Cherry-picking and its Negative Spillover Effect on System Service Level: Evidence from a Radiology Workflow Platform

33 Pages Posted: 16 Nov 2018 Last revised: 28 Jun 2019

See all articles by Timothy Chan

Timothy Chan

University of Toronto, Mechanical and Industrial Engineering Department

Nicholas Howard

Assurance IQ

Saman Lagzi

University of Toronto - Rotman School of Management

Gonzalo Romero

University of Toronto - Rotman School of Management

Date Written: October 26, 2018

Abstract

Piece-rate compensation schemes, where workers are paid for each completed task regardless of the time spent on it, are common in practice. However, imbalances between pay and workload of different tasks could result in cherry-picking of tasks deemed to have high pay relative to workload. Using a large dataset from a radiology workflow platform that connects off-site radiologists with hospitals, we empirically investigate whether radiologists cherry-pick tasks with high pay-to-workload, and if cherry-picking has a negative impact on system service level. In the platform we study, radiologists have discretion to select tasks from a common pool and the service level is characterized by meeting priority-specific turnaround time targets. We show that turnaround time and likelihood of delay is monotonically decreasing in pay-to-workload. More importantly, we also show a spillover effect. Namely, that cherry-picking of low priority tasks can lead to longer turnaround times for higher priority tasks, resulting in delays and their accumulation in the system. Our results suggest that organizations where workers have task discretion from a common pool need to carefully align their piece-rate compensation scheme with the workload of each task. Imbalances may lead to a degradation in system service level provided to time-sensitive customers.

Keywords: Health Care Management, Empirical Research, Incentives and Contracting

Suggested Citation

Chan, Timothy and Howard, Nicholas and Lagzi, Saman and Romero, Gonzalo, Cherry-picking and its Negative Spillover Effect on System Service Level: Evidence from a Radiology Workflow Platform (October 26, 2018). Available at SSRN: https://ssrn.com/abstract=3273494 or http://dx.doi.org/10.2139/ssrn.3273494

Timothy Chan

University of Toronto, Mechanical and Industrial Engineering Department ( email )

Toronto
Canada

Nicholas Howard

Assurance IQ ( email )

Saman Lagzi

University of Toronto - Rotman School of Management ( email )

105 St. George Street
Toronto, Ontario M5S 3E6 M5S1S4
Canada

Gonzalo Romero (Contact Author)

University of Toronto - Rotman School of Management ( email )

105 St. George Street
Toronto, Ontario M5S 3E6 M5S1S4
Canada

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