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

电子出诊是一种替代传统的诊所出诊的医疗服务，通过安全的病人-医生通信成为可能，有可能改善获得护理的机会，提高提供者的效率和病人的满意度。对于采用电子就诊策略的诊所，出现了一些运营挑战。例如，如何确定最佳的人员配备水平，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。了解这些运作动态有助于确定可实施的缓解战略。这个赠款机会与行业学术联络（GOALI）研究项目将通过与院长卫生系统的合作，并利用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，以改善患者的可及性和护理质量。如果成功，这项研究的结果将提供数学模型，以研究复杂的初级保健提供过程，电子访问作为综合卫生系统（如Dean Health）提供的服务组合的一部分。基于对基层医疗运作的随机过程的分析研究，网络分析将用于模拟病人流量和诊所运作。研究小组将开始在诊所层面的病人流量分析，然后分析在办公室访问的工作流程。通过解决他们的相互作用，并考虑有限的可用性和多个任务的供应商通过递归算法，研究人员将研究最佳的人员配置，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.