Workforce sizing and scheduling in Telemedecine

远程医疗是利用电信和信息技术从远处提供医疗保健。患者和医疗保健专家之间的虚拟交互可以预先记录，也可以实时完成。在这种互动中，医疗保健专家提供建议，告诉患者是治疗他/她的症状更好，还是等着看他/她的常规医生，去诊所，还是去急诊室。在这个项目中，我们与Dialogue合作，这是一家总部位于蒙特利尔的初创公司，为加拿大公司提供先进和负担得起的移动医疗服务。对话采用了不同类型的医疗保健专家。虽然员工从周一到周五从早上8点工作到晚上8点，但患者可以在一天中的任何时间登录该应用程序。dialog目前通过估算比率来衡量和安排劳动力：护士每小时可以服务的聊天数量/到达系统的患者数量，助理数量/护士数量。此外，对医疗保健专家每个时间段可以服务的聊天数量的估计不包括员工的资历级别和经验。这种规划方法通常导致无法雇用适当数量的医疗保健专家，服务水平下降（即患者通常等待很长时间才能得到服务），以及护士的过度使用，因为他们通常被分配加班，并且分配给他们的病人超过了他们的能力。因此，该项目的目标是为员工提供一个决策支持工具，以确定尺寸和调度。这涉及到从建模和解决方案的角度来看的几个挑战。我们面临着复杂的工作法规、需求的可变性和不确定性以及规划周期的长度。为了解决这些挑战，我们建议使用两阶段随机规划模型。该模型将包括需求的不确定性，以提供可靠的人员配置和调度决策，以更好的方式对患者需求的变化做出反应。我们相信这一项目的实施将有助于减少病人的等待时间，提高病人的满意度。这也将缓解诊所和医院的拥挤。

Telemedicine is the use of telecommunication and information technology to provide healthcare from adistance. The virtual interaction between the patient and the healthcare expert can be either pre-recorded ordone in real-time. In this interaction, a healthcare expert offers advice on whether it is better for the patient totreat his/her symptoms, wait to see his/her regular doctor, go to a clinic, or go to an emergency room. In thisproject, we collaborate with Dialogue, a Montreal-based start-up that provides progressive and affordablehealthcare, accessible on mobile, for Canadian companies. Dialogue employs different types of healthcareexperts. Although employees work from 8am to 8pm from Monday to Friday, patients can log into the app atany time of the day. Dialogue currently dimensions and schedules the workforce by estimating ratios: numberof chats a nurse can serve per hour/number of patients arriving to the system, number of assistants/number ofnurses. Moreover, the estimate of the number of chats that a healthcare expert can serve per time period doesnot include the level of seniority and the experience of the employee. This planning method often results in theinability to hire an appropriate number of healthcare experts, in a decrease in the service level (i.e. patientsusually wait a long time before being served), and in the over-utilization of nurses as they are usually allocatedto overtime and they are assigned to more patients than they can handle. The objective of this project istherefore to provide Dialogue with a decision-support tool to staff dimensioning and scheduling. This involvesseveral challenges from the modeling and solution perspectives. We face complex work regulations, demandvariability and uncertainty and the length of the planning horizon. In order to address these challenges, wepropose to use a two-stage stochastic programming model. This model will include uncertainty in demands toprovide robust staffing and scheduling decisions that will react, in a better way, to changes in patients'requirements. We believe that the implementation of such a project will contribute to reducing patients' waittime and improving satisfaction. This should also relieve congestion in clinics and hospitals.