SlideShare a Scribd company logo
Abstract. We sought to use simulation modeling to
design effective scheduling processes in community
health centers (CHCs) to address appointments
related challenges that patients and clinics are facing.
Provider characteristics, patient characteristics,
number and types of appointments, and scheduling
methods and horizon will be used to build the
simulation model. All of this data has been collected
by questionnaires, interviews, workflow observations
and analysis of EMR data in CHCs.
Problem.
•  Patients challenges:
•  Long waiting times
•  Getting appointments at inconvenient times
•  Appointments with non-preferred providers
•  Clinics challenges:
•  Provider shortage
•  Limited provider availability
•  Multiple patient visit types
•  Appointment no-shows and cancellations
Purpose. Effective scheduling processes can reduce
clinic no-show rates and patient waiting time while
improving continuity of care and overall clinic
performance. We sought to develop a computer
simulation model to assess and simulate the
scheduling processes in CHCs, and provide a decision
making tool for clinic managers to analyze the impact
of a modified open access scheduling system, where
some provider capacity is allocated for same-day
appointments.
Methods!
Conclusion!
Assessing and Simulating Scheduling Processes in Community Health Centers!
Iman Mohammadi1, Ayten Turkcan2, Tammy Toscos1,3, Amy Miller1, Kislaya Kunjan1, Brad N. Doebbeling4!
1Department of BioHealth Informatics, Indiana University, Indianapolis, IN; 2Department of Mechanical and Industrial Engineering, Northeastern University, Boston, MA; 3Parkview Research Center, Fort Wayne, IN;!
4Department of Biomedical Informatics, Arizona State University, Phoenix, AZ"
References!
Motivation! Patient Flow!
Data requirements.
•  Patient characteristics
•  Provider characteristics
•  Appointment types
•  Visit frequencies
•  Scheduling methods
Approaches to gather data.
1.  Structured questionnaires and interviews. Clinic
managers, staff, quality assurance directors,
schedulers, financial advisors, nurse managers, call
center staff and front desk staff were the key
respondents.
2.  Workflow observations. The clinic staff working at
the front desks, call centers, scheduling and
enrollment stations were observed to map the
scheduling processes.
3.  EMR data analysis. We collected EMR data to build
patient population characteristics, provider capacities
and visit frequencies. We used clinics EMR data to
develop no-show prediction models using logistic
regression.
Simulation modeling.
We developed agent-based simulation models for each
clinic in AnyLogic.
Performance Measures
and Scenarios!
This project is part of a 3-year study funded by PCORI
to understand and improve access to healthcare in
Indiana through collaboration with seven community
health centers in the state. Questionnaires and
interviews for understanding overall operations of the
partner clinics, workflow observations and EMR data
analysis can be used to build the simulation model to
identify effective scheduling processes and test alternate
strategies to improve timely access to care.
Performance measures.
•  No-show rates
•  Waiting time for an appointment
•  Clinic/provider productivity
•  Continuity of care
Scenarios.
•  Does changing the number of triage appointments
improve outcome measures?
•  How does open access scheduling affect performance
measures?
•  How does overbooking affect operational performance
measures?
•  Can care teams improve the performance measures?
•  What would be the impact of after-hour or weekend
hours on performance measures?
•  Pediatric, adult, pregnant and women are the four
main patient types.
•  Our no-show prediction modeling shows that duration
of appointments, patient groups based on gender and
age, insurance types, lead time between appointment
day and appointment request day and prior no-show
behavior of patient are significant predictors of no-
show.
Scheduling Algorithm!
1. Turkcan A, Toscos T, Doebbeling BN. Patient-Centered Appointment
Scheduling Using Agent-Based Simulation. In: AMIA 2014 – Proceedings of the
Annual Symposium of the AMIA. Washington, D.C., 2014; (pp. 1125-1133).

