Doctoral student Prashant Meckoni of the Mechanical and Industrial Engineering (MIE) Department won first place in the Best Student Paper competition during the Health Systems Track at the Institute of Industrial & Systems Engineers’ IISE Annual Conference. Meckoni’s winning paper was titled “Appointment Scheduling in Primary Care with Recurring Visits,” and his faculty advisor is MIE Professor Hari Balasubramanian.
As Balasubramanian says about his student, “What is amazing is that this was Prashant's first ever conference presentation. Well done, Prashant!”
The IISE conference, the largest of its kind held this year, was staged in Orlando, Florida, from May 18 to 21.
Meckoni explains to us that the use of appointment systems in primary care practitioners such as pediatricians, general physicians, family doctors, and dentists denies access to healthcare to the patients who need it the most. The patients who frequently visit their primary care providers often find no appointment slots available to them, while the patients needing infrequent visits are able to book appointment slots much into the future.
“In the context of healthcare,” says Meckoni, “traditional queues are seen in walk-in clinics or emergency room visits where the queue policy may be ‘first in, first out’ or based on patient criticality.”
By contrast, the appointment-based schedules used by many primary healthcare providers allow patients to schedule their appointments several weeks ahead of a desired date. But, according to Meckoni, early scheduling might very well fill up all the available slots during any day far in advance, thus restricting other patients who might need those slots on short notice due to problems developing for their chronic conditions.
Meckoni notes that patients who visit their healthcare providers more frequently might also experience recurrent delays, thus denying them their desired access to healthcare.
As a potential answer to these problems, says Meckoni, “We explore the use of reservations [or reserving open slots each day] for patients who frequently need to see their doctor at a relatively short notice as compared to most other patients. For the practitioner, using a reservation system can help reduce delay for the most needy patients and thus be able to provide the adequate care they need.”
As Meckoni adds, “We hypothesize that the reduced chance of getting an appointment slot for the requested day for the patients seeking frequent visits, and thus possibly having worse chronic health conditions as compared to others, makes it difficult for the most needy patients to have better access to healthcare.” The paper additionally discusses the role of reserving slots for patients needing frequent access to healthcare and its effect on utilization of the practice and delay.
Meckoni concludes that “We intend to find out if the patients needing frequent visits experience more delay than those needing infrequent visits. We examine the role of reserving slots for the certain in affecting this delay. A simplified model is discussed for a fixed panel size to understand interaction between capacity, delays for patients, and capacity reservation.”
Meckoni also says that Operations Research can answer many questions in healthcare and its delivery and thanks his advisor for the encouragement. (June 2019)