Better scheduling through math
The number of people seeking healthcare services is expected to swell as the population ages, more people develop chronic conditions and more people gain insurance coverage. The number of doctor visits could increase as much as 80% over the next 10 to 15 years. But at the same time, growth in the nursing and physician workforce is unlikely to keep pace. That means healthcare providers will need to work more efficiently with the resources they already have.
One area ripe for improvement is the scheduling process.
LeanTaas, a 6-year-old company based in Santa Clara, Calif., employs sophisticated algorithms and Lean process-improvement principles to help providers manage workflow. “We’re not doing clinical optimization, but we’re trying to do operational excellence,” said Mohan Giridharadas, the company’s founder and CEO.
The company compares the problem to a game of Tetris, where different size blocks drop down at random and must be aligned into neat rows. The blocks represent different types of appointments and the randomness reflects the way patients are currently scheduled: as they call in. The goal is to eliminate the gaps between blocks to get the best fit.
LeanTaas begins its work with a client by analyzing a number of workflow issues, such as previous utilization patterns, physician preferences, bed availability, seasonality and whether there are clinical trials or other special circumstances. Its iQueue software then uses predictive analytics to create scheduling templates for each day of the week. The technology also self-corrects over time as it generates its own data.
Providers can integrate the software with their electronic health record systems so their scheduling workflow does not change.
LeanTaas got its start working with large manufacturers on supply-chain challenges but zeroed in on healthcare over the past two years. Now its clients include large health systems and cancer centers, such as Stanford Health Care, Vanderbilt Health, Wake Forest Baptist Health and the University of California at San Francisco.
The company says its software is delivering 21% more patient volume, 30% shorter waits and 50% less staff overtime. “If you can solve one-third of the problem by better math, that’s a big deal,” said Sanjeev Agrawal, pres- ident of LeanTaas Healthcare. “You don’t need more operating rooms; you don’t need more infusion chairs.”
University of Colorado Health began working with LeanTaas last summer after experiencing double-digit growth in patient volume at its cancer center in two years. Its infusion center had already added extra chairs as well as expanded weekend hours, but it still needed to find a way to meet the additional demand.
During peak hours, typically between 10 a.m. and 2 p.m., its nurses would be slammed with patients. They found it hard to take lunch breaks and began to worry about the potential for errors during the flurry of activity.
After consulting with UCHealth, LeanTaas created daily templates for the system based on five appointment types. And the system also began to better manage its appointments, including tightening its policies regarding late and early arrivals.
“The fundamental principle we’re operating under is trying to create truth in scheduling,” said Brian Shields, a process improvement engineer at UCHealth. “We’ve been much more stringent about making people wait until their appointment time and then delivering on that appointment time.”
Wait times and patient-satisfaction scores have remained consistent. UCHealth is no longer running out of chairs during peak hours, and it has seen a significant reduction in overtime hours. “The nurses will tell you that their day is less chaotic,” Shields said. “It’s really just adjusting things slightly. It’s not necessarily shifting the volume to mornings and evenings but trying to take advantage of unused capacity at the peak.”
LeanTaas markets three software products—for patient scheduling at infusion centers and clinics and for scheduling nurses. It has three more products under development that will tackle scheduling for surgery, inpatient beds and laboratories.
The company charges a subscription fee that’s either per chair per month, per doctor per month, or per operating room per month, depending on the product.
LeanTaas closed a $3 million Series B financing round in September and is looking to raise another $6 million to $7 million from health system investors. It is expecting more than $6 million in revenue this year, which would represent 50% growth over 2015. It has 25 U.S. employees and 30 overseas.