GOALI: Improving Access to Primary Care through E-Visits: Theory and Applications

电子就诊是一种替代传统医疗服务的办公室就诊方式，通过安全的医患沟通成为可能，它有可能改善获得护理的机会，并提高提供者的效率和患者的满意度。对于采用电子访问策略的诊所来说，出现了几个操作挑战。例如，如何确定最佳人员配置水平，如何在不同类型的访问之间分配提供者的时间，如何安排办公室和电子访问请求，以及如何确定系统瓶颈。了解这些业务动态有助于确定可实施的缓解战略。这个GOALI研究项目将通过与Dean Health系统的合作获得信息，并利用Dean Health作为测试案例进行验证。这项工作的成功完成将为初级保健从业者和管理人员提供严格的量化工具，以改善患者的接触和护理质量。如果成功，这项研究的结果将提供数学模型，以研究通过电子访问作为综合卫生系统(如Dean Health)提供的一系列服务的复杂初级保健提供过程。基于对初级保健操作背后的随机过程的分析调查，将使用网络分析来对患者流和临床操作进行建模。研究小组将从诊所层面的病人流程分析开始，然后分析办公室访问中的工作流程。通过解决它们之间的相互作用，并通过递归算法考虑供应商的有限可用性和多任务，研究人员将研究最优人员配备、资源分配和工作流调度问题。将进行瓶颈分析，以确定重大制约因素，并制定缓解这些制约因素的战略。

E-visits, an alternative to the traditional office visit for medical services made possible by secure patient-physician communication, has the potential to improve access to care, and increase provider efficiency and patient satisfaction. For clinics that adopt e-visit strategy, several operational challenges arise. For example, how to determine the optimal staffing levels, how to allocate providers' time across different types of visits, how to schedule both office and e-visit requests, and how to identify system bottlenecks. An understanding of these operational dynamics can help in the identification of implementable mitigation strategies. This Grant Opportunity for Academic Liaison with Industry (GOALI) research project will be informed by collaboration with the Dean Health System and validated by utilizing Dean Health as a test case. The successful completion of this work will provide rigorous quantitative tools for primary care practitioners and administrators to improve patient access and quality of care.If successful, the results of this research will provide mathematical model to study the complex primary care delivery process with e-visits as part of a mix of services offered by comprehensive health systems such as Dean Health. Based on analytical investigation of the stochastic processes underlying primary care operations, network analyses will be used to model the patient flow and clinic operations. The research team will begin with analyses of patient flow at the clinic level and then analyze work flow within an office visit. By addressing their interactions and considering the limited availability and multiple tasks of providers through recursive algorithms, researchers will investigate optimal staffing, resource allocation, and workflow scheduling problems. Bottleneck analysis will be performed to identify significant constraints and to develop strategies to mitigate them.