by K. W. Wesselink-Schram, University of Twente

Credit: CC0 Public Domain

In collaboration with Isala Zwolle, researchers from the TechMed Center of the University of Twente developed a smart system to schedule patients with chronic kidney damage more efficiently. This system assesses in advance whether an appointment with the nephrologist is necessary, which leads to 18% fewer repeat appointments. This not only saves time and money but also frees up caregivers for patients who need them.

Many kidney patients need to return to the doctor regularly for check-ups, although not all appointments are necessary. That is why the researchers developed a system that can assess whether a patient really needs a visit, using medical data such as recent blood values.

Different criteria defined by a focus group of doctors determine which patients can skip their appointment or be helped over the phone. Patients remain under the care of their doctor and can always make an appointment if they have any questions. In some cases, patients may even be referred back to their GP earlier.

Not every appointment is necessary

"It's a shame when people come to the hospital when they don't have to. With this system, they remain under control, but don't have to travel as often," says Gréanne Leeftink, one of the researchers. In addition to saving time for both patients and doctors, the system allows outpatient clinics to treat 20% more patients without compromising the quality of care.

The new system does make scheduling more complex. "Previously, patients came for check-ups every three months, and you could plan care well in advance. Now, the system requires keeping slots available for short-term appointments," says Ph.D. candidate Jedidja Lok-Visser.

Mathematical algorithm

"To address this, we developed a mathematical algorithm that determines when to keep time free, without reducing access to care," adds Leeftink. "The algorithm maximizes the efficient use of specialists' time."

The project has been successfully tested at Isala hospital and may also be applied to other chronic specialties, such as lung care. In follow-up research, the team will explore whether this patient scheduling system can be used in regional collaboration with GPs.

The researchers published their findings in the journal BMC Health Services Research. The article is titled "Criteria-based outpatient scheduling at a nephrology clinic: prospective evaluation of patient pre-assessment and its corresponding adaptive scheduling strategy."

Dr. Gréanne Leeftink is an assistant professor in the Department of Industrial Engineering and Business Information Systems (IEBIS; Faculty of BMS). The research was carried out in the Center for Health care Operations Improvement and Research (CHOIR; TechMed Center / Digital Society Institute).

She conducted the research together with her master's student Ruben Klaas, MSc., Ph.D. candidate Jedidja Lok-Visser, Dr. Sebastian Rachuba, and doctors and department managers of Isala Zwolle, a top clinical hospital in Zwolle and the largest non-academic hospital in the Netherlands.

More information: Ruben Klaas et al, Criteria-based outpatient scheduling at a nephrology clinic: prospective evaluation of patient pre-assessment and its corresponding adaptive scheduling strategy, BMC Health Services Research (2024). DOI: 10.1186/s12913-024-11615-7

Provided by University of Twente