An adaptive decision support system for outpatient appointment scheduling with heterogeneous service times

Sci Rep. 2024 Nov 12;14(1):27731. doi: 10.1038/s41598-024-77873-x.

Abstract

Appointment scheduling (AS) plays a crucial role in outpatient clinic management. Traditional methods involve patient grouping using pre-defined rules and scheduling based on these groups. However, pre-defined rules may not adequately capture the heterogeneity in patients' service times (i.e., consultation duration). Advanced machine learning (ML) methods can address individual-level heterogeneity but pose challenges for practical scheduling. To strike a balance, we propose a data-driven AS decision support system, Cluster-Predict-Schedule (CPS), integrating both supervised and unsupervised ML for efficient patient grouping and scheduling. The novelty of CPS lies in its adaptability to service time heterogeneity through a data-driven approach, determining patient groups based on data rather than pre-defined rules. Additionally, CPS includes a generic and efficient algorithm for generating appointment templates adaptable to any number of patient groups. Our system's efficacy is demonstrated using a real-world dataset. Evaluated by the weighted sum of patient wait times, physician idle time, and overtime, CPS achieves up to 15.0% cost reduction compared to the FCFA (first-call, first-appointment) scheme and over 4.7% savings against the common New/Return classification with traditional sequencing candidate (TSC) rules. In addition, CPS enhances outpatient operational efficiency without compromising fairness.

Keywords: Decision support systems; Heterogeneous service times; Outpatient appointment scheduling; Supervised and unsupervised machine learning.

MeSH terms

  • Algorithms
  • Ambulatory Care Facilities / organization & administration
  • Appointments and Schedules*
  • Decision Support Systems, Clinical
  • Humans
  • Machine Learning
  • Outpatients
  • Time Factors