Bet­ter sched­ul­ing through math

Modern Healthcare - - INNOVATIONS - By Beth Kutscher

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.

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