More Related Content

What's hot

Emma presentation 0317
Emma presentation 0317Emma presentation 0317
Emma presentation 0317
Tim Cheng
 
Brad Doebbeling Slides for AHRQ Kick-Off Event
Brad Doebbeling Slides for AHRQ Kick-Off EventBrad Doebbeling Slides for AHRQ Kick-Off Event
Brad Doebbeling Slides for AHRQ Kick-Off EventShawnHoke
 
Models of evaluation in educational technology
Models of evaluation in educational technologyModels of evaluation in educational technology
Models of evaluation in educational technologyalsalmi
 
Jason Saleem Slides from AHRQ Kick-Off
Jason Saleem Slides from AHRQ Kick-OffJason Saleem Slides from AHRQ Kick-Off
Jason Saleem Slides from AHRQ Kick-Off
ShawnHoke
 
Heather Woodward Slides from AHRQ Kick-Off
Heather Woodward Slides from AHRQ Kick-OffHeather Woodward Slides from AHRQ Kick-Off
Heather Woodward Slides from AHRQ Kick-Off
ShawnHoke
 
David Haggstrom Slides from AHRQ Kick-Off Event
David Haggstrom Slides from AHRQ Kick-Off EventDavid Haggstrom Slides from AHRQ Kick-Off Event
David Haggstrom Slides from AHRQ Kick-Off Event
ShawnHoke
 
Cpoe Clinical Case
Cpoe Clinical CaseCpoe Clinical Case
Cpoe Clinical Casemaulinpshah
 
Building Customized Clinical Pathway Order Sets for CPOE Implementation
Building Customized Clinical Pathway Order Sets for CPOE ImplementationBuilding Customized Clinical Pathway Order Sets for CPOE Implementation
Building Customized Clinical Pathway Order Sets for CPOE Implementation
coffeegurrl
 
Transforming the Patient Experience HISA EHealth NSW
Transforming the Patient Experience  HISA EHealth NSWTransforming the Patient Experience  HISA EHealth NSW
Transforming the Patient Experience HISA EHealth NSW
Dr Avnesh Ratnanesan (Avi)
 
This Conversation May be Recorded for Quality Purposes
This Conversation May be Recorded for Quality PurposesThis Conversation May be Recorded for Quality Purposes
This Conversation May be Recorded for Quality Purposes
TraceByTWSG
 
Ashford HCA 305 Week 2 DQ 1 Hospital System Quality Improvement
Ashford HCA 305 Week 2 DQ 1 Hospital System Quality ImprovementAshford HCA 305 Week 2 DQ 1 Hospital System Quality Improvement
Ashford HCA 305 Week 2 DQ 1 Hospital System Quality Improvementsolvemyquestion.com
 
Dionisio Acosta: Clinical decision support systems
Dionisio Acosta: Clinical decision support systemsDionisio Acosta: Clinical decision support systems
Dionisio Acosta: Clinical decision support systems
Nuffield Trust
 
ESSA_2016_FC_Poster_FINAL
ESSA_2016_FC_Poster_FINALESSA_2016_FC_Poster_FINAL
ESSA_2016_FC_Poster_FINALSimon Moddel
 
Utilization Management in Population Health Management
Utilization Management in Population Health ManagementUtilization Management in Population Health Management
Utilization Management in Population Health Management
Nalashaa Healthcare Solutions
 
SAS CV of Narayana
SAS CV of NarayanaSAS CV of Narayana
SAS CV of NarayanaNarayana P
 
Storyboard iv
Storyboard ivStoryboard iv
Storyboard iv
scottsandra
 
Audits: Introduction and Procedure
Audits: Introduction and ProcedureAudits: Introduction and Procedure
Audits: Introduction and Procedurevtesimplified
 
Finance Final Project for LinkedIn
Finance Final Project for LinkedInFinance Final Project for LinkedIn
Finance Final Project for LinkedInKirti Patel
 
Decision support system : Concept and application
Decision support system : Concept and applicationDecision support system : Concept and application
Decision support system : Concept and application
Kawita Bhatt
 

What's hot (20)

Emma presentation 0317
Emma presentation 0317Emma presentation 0317
Emma presentation 0317
 
