networks- in-degree centrality measure Game of Thrones - In Degree Tywin Lannister Jamie Lannister Pyter Balysh Sandor Clegane Cersi Lannister Tyrion Lannister Sansa Stanrk Arya Stark Jorah Mormont Jon Snow Daenerys Targaryen

5 Networks- betweenness centrality measures Internet - Betweenness Measures Facebook University Washington VA Puget Sou oogle Scholar Google YouTube LinkedIn user

6 Networks- clustering

7 Networks- connected components connected component

8 PROSTHETICS REQUEST - (SEA) ORTHOSIS ONLY WOUND CARE OUTPATIENT (TAC) PODIATRY IFC (PUGET SOUND) STOMA CARE PRIMARY CARE MINOR PROCEDURE OUTPT (TAC) GASTRO(OUTPT)-MANOMETRY (S) PACT OUTPATIENT-WOUND PLASTIC SURGERY NON-VISIT IFC (PUGET SOUND) INFECTIOUS DISEASE GENERAL OUTPT (SEA) ORTHOPEDICS NON-VISIT IFC (PUGET SOUND) OTOLARYNGOLOGY NON-VISIT IFC (PUGET SOUND) AUDIOLOGY-VESTIBULAR ASSESSMENT OUTPT ORAL & MAXILLOFACIAL SURGERY OUTPT DIABETES OUTPT (SEA) WOUND CARE IFC (PUGET SOUND) GENERAL SURGERY OUTPATIENT (SEA) OTOLARYNGOLOGY IFC (PUGET SOUND) OTO-URGENT OTO-MOHS REFERRALS OUTPT OUTPT (SEA) RCS CHIROPRACTIC CARE OUTPT PAIN SERVICE (MEDICATION CONSULT) OUTPT RCS OT CARDIAC INPT (SEA) ORTHOPEDICS HAND OUTPT ORTHOPEDICS INPATIENT (SEA) DERMATOLOGY OUTPATIENT AUDIOLOGY-DIZZINESS/VERTIGO OUTPT (SEA) NUTRITION OUTPT (BREMERTON CBOC) NUTRITION OUTPT (TAC) PODIATRY NON-VISIT IFC (PUGET SOUND) PLASTIC SURGERY INPATIENT RCS MUSCULOSKELETAL OUTPT (TAC) BENEFICIARY TRAVEL (SEA) RHEUMATOLOGY OUTPT (TAC) RCS OT INPATIENT-NHCU (TAC) SKILLED HOME CARE REFERRALS (TAC) RCS SUBACUTE CONSULT INPT (TAC) NEUROLOGY OUTPT (TAC) RHEUMATOLOGY OUTPT (SEA) NEUROSURGERY NON-VISIT IFC (PUGET SOUND) PAIN SERVICE OUTPT (PROCEDURE ONLY) NEUROGENETICS NUTRITION INPT (SEA) PROSTHETICS REQUEST - (TAC) ORTHOSIS ONLY GENERAL SURGERY IFC (PUGET SOUND) RHEUMATOLOGY NON-VISIT IFC (PUGET SOUND) SKIN INTEGRITY-INPATIENT RCS POLYTRAUMA OCCUPATIONAL THERAPY OUTPT (TAC) RCS ALS INTERDISCIPLINARY CARE TEAM OUTPT NUTRITION OUTPT (SEA) BEHAVIORAL MEDICINE OUTPT (SEA) DIABETIC RETINOPATHY SURVEILLANCE (SEA) OUTPT OPTOMETRY OUTPT (SEA) RCS GENERAL REHAB OUTPT RCS OT INPATIENT-REHAB (SEA) RCS OT INPATIENT-CONSULTS (SEA) RCS MOBILITY CLINIC OUTPT (SEA) PROSTHETICS REQUEST - (SEA) PROSTHESIS ONLY RCS DRIVER REHAB OUTPT (SEA) RCS OT INPATIENT-TCU (SEA) CARDIAC SURGERY IFC (PUGET SOUND) CARDIOLOGY IFC (PUGET SOUND) NEUROSURGERY-INPATIENT (SEA) PAIN SERVICE OUTPT (COMPREHENSIVE MANAGEMENT) RCS MULTIPLE SCLEROSIS OUTPATIENT (SEA) PROSTHETICS REQUEST - (TAC) PROSTHESIS ONLY PROSTHETICS REQUEST - (TAC) ACUPUNCTURE CONSULT/REFERRAL (SEA/TAC) PULMONARY IFC (PUGET SOUND) CARDIAC SURGERY NON-VISIT IFC (PUGET SOUND) OPHTHALMOLOGY IFC (PUGET SOUND) INTERFACILITY IMAGING REQUEST (SEA) RCS AMPUTEE INPATIENT (SEA) THORACIC SURGERY OUTPT DENTAL IFC (PUGET SOUND) CARDIAC SURGERY INPT RENAL IFC (PUGET SOUND) REHAB IFC (PUGET SOUND) SCI OT-INPT PULMONARY-OTHER OUTPT (SEA) RCS MD REHAB CONSULTATION INPT (SEA) RCS STROKE (OUTPATIENT) RCS PHYSICAL THERAPY EQUIPMENT-OUTPATIENT (SEA) GYNECOLOGY IFC (PUGET SOUND) NEUROLOGY IFC (PUGET RCS SOUND) PHYSICAL THERAPY-OUTPT BACK & NECK PAIN (SEA) NON VA CARE COLONOSCOPY THORACIC SURGERY IFC (PUGET SOUND) OPHTHALMOLOGY/OPTOMETRY OUTPT DIABETIC (MT. VERNON RETINOPATHY CBOC) SURVEILLANCE (CHEHALIS) OUTPT OPHTHALMOLOGY/OPTOMETRY DIABETIC RETINOPATHY SURVEILLANCE (TAC) OUTPT (TAC) (SEA) TELEDERMATOLOGY PATHOLOGY IFC (PUGET SOUND) RCS REC THERAPY OUTPT REHAB (SEA) VASCULAR SURGERY IFC (PUGET SOUND) VIRS COORDINATOR IFC (PUGET SOUND) VIST (VISUAL IMPAIRMENT) OUTPT (TAC) BLIND REHAB-OPTOMETRY OUTPT (TAC) RCS LYMPHEDEMA THERAPY OUTPT (SEA) SCI PT-INPT RCS MOBILITY CLINIC OUTPT (TAC) ONCOLOGY IFC (PUGET SOUND) PROSTHETICS REQUEST - (SEA) RCS PHYSICAL THERAPY EQUIPMENT-INPATIENT (SEA) NON VA CARE GENERAL RCS SPASTICITY BLOCK OUTPT PLASTIC SURGERY IFC (PUGET SOUND) GASTRO(OUTPT)-COLON CA SCREENING (T) RCS CARDIAC REHAB OUTPT (SEA) PAIN IFC (PUGET SOUND) GASTROENTEROLOGY IFC (PUGET SOUND) HEMATOLOGY IFC (PUGET SOUND) RADIATION ONCOLOGY OUTPT ONCOLOGY OUTPT SKILLED HOME CARE REFERRALS (SEA) RCS LYMPHEDEMA THERAPY OUTPT (TAC) RCS OT INPATIENT (TAC) GASTRO(OUTPT)-POLYP F/U (S) NEUROSURGERY IFC (PUGET SOUND) Putting it Together: Network Science to Outpaient Consults RCS OT OUTPATIENT (SEA) PODIATRY OUTPT (SEA) RCS PHYSICAL THERAPY-OUTPT BACK & NECK PAIN (TAC) RCS AMPUTEE OUTPATIENT (SEA) RCS PHYSICAL THERAPY EQUIPMENT OUTPT (TAC) RCS OT OUTPATIENT (TAC) RCS MUSCULOSKELETAL OUTPT (SEA) RCS SPINE OUTPT (TAC) NEUROSURGERY-OUTPATIENT (SEA) RCS SPINE OUTPT (SEA)

