A Markov chain model for analysis of physician workflow in primary care clinics
- PDF / 2,170,569 Bytes
- 20 Pages / 595.224 x 790.955 pts Page_size
- 113 Downloads / 180 Views
A Markov chain model for analysis of physician workflow in primary care clinics Sujee Lee1 · Philip A. Bain2 · Albert J. Musa2 · Jingshan Li1 Received: 19 April 2019 / Accepted: 3 August 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract This paper studies physician workflow management in primary care clinics using terminating Markov chain models. The physician workload is characterized by face-to-face encounters with patients and documentation of electronic health record (EHR) data. Three workflow management policies are considered: preemptive priority (stop ongoing documentation tasks if a new patient arrives); non-preemptive priority (finish ongoing documentation even if a new patient arrives); and batch documentation (start and finish documentation when the desired number of tasks is reached). Analytical formulas are derived to quantify the performance measures of three management policies, such as physician’s daily working time, patient’s waiting time, and documentation waiting time. A comparison of the results under three policies is carried out. Finally, a case study in a primary care clinic is carried out to illustrate model applicability. Such a work provides a quantitative tool for primary care physicians to design and manage their workflow to improve care quality. Keywords Primary care · Physician workflow · Markov chain · Face-to-face-encounter · Documentation · Operations research Highlights •
•
A terminating Markov chain model is introduced to study physician work including face-to-face encounters with patients and documentation of EHR data, which can be used to design, evaluate and compare the efficacy of different workflow management policies. Analytical formulas are derived to evaluate system performance (such as physician daily work time, patient
This paper is supported in part by NSF Grant CMMI-1536987.
•
and documents waiting time) under three workflow management policies: stop documentation upon patient arrival - PEP model; nish documentation regardless of patient arrival - NPP model; start documentation after task accumulation - BDC model. It is shown that NPP model can be more favorable. A case study in a primary care clinic is carried out to illustrate the model applicability, which validates that such a work can provide a quantitative tool for primary care physicians to design and manage their workflow to improve care quality.
Jingshan Li
[email protected] Sujee Lee [email protected] Philip A. Bain [email protected] Albert J. Musa [email protected] 1
Department of Industrial and Systems Engineering, University of Wisconsin, Madison, WI, USA
2
SSM Health Dean Medical Group, Madison, WI, USA
1 Introduction As the backbone of nation’s healthcare system, primary care is facing significant challenges in recent years [1– 3]. Physicians have become increasingly busy to deal with overwhelming amounts of tasks, regulation pressures, and electronic health record (EHR) usages [4]. A general internist in a typical primary care clinic may spen
Data Loading...