Brad Doebbeling Slides for AHRQ Kick-Off Event
Brad Doebbeling Slides for AHRQ Kick-Off EventBrad Doebbeling Slides for AHRQ Kick-Off Event
Brad Doebbeling Slides for AHRQ Kick-Off Event
 
Models of evaluation in educational technology
Models of evaluation in educational technologyModels of evaluation in educational technology
Models of evaluation in educational technology
 
Jason Saleem Slides from AHRQ Kick-Off
Jason Saleem Slides from AHRQ Kick-OffJason Saleem Slides from AHRQ Kick-Off
Jason Saleem Slides from AHRQ Kick-Off
 
(slides)
(slides)(slides)
(slides)
 
Heather Woodward Slides from AHRQ Kick-Off
Heather Woodward Slides from AHRQ Kick-OffHeather Woodward Slides from AHRQ Kick-Off
Heather Woodward Slides from AHRQ Kick-Off
 
David Haggstrom Slides from AHRQ Kick-Off Event
David Haggstrom Slides from AHRQ Kick-Off EventDavid Haggstrom Slides from AHRQ Kick-Off Event
David Haggstrom Slides from AHRQ Kick-Off Event
 
Cpoe Clinical Case
Cpoe Clinical CaseCpoe Clinical Case
Cpoe Clinical Case
 
Building Customized Clinical Pathway Order Sets for CPOE Implementation
Building Customized Clinical Pathway Order Sets for CPOE ImplementationBuilding Customized Clinical Pathway Order Sets for CPOE Implementation
Building Customized Clinical Pathway Order Sets for CPOE Implementation
 
Transforming the Patient Experience HISA EHealth NSW
Transforming the Patient Experience  HISA EHealth NSWTransforming the Patient Experience  HISA EHealth NSW
Transforming the Patient Experience HISA EHealth NSW
 
This Conversation May be Recorded for Quality Purposes
This Conversation May be Recorded for Quality PurposesThis Conversation May be Recorded for Quality Purposes
This Conversation May be Recorded for Quality Purposes
 
Ashford HCA 305 Week 2 DQ 1 Hospital System Quality Improvement
Ashford HCA 305 Week 2 DQ 1 Hospital System Quality ImprovementAshford HCA 305 Week 2 DQ 1 Hospital System Quality Improvement
Ashford HCA 305 Week 2 DQ 1 Hospital System Quality Improvement
 
Dionisio Acosta: Clinical decision support systems
Dionisio Acosta: Clinical decision support systemsDionisio Acosta: Clinical decision support systems
Dionisio Acosta: Clinical decision support systems
 
ESSA_2016_FC_Poster_FINAL
ESSA_2016_FC_Poster_FINALESSA_2016_FC_Poster_FINAL
ESSA_2016_FC_Poster_FINAL
 
Utilization Management in Population Health Management
Utilization Management in Population Health ManagementUtilization Management in Population Health Management
Utilization Management in Population Health Management
 
SAS CV of Narayana
SAS CV of NarayanaSAS CV of Narayana
SAS CV of Narayana
 
Storyboard iv
Storyboard ivStoryboard iv
Storyboard iv
 
Audits: Introduction and Procedure
Audits: Introduction and ProcedureAudits: Introduction and Procedure
Audits: Introduction and Procedure
 
Finance Final Project for LinkedIn
Finance Final Project for LinkedInFinance Final Project for LinkedIn
Finance Final Project for LinkedIn
 
Decision support system : Concept and application
Decision support system : Concept and applicationDecision support system : Concept and application
Decision support system : Concept and application
 

Viewers also liked

Suzanne Marketing Book
Suzanne Marketing BookSuzanne Marketing Book
Suzanne Marketing BookSuzanne Webb
 
Assignment Three
Assignment ThreeAssignment Three
Assignment Three
Carolyn Leonardo
 
