New Rutgers research suggests that much of the waiting for complex medical care can be reduced by recreating operations inside a computer and testing possible improvements, according to a June 23 study. The research, published in the Annals of Operations Research, details how researchers from Rutgers Cancer Institute and Rutgers Business School developed a computer simulation of the institute's blood cancer clinic to identify and address bottlenecks that caused patients to wait up to three hours between check-in and treatment.
Following changes based on the simulation's findings, laboratory blood work turnaround was cut from approximately 90 minutes to less than 30 minutes. The clinic also nearly doubled its daily infusion patient capacity from about 50 to about 80. Researchers said this approach could be applied at many other medical oncology offices.
"The multistep process for oncology patients exists at every cancer center in the country, if not the world," said Andrew Evens, deputy director for clinical services at Rutgers Cancer Institute. He added that the framework could apply wherever patients move through a sequence of constrained resources, including outpatient clinics, emergency departments, and surgical units.
The project began when Evens contacted his former professors at Rutgers Business School after completing an executive master of business administration degree there in 2022. A team led by Xin Ding embedded graduate students in the clinic to observe patient flow and combined those observations with timestamped electronic health records tracking each step from check-in to checkout.
Ding said: "From there, we can generate distributions and find patterns. What is the pattern for them to come? What is the pattern for them to leave? And we can do that for each point of the process." The result was an animated three-dimensional simulation known as a digital twin that allowed virtual testing before implementing changes in real life.
Evens cautioned that hospitals cannot simply adopt the Rutgers model without adaptation, "You could probably take some learned lessons from this article and apply them, but at the end of the day, you're going to need to do your own analysis." With new workflow challenges emerging following their move into a new facility last year, Evens indicated they may collaborate again with business school experts.
