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Telfer Research Seminar Series - Carri Chan Healthier

Waiting Online versus In-person in Outpatient Clinics: An Empirical Study on Visit Incompletion

Date & Time

February 28, 2023


Online - link provided in reminder email before the seminar


Kathy Cunningham

***M.Sc. Students, this event can count towards one of the six mandatory Research Seminars Series needed to attend (MHS6991 or MGT6991).***

Carri Chan, PhD

The use of telemedicine has increased rapidly over the last few years. To better manage telemedicine visits and effectively integrate them with in-person visits, we need to better understand patient behaviors under the two modalities of visits. Utilizing data from two large outpatient clinics, we take an empirical approach to study service incompletion for in-person versus telemedicine appointments. We focus on estimating the causal effect of physician availability on service incompletion; physician availability is likely to affect the likelihood a patient leaves without being seen behavior but only for patients who show up for the appointment. That is, physician availability should not impact the likelihood of patient no-show. We introduce a multivariate probit model with instrumental variables to handle estimation challenges due to endogeneity, sample selection bias, and measurement error. Our estimation results show that intra-day delay increases the telemedicine service incompletion rate by 7.40%, but does not have a significant effect on the in-person service incompletion rate. This suggests that telemedicine patients may leave without being seen when delayed, while in-person patients are not sensitive to intra-day delay. We conduct counterfactual experiments to optimize the intra-day sequencing rule when having both telemedicine and in-person patients. Our analysis indicates that not correctly differentiating the types of incompletions due to intra-day delays from no-show behavior can lead to highly suboptimal patient sequencing decisions. Joint work with Jimmy Qin and Jing Dong.

About the Speaker

Carri W. Chan is the John A. Howard Professor of Business and the Carri Chan Faculty Director of the Healthcare and Pharmaceutical Management Program at Columbia Business School. Her research is in the area of healthcare operations management. Her primary focus is in data-driven modeling of complex stochastic systems, efficient algorithmic design for queuing systems, dynamic control of stochastic processing systems, and econometric analysis of healthcare systems. Her research combines empirical and stochastic modeling to develop evidence-based approaches to improve patient flow through hospitals. She has worked with clinicians and administrators in numerous hospital systems including Northern California Kaiser Permanente, New York Presbyterian, and Montefiore Medical Center. She is the recipient of a 2014 NSF CAREER award, the 2016 POMS Wickham Skinner Early Career Award, and the 2019 MSOM Young Scholar Prize. She currently serves as a co-Department Editor for the Healthcare Management Department at Management Science. She received her BS in electrical engineering from MIT and MS and Ph.D. in electrical engineering from Stanford University.

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