Mohitpadhan
MohitpadhanMohitpadhan
Mohitpadhan
maceymaddox
 
Reflexión 12
Reflexión 12Reflexión 12
Reflexión 12Macorsa
 
Fa102a #2.5
Fa102a #2.5Fa102a #2.5
Fa102a #2.5
JustinArch
 
Hml. pesta keluarga kudus
Hml. pesta keluarga kudusHml. pesta keluarga kudus
Hml. pesta keluarga kuduskarangpanas
 
Advancedblogging 130201213618-phpapp02
Advancedblogging 130201213618-phpapp02Advancedblogging 130201213618-phpapp02
Advancedblogging 130201213618-phpapp02
Digital Maniacs
 
NO NL Micro algae opportunities in aquaculture
NO NL Micro algae opportunities in aquacultureNO NL Micro algae opportunities in aquaculture
NO NL Micro algae opportunities in aquaculture
Sytse YBEMA
 
Graficas ¿que es el aprendizaje y como se aprende?
Graficas ¿que es el aprendizaje y como se aprende?Graficas ¿que es el aprendizaje y como se aprende?
Graficas ¿que es el aprendizaje y como se aprende?
chivastravieso
 
A paz que trago
A paz que tragoA paz que trago
A paz que trago
pietra bravo
 
Manual balay campana 3bc8855b
Manual balay   campana 3bc8855bManual balay   campana 3bc8855b
Manual balay campana 3bc8855b
Alsako Electrodomésticos
 
Reducing attack surface on ICS with Windows native solutions
Reducing attack surface on ICS with Windows native solutionsReducing attack surface on ICS with Windows native solutions
Reducing attack surface on ICS with Windows native solutions
Jan Seidl
 
English: Adjectives for Hobbies
English: Adjectives for HobbiesEnglish: Adjectives for Hobbies
English: Adjectives for Hobbies
KatieEnglishTutoring
 
Imprimir fichas semana 25 04-16 NIÑOS 2 AÑOS
Imprimir fichas semana 25 04-16 NIÑOS 2 AÑOSImprimir fichas semana 25 04-16 NIÑOS 2 AÑOS
Imprimir fichas semana 25 04-16 NIÑOS 2 AÑOS
Cynthia Patricia Isla Bernal
 

Viewers also liked (17)

Suzanne Marketing Book
Suzanne Marketing BookSuzanne Marketing Book
Suzanne Marketing Book
 
Assignment Three
Assignment ThreeAssignment Three
Assignment Three
 
Mohitpadhan
MohitpadhanMohitpadhan
Mohitpadhan
 
Reflexión 12
Reflexión 12Reflexión 12
Reflexión 12
 
Fa102a #2.5
Fa102a #2.5Fa102a #2.5
Fa102a #2.5
 
Miladecor
MiladecorMiladecor
Miladecor
 
Hml. pesta keluarga kudus
Hml. pesta keluarga kudusHml. pesta keluarga kudus
Hml. pesta keluarga kudus
 
Advancedblogging 130201213618-phpapp02
Advancedblogging 130201213618-phpapp02Advancedblogging 130201213618-phpapp02
Advancedblogging 130201213618-phpapp02
 
NO NL Micro algae opportunities in aquaculture
NO NL Micro algae opportunities in aquacultureNO NL Micro algae opportunities in aquaculture
NO NL Micro algae opportunities in aquaculture
 
Graficas ¿que es el aprendizaje y como se aprende?
Graficas ¿que es el aprendizaje y como se aprende?Graficas ¿que es el aprendizaje y como se aprende?
Graficas ¿que es el aprendizaje y como se aprende?
 
