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

电子就诊是通过安全的医患通信实现的传统诊所就诊的替代方案，有可能改善获得护理的机会，提高提供者效率和患者满意度。对于采用电子就诊策略的诊所来说，会出现一些运营方面的挑战。例如，如何确定最佳的人员配置级别，如何在不同类型的访问中分配提供者的时间，如何安排办公室和电子访问请求，以及如何识别系统瓶颈。了解这些业务动态有助于确定可实施的缓解战略。该学术与行业联络资助机会（GOALI）研究项目将与院长健康系统合作，并通过院长健康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人员和管理人员提供严格的定量工具，以改善患者的获取和护理质量。如果成功，这项研究的结果将为研究复杂的初级保健提供过程提供数学模型，电子就诊是院长健康等综合卫生系统提供的混合服务的一部分。基于对初级保健操作的随机过程的分析调查，网络分析将用于模拟病人流和诊所操作。研究小组将从分析临床层面的病人流程开始，然后分析办公室访问的工作流程。通过解决他们之间的相互作用，并考虑到通过递归算法的有限可用性和提供者的多个任务，研究人员将研究最佳人员配置，资源分配和工作流调度问题。将进行瓶颈分析，以确定重要的制约因素，并制定缓解这些制约因素的策略。

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.