9 VASCULAR LAB-OUTPAT (ALL EXAMS) GERIATRIC MOOD DISORDER OUTPT (SEA) PERIPHERAL VASCULAR SURGERY INPT (SEA) VASCULAR AND INTERVENTIONAL RADIOLOGY OUTPT VASCULAR LAB-INPAT (ALL EXAMS) VASCULAR SURGERY NON-VISIT IFC (PUGET SOUND) AUDIOLOGY-COCHLEAR IMPLANT IFC (PUGET SOUND) AUDIOLOGY-TINNITUS OUTPT (TAC) AUDIOLOGY-HEARING TEST/HEARING AIDS OUTPT (TAC) TRANSCRANIAL DOPPLER STUDIES (SEA) VASCULAR LAB (SEA) AUDIOLOGY IFC (PUGET SOUND) OTO-URGENT REFERRALS OUTPT (TAC) AUDIOLOGY-HEARING TEST/HEARING AIDS OUTPT (SEA) AUDIOLOGY-VIST OUTPT AUDIOLOGY-DIZZINESS/VERTIGO OUTPT (TAC) OTO-IMPACTED CERUMEN OUTPT (TAC) Putting it Together: Network Science in Outpaient Consults PLASTIC SURGERY OUTPATIENT (SEA) PERIPHERAL VASCULAR SURGERY OUTPT (SEA) ORTHOPEDICS OUTPATIENT OTO-GENERAL OUTPT (TAC)