A paz que trago
A paz que tragoA paz que trago
A paz que trago
 
Cuantos objetos hay
Cuantos objetos hayCuantos objetos hay
Cuantos objetos hay
 
Manual balay campana 3bc8855b
Manual balay   campana 3bc8855bManual balay   campana 3bc8855b
Manual balay campana 3bc8855b
 
Reducing attack surface on ICS with Windows native solutions
Reducing attack surface on ICS with Windows native solutionsReducing attack surface on ICS with Windows native solutions
Reducing attack surface on ICS with Windows native solutions
 
Opamps
OpampsOpamps
Opamps
 
English: Adjectives for Hobbies
English: Adjectives for HobbiesEnglish: Adjectives for Hobbies
English: Adjectives for Hobbies
 
Imprimir fichas semana 25 04-16 NIÑOS 2 AÑOS
Imprimir fichas semana 25 04-16 NIÑOS 2 AÑOSImprimir fichas semana 25 04-16 NIÑOS 2 AÑOS
Imprimir fichas semana 25 04-16 NIÑOS 2 AÑOS
 

Similar to AMIAPoster_Iman

Lean Six Sigma for Nurse Scheduling
Lean Six Sigma for Nurse SchedulingLean Six Sigma for Nurse Scheduling
Lean Six Sigma for Nurse SchedulingWilliam Reau
 
6. Advanced Access and Predictive Analytics
6. Advanced Access and Predictive Analytics6. Advanced Access and Predictive Analytics
6. Advanced Access and Predictive Analytics
Michele Molden
 
2. Setting an Organizational Agenda
2. Setting an Organizational Agenda2. Setting an Organizational Agenda
2. Setting an Organizational Agenda
Michele Molden
 
Operational Management in Health Administration
Operational Management in Health AdministrationOperational Management in Health Administration
Operational Management in Health Administration
Sonali Shah
 
Physician schedule optimization model - Endeavor Analytics
Physician schedule optimization model - Endeavor AnalyticsPhysician schedule optimization model - Endeavor Analytics
Physician schedule optimization model - Endeavor Analytics
Endeavor Management
 
Issue BrIefC AL I FORNIAHEALTHCAREFO.docx
Issue BrIefC AL I FORNIAHEALTHCAREFO.docxIssue BrIefC AL I FORNIAHEALTHCAREFO.docx
Issue BrIefC AL I FORNIAHEALTHCAREFO.docx
christiandean12115
 
SIMTEGR8: Simulation To Evaluate Great Care
SIMTEGR8: Simulation To Evaluate Great CareSIMTEGR8: Simulation To Evaluate Great Care
SIMTEGR8: Simulation To Evaluate Great Care
SIMUL8 Corporation
 
Lean management in healthcare
Lean management in healthcareLean management in healthcare
Lean management in healthcare
DrSiddharthSingh5
 
An Analytics Journey: Case Study over Seven Years-Rich Pollack, VCU Health
An Analytics Journey: Case Study over Seven Years-Rich Pollack, VCU HealthAn Analytics Journey: Case Study over Seven Years-Rich Pollack, VCU Health
An Analytics Journey: Case Study over Seven Years-Rich Pollack, VCU Health
Healthcare Network marcus evans
 
Managing Cost in the Era of Healthcare Reform
Managing Cost in the Era of Healthcare Reform  Managing Cost in the Era of Healthcare Reform
Managing Cost in the Era of Healthcare Reform
Mikan Associates
 
Avoid PRM failures
Avoid PRM failuresAvoid PRM failures
Avoid PRM failures
Endeavor Management
 
Tina Hindo Resume'
Tina Hindo Resume'Tina Hindo Resume'
Tina Hindo Resume'Hindo Tina
 
Managementinformationandevaluationsystem 130416133526-phpapp02
Managementinformationandevaluationsystem 130416133526-phpapp02Managementinformationandevaluationsystem 130416133526-phpapp02
Managementinformationandevaluationsystem 130416133526-phpapp02
Chithra Saju
 
Managementinformationandevaluationsystem 130416133526-phpapp02
Managementinformationandevaluationsystem 130416133526-phpapp02Managementinformationandevaluationsystem 130416133526-phpapp02
Managementinformationandevaluationsystem 130416133526-phpapp02
Chithra Saju
 
Edifecs CJR: don't fumble with your bundle ss
Edifecs CJR: don't fumble with your bundle ssEdifecs CJR: don't fumble with your bundle ss
Edifecs CJR: don't fumble with your bundle ss
Edifecs Inc
 
