EURO 2024 Copenhagen
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431. Rationing by Waiting Time for Outpatient Clinical Appointment Workflows via Novel Patient Access Workflows

Invited abstract in session TB-15: Appointment planning, stream OR in Health Services (ORAHS).

Tuesday, 10:30-12:00
Room: 18 (building: 116)

Authors (first author is the speaker)

1. Esma Gel
College of Business, University of Nebraska-Lincoln
2. Derya Kilinc
Mayo Clinic Rochester
3. Mustafa Sir
Amazon
4. Kalyan Pasupathy
Kern Center for the Science of Health Care Delivery, Mayo College of Medicine

Abstract

Increasing demand for healthcare has necessitated the need to ration care resources by prioritization. While such prioritization is effectively implemented in many settings, their use in appointment workflows have been impossible since appointments are provided on a first-come-first-serve basis. We present a novel approach to enable rationing by waiting time in outpatient settings offering clinical appointments. Under the Time Windows Access Protocol (TWAP), scheduling agents are provided a distinct contiguous portion of the booking horizon to search for an available appointment upon an appointment request at from a priority class. Patients with requests from high priority classes (i.e., urgent, complex, high match with provider services) are uniformly incentivized to book and attend appointments with low wait offers, while sufficient dilution of requests from lower priority classes are induced with higher (but still, medically safe) levels of wait. We present a computationally efficient methodology to determine the optimal time windows for given delay-dependent appointment realization probabilities that reflect patients' delay tolerance (i.e., sensitivity to wait). We demonstrate the potential use and effectiveness of TWAP for new patient appointment requests under different rationing schemes (i.e., the desired patient mix) using simulations as well as real-life transactional data from a leading academic medical center.

Keywords

Status: accepted

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