Thursday, April 2, 2015

How to allocate a particular scarce resource

Business requirements for limited annual medical appointments.

Linda and I have the same family doctor. He seems to be good at what he does, and no doubt he tries very hard to be a good doctor to all his patients. But scheduling an annual physical sucks. He does only so many in a month, and they book up quickly.

A few years ago I finished an appointment and thought I was smart to book next years right then. Except they were booking 18 months out. Colour me gobsmacked. I booked, but was considering over a 10 year period, I was only going to get 2/3rds of the medical care I should have got.

Then he went to a different system so that people weren't booking so far in advance. It works like this. He books physicals a month at a time, a year out. So if you go in for an appointment in mid April 2015, all the appointments will likely be booked for April 2016. You have to wait till the start of the first business day in May 2015 to book for May 2016.

In practice the office phone explodes about the start of that day. By about noon it's all over but the crying for the losers in the phone lottery; the ones without redial or something more important to do just then, to say nothing of the office staff who have to explain over and over again. This isn't good for anyone, not the patients, not the staff. There has to be a better way, and there is. Some software developer is welcome to take this BPDD and build functional software to flog to the medical industry. Or anyone else where the model fits.

All current patients go onto a list ranked by last appointment date, most overdue first. Doctor sets the date/time of available appointments in a month. Patients supply on line contact information, email, facebook or twitter message, text, whatever. Every month, for a year out, the system considers the most overdue users and tentatively assigns them an appointment. That user is sent a notification, and they have 24 hours to accept. (or some reasonable window.) Upon the acceptance being logged into the system, the patient receives confirmation of their appointment date and time. They system could be configured to give reminders at set intervals as desired.

As long as there are openings, the system works backwards through the most overdue people. If the first person refuses a date or doesn't respond in time, it goes back into the pool. It could be a configurable choice if that user goes to the bottom of the list, or stays at the top, giving them a chance at another date. My default choice would be to bump them to the bottom of the list.

Eventually, all the spots fill up. The system snoozes. If a patient cancels, or new appointment slots are added, it kicks into gear again. When the appointment is several days out it works through the most overdue patients. Perhaps there is a doctor assigned priority list to work through first. If it's the next day maybe everybody that is due or overdue gets a notification, and the first response wins.

The software ties into the doctor's appointment system to book without needing human intervention. It ties into various internet communication channels. The doctor could get a monthly report indicating which patients refuse the most appointments, or are most overdue. Some people have a preference for appointments on a particular day, and in phase two there could be a mechanism for a patient to log into their account and set preferences. The cynical business analyst in me would instruct the developer to ignore such preferences as long as there are many patients wanting a limited number of appointment slots.

This system saves a lot of people a lot of time and aggravation. The really clever developer also markets an app that ties into this system, so it automatically accepts the appointment (if the space is clear) and puts it on the calendar. For something as important as a medical appointment, booked a year out, people can schedule around it.

There. An idea for a developer. Fill your boots. No payment required, though an honorarium would be nice if you make a ton of money. Contact me to get even more details, a process flow chart, and supporting materials done for you, and we can work out a revenue sharing arrangement.

1 comment:

  1. I noticed the same type of issue with our family doctor! I couldn't believe it! In the states (yeah, yeah insert a bunch of healthcare issue mumbo jumbo + the fact that more comes out of our pockets for these appts) they book you a year out easy peasy.

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