Cherye Morgan_Navigant Resume
Cherye Morgan_Navigant ResumeCherye Morgan_Navigant Resume
Cherye Morgan_Navigant ResumeCherye Morgan
 
HMSAnalysisReportPresentationforclg.pptx
HMSAnalysisReportPresentationforclg.pptxHMSAnalysisReportPresentationforclg.pptx
HMSAnalysisReportPresentationforclg.pptx
PraveenNaidu37
 

Similar to AMIAPoster_Iman (20)

Lean Six Sigma for Nurse Scheduling
Lean Six Sigma for Nurse SchedulingLean Six Sigma for Nurse Scheduling
Lean Six Sigma for Nurse Scheduling
 
6. Advanced Access and Predictive Analytics
6. Advanced Access and Predictive Analytics6. Advanced Access and Predictive Analytics
6. Advanced Access and Predictive Analytics
 
2. Setting an Organizational Agenda
2. Setting an Organizational Agenda2. Setting an Organizational Agenda
2. Setting an Organizational Agenda
 
Operational Management in Health Administration
Operational Management in Health AdministrationOperational Management in Health Administration
Operational Management in Health Administration
 
Internship final poster
Internship final posterInternship final poster
Internship final poster
 
Physician schedule optimization model - Endeavor Analytics
Physician schedule optimization model - Endeavor AnalyticsPhysician schedule optimization model - Endeavor Analytics
Physician schedule optimization model - Endeavor Analytics
 
Issue BrIefC AL I FORNIAHEALTHCAREFO.docx
Issue BrIefC AL I FORNIAHEALTHCAREFO.docxIssue BrIefC AL I FORNIAHEALTHCAREFO.docx
Issue BrIefC AL I FORNIAHEALTHCAREFO.docx
 
SIMTEGR8: Simulation To Evaluate Great Care
SIMTEGR8: Simulation To Evaluate Great CareSIMTEGR8: Simulation To Evaluate Great Care
SIMTEGR8: Simulation To Evaluate Great Care
 
Lean management in healthcare
Lean management in healthcareLean management in healthcare
Lean management in healthcare
 
An Analytics Journey: Case Study over Seven Years-Rich Pollack, VCU Health
An Analytics Journey: Case Study over Seven Years-Rich Pollack, VCU HealthAn Analytics Journey: Case Study over Seven Years-Rich Pollack, VCU Health
An Analytics Journey: Case Study over Seven Years-Rich Pollack, VCU Health
 
Managing Cost in the Era of Healthcare Reform
Managing Cost in the Era of Healthcare Reform  Managing Cost in the Era of Healthcare Reform
Managing Cost in the Era of Healthcare Reform
 
Avoid PRM failures
Avoid PRM failuresAvoid PRM failures
Avoid PRM failures
 
Tina Hindo Resume'
Tina Hindo Resume'Tina Hindo Resume'
Tina Hindo Resume'
 
Presentation
PresentationPresentation
Presentation
 
Managementinformationandevaluationsystem 130416133526-phpapp02
Managementinformationandevaluationsystem 130416133526-phpapp02Managementinformationandevaluationsystem 130416133526-phpapp02
Managementinformationandevaluationsystem 130416133526-phpapp02
 
Managementinformationandevaluationsystem 130416133526-phpapp02
Managementinformationandevaluationsystem 130416133526-phpapp02Managementinformationandevaluationsystem 130416133526-phpapp02
Managementinformationandevaluationsystem 130416133526-phpapp02
 
Edifecs CJR: don't fumble with your bundle ss
Edifecs CJR: don't fumble with your bundle ssEdifecs CJR: don't fumble with your bundle ss
Edifecs CJR: don't fumble with your bundle ss
 
Cherye Morgan_Navigant Resume
Cherye Morgan_Navigant ResumeCherye Morgan_Navigant Resume
Cherye Morgan_Navigant Resume
 
