An Operational Framework for the Adoption and Integration of New Diagnostic Tests

Production and Operations Management

72 Pages Posted: 6 Aug 2019 Last revised: 12 Aug 2020

See all articles by Pengyi Shi

Pengyi Shi

Purdue University - Krannert School of Management

Jonathan Helm

Indiana University - Kelley School of Business - Department of Operation & Decision Technologies

H. Sebastian Heese

North Carolina State University - Poole College of Management

Alice Mitchel

Indiana University Purdue University Indianapolis (IUPUI) - Indiana University School of Medicine

Date Written: May 27, 2020

Abstract

The gap between medical research on diagnostic testing and clinical workflow can lead to rejection of valuable medical research in a busy clinical environment due to increased workloads, or rejection of medical research in the lab that may be valuable in practice due to a misunderstanding of the system-level benefits of the new test. This has implications for research organizations, diagnostic test manufacturers, and hospital managers. To bridge this gap, we develop a Markov Decision Process (MDP) from which we create “adoption regions” that specify the combination of test characteristics medical research must achieve for the test to be feasible for adoption in practice. To address the curse of dimensionality from patient risk stratification, we develop a decomposition heuristic along with structural properties that shed light on which patients and when a new diagnostic test should be used.

In a case study of a partner Emergency Department, we show that the conventional myopic medical criterion can lead to poor decision making in both research development and clinical practice. This myopic approach can lead to overvaluing or undervaluing new medical research. This mismatch is accentuated when a simple (current) policy is used to integrate research into the clinical environment compared with our MDP's policy – poor implementation of a new test can also lead to unnecessary rejection. Our framework provides easily interpretable guidelines for medical research development and clinical adoption decisions that can guide medical research as to which test characteristics to focus on to improve chances of adoption.

Keywords: Diagnostic Tests, Emergency Department, MDP, Decomposition Heurstic

Suggested Citation

Shi, Pengyi and Helm, Jonathan and Heese, H. Sebastian and Mitchel, Alice, An Operational Framework for the Adoption and Integration of New Diagnostic Tests (May 27, 2020). Production and Operations Management, Available at SSRN: https://ssrn.com/abstract=3430980 or http://dx.doi.org/10.2139/ssrn.3430980

Pengyi Shi (Contact Author)

Purdue University - Krannert School of Management ( email )

1310 Krannert Building
West Lafayette, IN 47907-1310
United States

Jonathan Helm

Indiana University - Kelley School of Business - Department of Operation & Decision Technologies ( email )

Business 670
1309 E. Tenth Street
Bloomington, IN 47401
United States

H. Sebastian Heese

North Carolina State University - Poole College of Management ( email )

Hillsborough Street
Raleigh, NC 27695-8614
United States

Alice Mitchel

Indiana University Purdue University Indianapolis (IUPUI) - Indiana University School of Medicine ( email )

Riley Hospital for Children
705 Riley Hospital Dr.
Indianapolis, IN 46202
United States

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