Next Generation Appointment Systems

下一代预约系统

• 批准号: 6582072
• 负责人: DIWAKAR GUPTA
• 金额: $ 10万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-30 至 2005-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6582072
• 关键词: Internet; automated health care system; clinical research; computer simulation; health care model; health care policy; health care service organization; health services research tag; human data; human subject; interview; mathematical model; medical appointment; medical records; method development; model design /development; patient care management; primary care physician; statistics /biometry

DESCRIPTION (provided by applicant): As the first point of contact between patients and health service providers, appointments systems are important determinants of overall patient satisfaction. They can increase the utilization of resources, match workload to available capacity, and smooth the flow of patients. Yet, important policy decisions concerning the management of appointment systems are made without the benefit of decision-support tools. For example, some service providers are adopting a same-day appointments system. Under this scheme, physicians are encouraged to clear their backlog and to attempt to see all those patients who call for appointments the same day. While such a system has been successful in preliminary implementation at several large clinics, its long-term success is not guaranteed. More importantly, there is not enough research in the literature to provide an understanding of its success factors, conditions under which it may falter, and how it could be monitored and improved. The overall goal of this research project is to fill this gap by developing a suite of analytical tools that can be used to set policy parameters. Specifically, the hypotheses that will be addressed in this project are as follows: 1. a physician whose work schedule is less irregular, who has a more stable work schedule, should have a smaller target number of open slots; 2. more homogeneous work-day schedules (with fewer non-standard appointment lengths) are better suited for same-day appointments; 3. there exists a threshold ratio of demand to capacity above which the ability to successfully implement a same-day appointment system is seriously jeopardized; 4. mathematical models can help identify optimal decision rules governing timing of open slots, release of protected slots, and double-booking. The project goals will be achieved via a multi-pronged approach. Data from a clinic that has implemented a same-day appointments system will be used to test the above hypotheses, and to estimate parameter values. At the same time, mathematical- and computer-simulation models will be developed to evaluate the robustness of the existing management practices and to identify optimal decision rules. This study will impact practice in two ways: 1) it will allow policy makers to use a scientific approach to set policy parameters; and 2) it will provide a framework for building of the next generation of computer-assisted appointment systems that allow patients to set appointments via the Internet.

描述(申请人提供)：预约系统作为患者和医疗服务提供者之间的第一个接触点，是患者总体满意度的重要决定因素。它们可以提高资源利用率，使工作量与可用容量相匹配，并畅通患者流动。然而，与任命制度管理有关的重要决策是在没有决策支持工具的情况下做出的。例如，一些服务提供商正在采用当天预约制度。根据这项计划，医生被鼓励清理他们的积压，并尝试在同一天为所有打电话预约的患者看病。虽然这种系统已经在几家大型诊所初步实施成功，但它的长期成功并不能得到保证。更重要的是，文献中没有足够的研究来提供对其成功因素的理解，在哪些条件下它可能会摇摇欲坠，以及如何对其进行监控和改进。这一研究项目的总体目标是通过开发一套可用于设定政策参数的分析工具来填补这一空白。具体地说，本项目将涉及的假设如下： 1.工作时间安排不那么不规律，工作时间安排更稳定的医生，应该有较少的目标开放时段数量； 2.工作日时间安排更同质(非标准预约时间更短)更适合当天预约； 3.存在需求与能力的阈值比率，超过该比率，成功实施当天预约制度的能力将受到严重威胁； 4.数学模型可帮助确定关于开放时段、释放受保护时段和重复预订的最佳决策规则。 项目目标将通过多管齐下的方法实现。来自一家实施当日预约制度的诊所的数据将被用来检验上述假设，并估计参数值。同时，将开发数学和计算机模拟模型，以评估现有管理做法的稳健性，并确定最佳决策规则。这项研究将在两个方面对实践产生影响：1)它将使政策制定者能够使用科学的方法来设定政策参数；2)它将为建立下一代计算机辅助预约系统提供一个框架，使患者能够通过互联网进行预约。