HMSAnalysisReportPresentationforclg.pptx
HMSAnalysisReportPresentationforclg.pptxHMSAnalysisReportPresentationforclg.pptx
HMSAnalysisReportPresentationforclg.pptx
 
Improving Ambulatory Clinic Workflow
Improving Ambulatory Clinic WorkflowImproving Ambulatory Clinic Workflow
Improving Ambulatory Clinic Workflow
 

AMIAPoster_Iman

  • 1. Abstract. We sought to use simulation modeling to design effective scheduling processes in community health centers (CHCs) to address appointments related challenges that patients and clinics are facing. Provider characteristics, patient characteristics, number and types of appointments, and scheduling methods and horizon will be used to build the simulation model. All of this data has been collected by questionnaires, interviews, workflow observations and analysis of EMR data in CHCs. Problem. •  Patients challenges: •  Long waiting times •  Getting appointments at inconvenient times •  Appointments with non-preferred providers •  Clinics challenges: •  Provider shortage •  Limited provider availability •  Multiple patient visit types •  Appointment no-shows and cancellations Purpose. Effective scheduling processes can reduce clinic no-show rates and patient waiting time while improving continuity of care and overall clinic performance. We sought to develop a computer simulation model to assess and simulate the scheduling processes in CHCs, and provide a decision making tool for clinic managers to analyze the impact of a modified open access scheduling system, where some provider capacity is allocated for same-day appointments. Methods! Conclusion! Assessing and Simulating Scheduling Processes in Community Health Centers! Iman Mohammadi1, Ayten Turkcan2, Tammy Toscos1,3, Amy Miller1, Kislaya Kunjan1, Brad N. Doebbeling4! 1Department of BioHealth Informatics, Indiana University, Indianapolis, IN; 2Department of Mechanical and Industrial Engineering, Northeastern University, Boston, MA; 3Parkview Research Center, Fort Wayne, IN;! 4Department of Biomedical Informatics, Arizona State University, Phoenix, AZ" References! Motivation! Patient Flow! Data requirements. •  Patient characteristics •  Provider characteristics •  Appointment types •  Visit frequencies •  Scheduling methods Approaches to gather data. 1.  Structured questionnaires and interviews. Clinic managers, staff, quality assurance directors, schedulers, financial advisors, nurse managers, call center staff and front desk staff were the key respondents. 2.  Workflow observations. The clinic staff working at the front desks, call centers, scheduling and enrollment stations were observed to map the scheduling processes. 3.  EMR data analysis. We collected EMR data to build patient population characteristics, provider capacities and visit frequencies. We used clinics EMR data to develop no-show prediction models using logistic regression. Simulation modeling. We developed agent-based simulation models for each clinic in AnyLogic. Performance Measures and Scenarios! This project is part of a 3-year study funded by PCORI to understand and improve access to healthcare in Indiana through collaboration with seven community health centers in the state. Questionnaires and interviews for understanding overall operations of the partner clinics, workflow observations and EMR data analysis can be used to build the simulation model to identify effective scheduling processes and test alternate strategies to improve timely access to care. Performance measures. •  No-show rates •  Waiting time for an appointment •  Clinic/provider productivity •  Continuity of care Scenarios. •  Does changing the number of triage appointments improve outcome measures? •  How does open access scheduling affect performance measures? •  How does overbooking affect operational performance measures? •  Can care teams improve the performance measures? •  What would be the impact of after-hour or weekend hours on performance measures? •  Pediatric, adult, pregnant and women are the four main patient types. •  Our no-show prediction modeling shows that duration of appointments, patient groups based on gender and age, insurance types, lead time between appointment day and appointment request day and prior no-show behavior of patient are significant predictors of no- show. Scheduling Algorithm! 1. Turkcan A, Toscos T, Doebbeling BN. Patient-Centered Appointment Scheduling Using Agent-Based Simulation. In: AMIA 2014 – Proceedings of the Annual Symposium of the AMIA. Washington, D.C., 2014; (pp. 1125-1133).