Design of Patient Visit Itineraries in Tandem Systems

Manufacturing & Service Operations Management (forthcoming)

49 Pages Posted: 22 Mar 2023 Last revised: 27 Feb 2024

See all articles by Nan Liu

Nan Liu

Boston College - Carroll School of Management

Guohua Wan

Shanghai Jiao Tong University (SJTU) - Antai College of Economics and Management

Shan Wang

Sun Yat-sen University

Date Written: February 20, 2024

Abstract

Problem definition: Multi-stage service is common in healthcare. One widely adopted approach to manage patient visits in multi-stage service is to provide patients with visit itineraries, which specify personalized appointment time for each patient at each service stage. We study how to design such visit itineraries.

Methodology/results: We develop the first optimization modeling framework to provide each patient a personalized visit itinerary in a tandem (healthcare) service system. Due to interdependencies among stages, our model loses those elegant properties (e.g., L-convexity and submodularity) often utilized to solve the classic single-stage models. To address these challenges, we develop two original reformulations. One is directly amenable to off-the-shelf optimization software and the other is a concave minimization problem over a polyhedron shown to have neat structural properties, based on which we develop efficient solution algorithms. In addition to these exact solution approaches, we propose an approximation approach with a provable optimality bound and numerically validated performance to serve as an easy-to-implement heuristic. A case study populated by data from the Dana-Farber Cancer Institute shows that our approach makes a remarkable 28% cost reduction over practice on average.

Managerial implications: Common approaches used in practice are based on simple adjustments to schedules generated by single-stage models, often assuming deterministic service times. Whereas such approaches are intuitive and take advantage of existing knowledge on single-stage models, they can lead to significant loss of operational efficiency in managing multi-stage services. A well-designed patient visit itinerary which carefully addresses the interdependencies among stages can significantly improve patient experience and provider utilization.

Note:
Funding Information: Guohua Wan is supported in part by the National Natural Science Foundation of China [Grant 71931008. Shan Wang is supported in part by the National Natural Science Foundation of China [Grant 72001220]. Nan Liu has no funding information to report

Conflict of Interests: We declare no competing interest.

Keywords: Healthcare Operations Management, Patient Acheduling, Tandem Systems, Optimization

JEL Classification: C44, C61, M10, I10

Suggested Citation

Liu, Nan and Wan, Guohua and Wang, Shan, Design of Patient Visit Itineraries in Tandem Systems (February 20, 2024). Manufacturing & Service Operations Management (forthcoming), Available at SSRN: https://ssrn.com/abstract=4377643 or http://dx.doi.org/10.2139/ssrn.4377643

Nan Liu (Contact Author)

Boston College - Carroll School of Management ( email )

140 Commonwealth Avenue
Chestnut Hill, MA 02467
United States

HOME PAGE: http://sites.google.com/site/nanliuacademic/

Guohua Wan

Shanghai Jiao Tong University (SJTU) - Antai College of Economics and Management ( email )

1954 Huashan Road
ACEM, Jiao Tong University
Xuhui District, Shanghai 200030
China

Shan Wang

Sun Yat-sen University ( email )

Haizhu District
China
510275 (Fax)

Do you have a job opening that you would like to promote on SSRN?

Paper statistics

Downloads
93
Abstract Views
365
Rank
527,782
PlumX Metrics