10 STROKE EVALUATION AND TREATMENT NEUROLOGY OUTPT (MTZ) (OAK) TBI NEURO OUTPT (MTZ) MEMORY ASSESSMENT NEUROPSYCH MENTAL MHC OUTPT HEALTH (OAK) (MTZ) OUTPT (MTZ) PCMHI-PRIMARY CARE MENTAL HEALTH INTEGRATION CLINIC OUTPT (MTZ) PHARMACY IFC PAIN OUTPT MANAGEMENT (SAC) (MTZ) PRE-OPERATIVE CARDIOLOGY ECHO (RED) EVALUATION OUTPT (SAC) MHC GENERAL CONSULTS OUTPT (OAK) NEUROLOGY EMG OUTPT (MTZ) PAIN ECONSULT OUTPT NEUROLOGY NEUROMUSCULAR CLINIC (MTZ) PAIN MANAGEMENT OUTPT (SAC) IFC PAIN MANAGEMENT (SAC) NEUROBEHAVIOR TELEDERMATOLOGY CLINIC OUTPT DERMATOLOGY IMAGING (MTZ) REQUEST OUTPT - (CHICO) CONSULT OUTPT (CHICO) PHYSICAL MEDICINE OUTPT (SAC) NEUROPSYCH NEUROLOGY OUTPT (SAC) MOVEMENT NEUROLOGY DISORDER GENERAL OUTPT (MTZ) TBI PHYSIATRY OUTPT (MTZ) PTSD OUTPT (SAC) DERMATOLOGY GASTROENTEROLOGY OUTPT (RED) OUTPT COLONOSCOPY (OAK) SCREENING (MTZ) PROSTHETICS REQUEST - CUSTOM SHOES SUBSTANCE ABUSE OUTPT (SAC) PODIATRY OUTPT (FF) PODIATRY OUTPT (MCCL) MHC GENERAL CONSULT OUTPT (MCCLELLAN) GASTROENTEROLOGY EGD (MTZ) OUTPT (MTZ) PHYSICAL THERAPY WOUND OUTPT (MTZ) COLONOSCOPY OUTPT (MTZ) NEUROCOGNITIVE REHABILITATION MHC OUTPT BARIATRIC (SAC) PSYCHOLOGICAL DERMATOLOGY EVALUATION OUTPT OUTPT (SAC) FEE (EMERGENCY GENERAL) NEUROLOGY TBI PHYSIATRY TBI OUTPT (SAC) PODIATRY OUTPT (SAC) PODIATRY IFC OUTPT PHYSICAL PROSTHETICS (OAK) THERAPY REQUEST (SAC)- ORTHOTICS (MTZ/OAK/RED/All Other) IFC NEUROLOGY (SAC) MENTAL HEALTH OUTPT (SAC) PROSTHETICS REQUEST - SHOES (SAC) IFC DERMATOLOGY (SAC) PHYSICAL THERAPY ANGER MANAGEMENT OUTPT (SAC) HBPC OUTPT SOCIAL (MCCL) WORK OUTPT (SAC) MENTAL HEALTH OUTPT (CHICO) PODIATRY OUTPT (MTZ) PODIATRY NON VA CARE OUTPT DGMC (RED) ORTHOPEDIC SURGERY PROSTHETICS REQUEST - DME (SAC) - SHOES (MTZ/OAK/RED/ALL OTHERS) TELEDERMATOLOGY IMAGING REQUEST - CONSULT OUTPT (RED) PROSTHETICS REQUEST - CUSTOM BRACE (MTZ) FEE (NON-EMERGENCY PHYSICAL GENERAL) THERAPY OUTPT (SAC) MENTAL HEALTH PHARMACY OUTPT (MTZ) PCMHI-PRIMARY CARE MENTAL HEALTH INTEGRATION CLINIC OUTPT (SAC) PODIATRY PAVE LEVEL 3 OUTPT (SAC) MH PHARMACOTHERAPY ECONSULT OUTPT NEUROLOGY EEG BEHAVIORAL OUTPT (SAC) HEALTH OUTPT (YUBA) PODIATRY OUTPT (CHICO) PHYSICAL THERAPY INPT (SAC) PHYSICAL THERAPY OUTPT (FF) IFC PHYSICAL THERAPY (MTZ) IFC FEE BASIS (NCHCS) NEUROLOGY TELEHEALTH EPILEPSY GENERAL EMG CLINIC OUTPT (SAC) OUTPT (SAC) (RED) SOCIAL PROSTHETICS WORK OUTPT REQUEST (CHICO) ORTHOPEDICS - ORTHOTICS (SAC) OUTPT (SAC) MENTAL HEALTH OUTPT (RED) PROSTHETICS PT PAIN OUTPT (MTZ) PM&R REQUEST PELVIC - PHYSICAL DME (MTZ) THERAPY