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Using machine learning techniques to reduce uncertainty for outpatient appointment scheduling practices in outpatient clinics

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  • Golmohammadi, Davood
  • Zhao, Lingyu
  • Dreyfus, David

Abstract

Most outpatient clinics apply deterministic block scheduling policies to patient visits even though patients utilize varying amounts of time, leaving patients, operations managers, and clinicians frustrated because patients and physicians are kept waiting. This paper offers a decision-making model for schedulers so that the service time needed for a specific patient can be predicted to allow outpatient clinics to schedule more effectively. We employed an analytical approach, with a data driven methodology consisting of two phases. In phase one, machine learning algorithms are used to predict service time for outpatient clinics servicing patients with various characteristics. This study supports the understanding of factors that impact service time. A large dataset from an outpatient clinic is obtained and used in the analyses. Four dominant data mining models are developed to predict service time, and their performances are compared: neural networks (NNs), generalized linear model (GLM), linear regression (LR), and support vector regression (SVM). The NN models performed the best. The reason for visiting the doctor and patient type are identified as the primary characteristics to aid in predicting patient service time. We compare the proposed NN models with commonly used scheduling policies in practice in the second phase via simulation modeling and analysis. This paper contributes to the literature in four ways. First, we obtained a large dataset and extracted quality data to test the prediction accuracy of multiple models to determine which one improves scheduling the best. Second, patient characteristics are identified through machine learning modeling and sensitivity analysis to understand which ones are most important for service time prediction accuracy. Third, we analyzed the performance of standard scheduling policies used in clinics. Lastly, we provide clinical policy implications and recommendations that will provide insights and support appointment scheduling decisions.

