Coordinated lab-clinics: A tactical assignment problem in healthcare

Abstract

In some medical outpatient settings, it is desirable to perform patient diagnostic testing just before the appointment with the physician, effectively linking the testing to the clinic appointment. If testing resources are shared by several physicians, it becomes difficult to assure that testing is completed in time (with some probability) due to the variation in testing requirements across patients and types of clinics held concurrently. To address this tactical-level doctor–clinic assignment problem, we develop a mixed-integer programming (MIP)-based approach for assigning time slots to the physician clinics. The approach maximizes the minimum service level across blocks of time to reduce the likelihood of a patient not completing testing in time for their clinic appointment. A branch-and-price heuristic procedure is proposed to solve practical problem instances, and numerical examples are presented to show the efficiency of this model. Two mini-cases based on clinics’ actual operations are provided. The results of the mini-cases suggest that the proposed scheduling method will bring important improvements to these systems.