OUTPT (SAC) TRANSPLANT PSYCHOLOGICAL EVALUATION OUTPT PM&R CHIROPRACTIC CARE OUTPT (MTZ) PHYSICAL THERAPY PROSTHETICS INPATIENT (CREC) PM&R OUTPT (SAC) IFC PHYSICAL THERAPY (OAK) REQUEST - DME (MI/OAK/FF) EYE CLINIC - DIABETES - GLASSES PHYSICAL - OUTPT THERAPY (MTZ) OUTPT (MTZ) PM&R PAIN GENERAL MANAGEMENT CLINIC OUTPT (MTZ) PROSTHETICS OCCUPATIONAL REQUEST THERAPY - POWER OUTPATIENT MOBILITY (ALL (SAC) SITES) M-KPAIN PT WOMENS HEALTH OUTPATIENT OCCUPATIONAL OUTPT SOCIAL WORK OUTPT (SAC) (MTZ) THERAPY/PHYSICAL THERAPY HOME CARE (OROVILLE) IFC OCCUPATIONAL THERAPY (MTZ) EYE CLINIC - DIABETES OUTPT (OAK) PM&R INPATIENT PROSTHETICS (CREC) HBPC REQUEST OT OUTPT - (MTZ) WHEELCHAIR LIFTS (ALL) SLEEP OCCUPATIONAL THERAPY OUTPT (MTZ) PROSTHETICS DISORDERS DIABETIC REQUEST OUTPT RETINOPATHY -(SAC) CPAP/BIPAP DIABETIC TELERETINAL SURVEILLANCE IMAGING OUTPT OUTPT (SAC) (SAC) HBPC PROSTHETICS PT HBPC OT WOMENS OUTPT REQUEST (SAC) HEALTH (SAC) OUTPATIENT - wheelchair (manual) (OAK) EYE CLINIC - DIABETES OUTPT (RED) SLEEP DISORDERS EQUIPMENT ONLY OUTPT (SAC) IFC OCCUPATIONAL PROSTHETICS THERAPY REQUEST (SAC) - DME (RED/CHICO) PM&R PHYSICAL MEDICINE CLINIC OUTPT (MTZ) ORTHOPEDIC OUTPT (OAK) PHYSICAL THERAPY OUTPT (RED) IFC EYE CLINIC EYE (MCCLELLAN) CLINIC - DIABETES OUTPT (SAC) PHYSICAL THERAPY OUTPT (OAK) EYE CLINIC EYE OUTPT DIABETIC OUTPT (SAC) (MCCLELLAN) RETINOPATHY SURVEILLANCE OUTPT OCCUPATIONAL (CHICO) THERAPY INPT (CREC) ORTHO/PT KNEE GROUP OUTPT (OAK) BLIND REHAB - VIST OUTPT OPTOMETRY OUTPT (SAC) OCCUPATIONAL THERAPY OUTPT (RED) OCCUPATIONAL THERAPY INPT (SAC) VASCULAR V-TEL OUTPT (RED) PROSTHETICS LOW REQUEST VISION AND - BLIND MOBILITY AIDS (ALL) OUTPT (MTZ) VASCULAR CLINIC OUTPT (SAC) IFC EYE (SAC) GERIATRIC OUTPT (SAC) IFC UROLOGY (SAC) INFECTIOUS DISEASE OUTPT (SAC) GENERAL SURGERY OUTPT (RED) UROLOGY OUTPT (RED) AGENT AGENT ORANGE/IONIZING ORANGE/IONIZING RAD OUTPT RAD OUTPT (MI/FF) (MTZ) ORTHOPEDIC OUTPT (RED) AUDIOLOGY OUTPT (RED) ORTHOPEDIC OUTPT (MTZ) INFECTIOUS DISEASE OUTPT (RED) UROLOGY OUTPT UROLOGY (OAK) OUTPT (MTZ) SURGERY BREAST GENERAL CLINIC SURGERY OUTPT (SAC) INPT (SAC) AUDIOLOGY OUTPT OUTPT (MCCLELLAN) (SAC) GENERAL SURGERY OUTPT (MTZ) AUDIOLOGY IFC AUDIOLOGY AUDIOLOGY OUTPT (CHICO) OUTPT (SAC)(MTZ) CARDIO/THORACIC OUTPT (SAC) HIV/AIDS OUTPT (MTZ) NEPHROLOGY OUTPT (SAC) PLASTIC ENT SURGERY (SAC) OUTPT IFC IFC ENT GENERAL (MTZ) (SAC) SURGERY (SAC) UROLOGY OUTPT (SAC) ENT OUTPT (CHICO) VASCULAR LAB/VASCULAR SURGERY OUTPT (MTZ) GENERAL PLASTIC SURGERY SPEECH OUTPT