Suggested Citation

  • Golmohammadi, Davood & Zhao, Lingyu & Dreyfus, David, 2023. "Using machine learning techniques to reduce uncertainty for outpatient appointment scheduling practices in outpatient clinics," Omega, Elsevier, vol. 120(C).
  • Handle: RePEc:eee:jomega:v:120:y:2023:i:c:s0305048323000713
    DOI: 10.1016/j.omega.2023.102907
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    1. M. M. Malik & S. Abdallah & M. Ala’raj, 2018. "Data mining and predictive analytics applications for the delivery of healthcare services: a systematic literature review," Annals of Operations Research, Springer, vol. 270(1), pages 287-312, November.
    2. Peter A. Salzarulo & Stephen Mahar & Sachin Modi, 2016. "Beyond Patient Classification: Using Individual Patient Characteristics in Appointment Scheduling," Production and Operations Management, Production and Operations Management Society, vol. 25(6), pages 1056-1072, June.
    3. Santanu Chakraborty & Kumar Muthuraman & Mark Lawley, 2010. "Sequential clinical scheduling with patient no-shows and general service time distributions," IISE Transactions, Taylor & Francis Journals, vol. 42(5), pages 354-366.
    4. Harris, Shannon L. & May, Jerrold H. & Vargas, Luis G., 2016. "Predictive analytics model for healthcare planning and scheduling," European Journal of Operational Research, Elsevier, vol. 253(1), pages 121-131.
    5. Denise L. White & Elham Torabi & Craig M. Froehle, 2017. "Ice-Breaker vs. Standalone: Comparing Alternative Workflow Modes of Mid-level Care Providers," Production and Operations Management, Production and Operations Management Society, vol. 26(11), pages 2089-2106, November.
    6. Simsek, Serhat & Dag, Ali & Tiahrt, Thomas & Oztekin, Asil, 2021. "A Bayesian Belief Network-based probabilistic mechanism to determine patient no-show risk categories," Omega, Elsevier, vol. 100(C).
    7. Deng, Yewen & Li, Na & Jiang, Zhibin & Xie, Xiaoqing & Kong, Nan, 2021. "Optimal differential subsidy policy design for a workload-imbalanced outpatient care network," Omega, Elsevier, vol. 99(C).
    8. Diwas S. Kc & Christian Terwiesch, 2009. "Impact of Workload on Service Time and Patient Safety: An Econometric Analysis of Hospital Operations," Management Science, INFORMS, vol. 55(9), pages 1486-1498, September.
    9. Yang, Liu & Millstein, Mitch A. & Campbell, James F., 2022. "Unlocking cost savings hidden in hospital tier contracts," Omega, Elsevier, vol. 113(C).
    10. Wang, Haifeng & Zheng, Bichen & Yoon, Sang Won & Ko, Hoo Sang, 2018. "A support vector machine-based ensemble algorithm for breast cancer diagnosis," European Journal of Operational Research, Elsevier, vol. 267(2), pages 687-699.
    11. Dina Bentayeb & Nadia Lahrichi & Louis-Martin Rousseau, 2019. "Patient scheduling based on a service-time prediction model: a data-driven study for a radiotherapy center," Health Care Management Science, Springer, vol. 22(4), pages 768-782, December.
    12. Claire Senot & Aravind Chandrasekaran & Peter T. Ward & Anita L. Tucker & Susan D. Moffatt-Bruce, 2016. "The Impact of Combining Conformance and Experiential Quality on Hospitals’ Readmissions and Cost Performance," Management Science, INFORMS, vol. 62(3), pages 829-848, March.
    13. Nikos S. Thomaidis & Georgios D. Dounias, 2012. "A comparison of statistical tests for the adequacy of a neural network regression model," Quantitative Finance, Taylor & Francis Journals, vol. 12(3), pages 437-449, October.
    14. Gupta, Jatinder N. D. & Sexton, Randall S., 1999. "Comparing backpropagation with a genetic algorithm for neural network training," Omega, Elsevier, vol. 27(6), pages 679-684, December.
    15. Gréanne Leeftink & Gabriela Martinez & Erwin W. Hans & Mustafa Y. Sir & Kalyan S. Pasupathy, 2022. "Optimising the booking horizon in healthcare clinics considering no-shows and cancellations," International Journal of Production Research, Taylor & Francis Journals, vol. 60(10), pages 3201-3218, May.
    16. Xiao Yu & Armagan Bayram, 2021. "Managing capacity for virtual and office appointments in chronic care," Health Care Management Science, Springer, vol. 24(4), pages 742-767, December.
    17. Marynissen, Joren & Demeulemeester, Erik, 2019. "Literature review on multi-appointment scheduling problems in hospitals," European Journal of Operational Research, Elsevier, vol. 272(2), pages 407-419.
    18. Michelle Alvarado & Lewis Ntaimo, 2018. "Chemotherapy appointment scheduling under uncertainty using mean-risk stochastic integer programming," Health Care Management Science, Springer, vol. 21(1), pages 87-104, March.
    19. Seung Jun Lee & Gregory R. Heim & Chelliah Sriskandarajah & Yunxia Zhu, 2018. "Outpatient Appointment Block Scheduling Under Patient Heterogeneity and Patient No†Shows," Production and Operations Management, Production and Operations Management Society, vol. 27(1), pages 28-48, January.
    20. Hyndman, Rob J. & Koehler, Anne B., 2006. "Another look at measures of forecast accuracy," International Journal of Forecasting, Elsevier, vol. 22(4), pages 679-688.
    21. Rohleder, Thomas R. & Klassen, Kenneth J., 2000. "Using client-variance information to improve dynamic appointment scheduling performance," Omega, Elsevier, vol. 28(3), pages 293-302, June.
    22. Ayten Turkcan & Lynn Nuti & Po-Ching DeLaurentis & Zhiyi Tian & Joanne Daggy & Lingsong Zhang & Mark Lawley & Laura Sands, 2013. "No-Show Modeling for Adult Ambulatory Clinics," International Series in Operations Research & Management Science, in: Brian T. Denton (ed.), Handbook of Healthcare Operations Management, edition 127, chapter 0, pages 251-288, Springer.
    23. Kenneth J. Klassen & Reena Yoogalingam, 2019. "Appointment scheduling in multi-stage outpatient clinics," Health Care Management Science, Springer, vol. 22(2), pages 229-244, June.
    24. Ahmadi-Javid, Amir & Jalali, Zahra & Klassen, Kenneth J, 2017. "Outpatient appointment systems in healthcare: A review of optimization studies," European Journal of Operational Research, Elsevier, vol. 258(1), pages 3-34.
    25. Tohidi, Mohammad & Kazemi Zanjani, Masoumeh & Contreras, Ivan, 2021. "A physician planning framework for polyclinics under uncertainty," Omega, Elsevier, vol. 101(C).
    26. K J Glowacka & R M Henry & J H May, 2009. "A hybrid data mining/simulation approach for modelling outpatient no-shows in clinic scheduling," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 60(8), pages 1056-1068, August.
    27. Arendt, Florian & Forrai, Michaela & Findl, Oliver, 2020. "Dealing with negative reviews on physician-rating websites: An experimental test of how physicians can prevent reputational damage via effective response strategies," Social Science & Medicine, Elsevier, vol. 266(C).
    28. Samorani, Michele & LaGanga, Linda R., 2015. "Outpatient appointment scheduling given individual day-dependent no-show predictions," European Journal of Operational Research, Elsevier, vol. 240(1), pages 245-257.
    29. Golmohammadi, Davood, 2011. "Neural network application for fuzzy multi-criteria decision making problems," International Journal of Production Economics, Elsevier, vol. 131(2), pages 490-504, June.
    30. John C. Hershey & Elliott N. Weiss & Morris A. Cohen, 1981. "A Stochastic Service Network Model with Application to Hospital Facilities," Operations Research, INFORMS, vol. 29(1), pages 1-22, February.
    31. Nan Liu & Stacey R. Finkelstein & Margaret E. Kruk & David Rosenthal, 2018. "When Waiting to See a Doctor Is Less Irritating: Understanding Patient Preferences and Choice Behavior in Appointment Scheduling," Management Science, INFORMS, vol. 64(5), pages 1975-1996, May.
    32. Pan, Xingwei & Geng, Na & Xie, Xiaolan, 2021. "Appointment scheduling and real-time sequencing strategies for patient unpunctuality," European Journal of Operational Research, Elsevier, vol. 295(1), pages 246-260.
    33. Mona Issabakhsh & Seokgi Lee & Hyojung Kang, 2021. "Scheduling patient appointment in an infusion center: a mixed integer robust optimization approach," Health Care Management Science, Springer, vol. 24(1), pages 117-139, March.
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