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Patient Journey Patient Journey Optimization using a Optimization using a Multi-agent ApproachMulti-agent Approach
Victor Choi
Supervisor: Dr. William CheungCo-supervisor: Prof. Jiming Liu
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AgendaAgendaIntroductionPatient scheduling problem in
Hong KongProposed scheduling frameworkExperimentsConclusions and future works
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INTRODUCTIONINTRODUCTION
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ObjectiveObjectiveTo improve patient journey by
reducing undesired waiting times for patients
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How to achieve our How to achieve our objectiveobjectiveWith limited medical resources,
we need to schedule patients in a way such that the resources could be utilized in a more efficient manner
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Reasons of using a multi-Reasons of using a multi-agent approachagent approachIt is found that hospitals have a
decentralized structure, a multi-agent approached is proposed since it favors geographically distributed entities to be coordinated
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Related works of using a Related works of using a multi-agent approach for multi-agent approach for patient schedulingpatient scheduling T. O. Paulussen, I. S. Dept, K. S. Decker, A.
Heinzl, and N. R. Jennings. Distributed patient scheduling in hospitals. In Coordination and Agent Technology in Value Networks. GITO, pages 1224–1232. Morgan Kaufmann, 2003.
I. Vermeulen, S. Bohte, K. Somefun, and H. La Poutre. Improving patient activity schedules by multi-agent pareto appointment exchanging. In CEC-EEE ’06: Proceedings of the The 8th IEEE International Conference on E-Commerce Technology and The 3rd IEEE International Conference on Enterprise Computing, E-Commerce, and E-Services, page 9, Washington, DC, USA, 2006. IEEE Computer Society.
The use of health state as an utility function has been challenged
Temporal constraints between treatment operations are not
considered
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PATIENT SCHEDULING PATIENT SCHEDULING PROBLEM IN HONG PROBLEM IN HONG KONGKONG
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Seven cancer clusters in Seven cancer clusters in Hong KongHong Kong
C = {HKE, HKW, KC, KE, KW, NTE, NTW}9
Treatment operations and Treatment operations and medical resourcesmedical resources
Treatment plan
Treatment operations
{ Radiotherapy, Surgery, Chemotherapy }
Medical resources (A)
{ Radiotherapy unit, Operation unit, Chemotherapy unit }
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Patient journeyPatient journeyWe define patient journey as the
duration between the date of diagnosis and the date of the last treatment completed
Patient journey
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PROPOSED PROPOSED SCHEDULING SCHEDULING FRAMEWORKFRAMEWORK
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Two types of agentsTwo types of agentsPatient agentResource agent
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Patient agentPatient agent
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Resource agentResource agent
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Resource agent (cont.)Resource agent (cont.)
Cluster(HKE)
Cluster(HKW)
Cluster(KC)
Cluster(KE)
Cluster(KW)
Cluster(NTE)
Cluster(NTW)
Radiotherapy unit
Operation unit
Chemotherapy unit
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Scheduling algorithmScheduling algorithm
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Coordination frameworkCoordination framework
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Coordination framework Coordination framework (cont.)(cont.)For each request, it includes:
Earliest Possible Start Date (EPS)◦The earliest date on which a treatment
operation could start
Latest Possible Start Date (LPS)◦The latest date on which a treatment
operation should start such that the treatment operation could be performed earlier
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Coordination framework Coordination framework (cont.)(cont.)
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Coordination framework Coordination framework (cont.)(cont.)For each Target patient agent PG :
Last = 0 if the involving treatment operation is not the last one for PG; otherwise
Temp = 0 if no temporal constraints are violated for PG; otherwise
Noti = 0 if there is a week’s time of notification for PG ;
otherwise
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EXPERIMENTSEXPERIMENTS
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DatasetDatasetA dataset provided by the Hospital
Authority in Hong Kong (containing 4720 cancer patient journeys) is used for performing the simulation
The diagnosis period of these 4720 patient journeys spanned across six months (1/7/2007 – 31/12/2007)
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4 experiment settings4 experiment settingsSetting 1: Patient agents are willing to
exchange timeslots with others whenever none of their overall schedules would be lengthened as a result
Setting 2: Only 20% of patients from each cancer cluster are allowed to exchange their timeslots
Setting 3: Patients are only be swapped to a nearby cancer cluster
Setting 4: Timeslots released by deceased patients are allocated to the patient agents with the longest patient journey
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ResultsResults
Average length of patient journey
Maximum length of patient journey
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Simulations revealing the Simulations revealing the impacts of varying the unit impacts of varying the unit capacitiescapacitiesTo study the cost-effectiveness of
increasing the capacities of medical units, 3 different timeslot allocation strategies were used:
1) 2 timeslots were added to each medical unit on a daily-basis
2) 14 timeslots were added to each medical unit on a weekly-basis
3) 60 timeslots were added to each medical unit on a monthly-basis
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Simulations revealing the Simulations revealing the impacts of varying the unit impacts of varying the unit capacities - Resultscapacities - Results
Average length of patient journey
Maximum length of patient journey
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CONCLUSIONS AND CONCLUSIONS AND FUTURE WORKSFUTURE WORKS
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Conclusions and future Conclusions and future worksworksA multi-agent framework had
been proposed for patient scheduling
While no temporal constraints are violated for any single patient, no patients will get a lengthened overall schedule
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Conclusions and future Conclusions and future works (cont.)works (cont.)Experiments showed that even with a
fixed amount of medical resources, the average length of patient journey could be shortened by about a week’s time
In the near future, rather than routinely allocate a fixed amount of additional timeslots to each cancer cluster, we are going to assess how resources (or timeslots) should be allocated to cancer clusters in a more sophisticated way such that the overall patient journey could be shortened in a greater extent.
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THE ENDTHE END
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Q & AQ & A
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