PATHOLOGY (SAC) ENT OUTPT (MTZ) - DEMENTIA OUTPT (MTZ) SPEECH PATHOLOGY OUTPT (SAC) (MTZ) PRIMARY CARE OUTPT (CHICO) PLASTIC SURGERY OUTPT (OAK) DYSPHAGIA OUTPT (SAC) VOICE OUTPT (MTZ) NURSING WOUND CARE SPEECH CLINIC OUTPT PATH GENERAL (SAC) CONSULT OUTPT (MTZ) GYNECOLOGY OUTPT (SAC) PRIMARY CARE OUTPT (OAK) PRIMARY CARE OUTPT (RED) DYSPHAGIA OUTPT (MTZ) PRIMARY PRIMARY CARE CARE OUTPT OUTPT (MCCL) (SAC) VASCULAR ABI OUTPT (MTZ) DERMATOLOGY OUTPT (MTZ) GENERAL SURGERY OUTPT (OAK) ENT OUTPT (OAK) PRIMARY CARE OUTPT (YUBA) ALLERGY OUTPT (MTZ) HCV OUTPT (MTZ) PRIMARY CARE OUTPT (FF) PRIMARY CARE OUTPT (MTZ) PRIMARY CARE OUTPT (MI) ALLERGY CLINIC OUTPT (SAC) INFECTIOUS DISEASE OUTPT (MTZ) INFECTIOUS DISEASE OUTPT (OAK) ONCOLOGY OUTPT (MTZ) MEDICAL ONCOLOGY OUTPT (SAC) IFC HEMATOLOGY/ONCOLOGY (SAC) EYE CLINIC OUTPT (OAK) PALLIATIVE CARE TEAM OUTPT (MTZ) PALLIATIVE CARE OUTPT (SAC) CREC HOSPICE CONSULT INPT CARDIOLOGY OUTPT (SAC) EYE CLINIC OUTPT (MTZ) DIETETICS MOVE OUTPT (CHICO) DIETETICS OUTPT (RED) DIETETICS OUTPT (SAC) NEUROLOGY EEG OUTPT (MTZ) DIETETICS MOVE OUTPT (FF) HOME TELEHEALTH MOVE!/WEIGHT MANAGEMENT OUTPT IFC NUTRITION (FAIRFIELD) DIETETICS OUTPT (MCCLELLAN) DIETETICS OUTPT (MTZ) IFC GASTROENTEROLOGY (SAC) LIVER CLINIC OUTPT (SAC) DIETETICS MOVE OUTPT (SAC) HOME TELEHEALTH (MTZ, FF, MI & OAK) WEIGHT LOSS PHARMACOTHERAPY (MTZ) DIETETICS MOVE OUTPT (MTZ) NUTRITION GROUP EDUCATION DIETETICS OUTPT OUTPT (FF) (OAK) DIETETICS MOVE GROUP OUTPT (YUBA) MOVE INDIVIDUAL M-OBESE (SAC) DIETETICS OUTPT (YUBA) DIETETICS MOVE OUTPT (NSAC) CARDIOLOGY OUTPT (RED) DIETETICS OUTPT (CHICO) CARDIOLOGY OUTPT (CHICO) EGD OUTPT (SAC) PFT OUTPT (MTZ) NUTRITION OUTPT (MI) DIAGNOSTIC PFT OXYGEN OUTPT (OAK) TESTING OUTPT IFC PULMONARY (MTZ) PFT OUTPT MHC (SAC) GENERAL CONSULT OUTPT (MI) IFC PULMONARY (SAC) GASTROENTEROLOGY OUTPT (RED) PULMONARY OUTPT (SAC) PTSD OUTPT (MTZ) PFT FUTURE CARE (MTZ) GENERAL ENDOCRINOLOGY OUTPT (MTZ) ANTICOAGULATION OUTPT (YUBA) PULMONARY GENERAL OUTPT (MTZ) PULMONARY GENERAL OUTPT (OAK) ANTICOAGULATION OUTPT (MCCLELLAN) MENTAL HEALTH OUTPT (MTZ) IFC SLEEP DISORDER (SAC) HEPATOLOGY/CD CHART CONSULT OUTPT EGD OUTPT (RED) COLONOSCOPY IFC LIVER CLINIC SCREENING (SAC) (SAC) NEUROLOGY CPAP OUTPT (MTZ) GASTROENTEROLOGY COLONOSCOPY OUTPT OUTPT (SAC) (SAC) NEUROLOGY SLEEP SLEEP DISORDERS APNEA SCREENING PROCEDURES OUTPT OUTPT (MTZ) (SAC) COLONOSCOPY OUTPT (RED) PCMHI-PRIMARY CARE MENTAL HEALTH INTEGRATION CLINIC OUTPT (OAK) MENTAL HEALTH OUTPT (FAIRFIELD) Putting it Together: Components-I

