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Barriers to adequate healthcare in rural areas remain a grand challenge for local healthcare systems. In addition to patients' travel burdens, lack of health insurance, and lower health literacy, rural healthcare systems also experience significant resource shortages, as well as issues with recruitment and retention of healthcare providers, particularly specialists. These factors combined result in complex change management-focused challenges for rural healthcare systems. Change management initiatives are often resource intensive, and in rural health organizations already strapped for resources, it may be particularly risky to embark on change initiatives. One way to address these change management concerns is by leveraging socio-technical simulation models to estimate techno-economic feasibility (e.g., is it technologically feasible, and is it economical?) as well as socio-utility feasibility (e.g., how will the changes be utilized?). We present a framework for how healthcare systems can integrate modeling and simulation techniques from systems engineering into a change management process. Modeling and simulation are particularly useful for investigating the amount of uncertainty about potential outcomes, guiding decision-making that considers different scenarios, and validating theories to determine if they accurately reflect real-life processes. The results of these simulations can be integrated into critical change management recommendations related to developing readiness for change and addressing resistance to change. As part of our integration, we present a case study showcasing how simulation modeling has been used to determine feasibility and potential resistance to change considerations for implementing a mobile radiation oncology unit. Recommendations and implications are discussed.

The traditional predictor of technical inefficiency proposed by Jondrow, Lovell, Materov, and Schmidt (1982) is a conditional expectation. This chapter explores whether, and by how much, the predictor can be improved by using auxiliary information in the conditioning set. It considers two types of stochastic frontier models. The first type is a panel data model where composed errors from past and future time periods contain information about contemporaneous technical inefficiency. The second type is when the stochastic frontier model is augmented by input ratio equations in which allocative inefficiency is correlated with technical inefficiency. Compared to the standard kernel-smoothing estimator, a newer estimator based on a local linear random forest helps mitigate the curse of dimensionality when the conditioning set is large. Besides numerous simulations, there is an illustrative empirical example.

Diffusion studies investigate the propagation of behavior, attitudes, or beliefs across a networked population. Some behavior is binary, e.g., whether or not to install solar panels, while other behavior is continuous, e.g., wastefulness with plastic. Similarly, attitudes and beliefs often allow nuance, but can become practically binary in polarized environments. We argue that this property of behavior and attitudes – whether they are binary or continuous – should critically affect whether a population becomes homogenous in its adoption of that behavior. Models show that only continuous behavior converges across a network. Specifically, binary behavior allows local convergence, as multiple states can be local majorities. Continuous behavior becomes uniform across the network through a logic of communicating vessels. We present a model comparing the diffusion of both types of behavior and report on a laboratory experiment that tests it. In the model, actors have to distribute an investment over two options, while a majority receives information that points to the optimal option and a minority receives misguided information that points toward the other option. We predict that when adjacent persons receive misguided information this can hinder convergence toward optimal investment behavior in small networked groups, especially when subjects cannot split their investment, i.e., binary choice. Results falsify our theoretical predictions: Although investment decisions are significantly negatively affected by local majorities only in the binary condition, this difference with the continuous condition is not itself significant. Binary and continuous behavior therefore achieve comparable incidences of optimal investment in the experiment. The failure of the theoretical predictions appears due to a substantial level of error in decision-making, which prevents local majorities from locking in on a suboptimal behavior.

This chapter discussed the implementation of the digital twin (DT) idea into construction. Through the adoption of DTs into construction practices, construction professionals have been able to project an identical virtual concept of sections of the project execution right from the onset. In the introduction and discussing of its origin, the DT was further assessed about its applications in construction beneficial in enhancing project delivery. Other sections like barriers, drivers and benefits of the DT in construction summarised what this chapter represents in terms of discussing the new involvement of digital tools in construction execution, management and sustainability.

A semiparametric stochastic frontier model is proposed for panel data, incorporating several flexible features. First, a constant elasticity of substitution (CES) production frontier is considered without log-transformation to prevent induced non-negligible estimation bias. Second, the model flexibility is improved via semiparameterization, where the technology is an unknown function of a set of environment variables. The technology function accounts for latent heterogeneity across individual units, which can be freely correlated with inputs, environment variables, and/or inefficiency determinants. Furthermore, the technology function incorporates a single-index structure to circumvent the curse of dimensionality. Third, distributional assumptions are eschewed on both stochastic noise and inefficiency for model identification. Instead, only the conditional mean of the inefficiency is assumed, which depends on related determinants with a wide range of choice, via a positive parametric function. As a result, technical efficiency is constructed without relying on an assumed distribution on composite error. The model provides flexible structures on both the production frontier and inefficiency, thereby alleviating the risk of model misspecification in production and efficiency analysis. The estimator involves a series based nonlinear least squares estimation for the unknown parameters and a kernel based local estimation for the technology function. Promising finite-sample performance is demonstrated through simulations, and the model is applied to investigate productive efficiency among OECD countries from 1970–2019.