11 EYE CLINIC OUTPT (MTZ) DIETETICS MOVE OUTPT (CHICO) NEUROLOGY EEG OUTPT (MTZ) LIVER CLINIC OUTPT (SAC) IFC NUTRITION (FAIRFIELD) DIETETICS OUTPT (YUBA) DIETETICS OUTPT (RED) HOME TELEHEALTH MOVE!/WEIGHT MANAGEMENT OUTPT DIETETICS MOVE OUTPT (SAC) DIETETICS MOVE GROUP OUTPT (YUBA) MOVE INDIVIDUAL M-OBESE (SAC) IFC GASTROENTEROLOGY (SAC) EGD OUTPT (SAC) NUTRITION GROUP EDUCATION OUTPT (FF) DIETETICS OUTPT (OAK) PFT OUTPT (OAK) GASTROENTEROLOGY OUTPT (RED) DIETETICS MOVE OUTPT (FF) DIETETICS MOVE OUTPT (MTZ) CARDIOLOGY OUTPT (RED) CARDIOLOGY OUTPT (CHICO) DIETETICS OUTPT (MCCLELLAN) NUTRITION OUTPT (MI) DIAGNOSTIC OXYGEN TESTING OUTPT IFC PULMONARY (SAC) HOME TELEHEALTH (MTZ, FF, MI & OAK) WEIGHT LOSS PHARMACOTHERAPY (MTZ) IFC PULMONARY (MTZ) PTSD OUTPT (MTZ) PFT FUTURE CARE (MTZ) Putting it Together: Components-II DIETETICS OUTPT (SAC) DIETETICS OUTPT (CHICO) DIETETICS OUTPT (MTZ) DIETETICS MOVE OUTPT (NSAC) PFT OUTPT (MTZ) PULMONARY GENERAL OUTPT (MTZ) PULMONARY OUTPT (SAC) PFT OUTPT (SAC) PULMONARY GENERAL OUTPT (OAK)

12 Looking Across the Board

13 Function Follows Form 100 seattle_ PaloAlto_640 mnpls_618 strongly_cc_size portland_648 sacramento_ boise_531 wallawalla_687 durham_558 SF_ time

14 Testing Strategies for Improving Access to Care simulation

15 Function Follows Form, Preliminary Results 1.00 reduction of wait time reduction in total wait time natural traingles pagerank max common neighbour max wt 1 max wt # of clinics merged

16 Complexity Science for Access to Care Summary

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