title: Success of automated algorithmic scheduling in an outpatient setting.
abstract: OBJECTIVE
  To determine if algorithmically generated double-booking recommendations could increase patient volume per clinical session without increasing the burden on physicians.
  
  
  METHODS
  A randomized controlled trial was conducted with 519 clinical sessions for 13 dermatologists from December 1, 2011, through March 31, 2012.
  
  
  METHODS
  Sessions were randomly assigned to "Smart-Booking," an algorithm that generates double-booking recommendations using a missed appointment (no-shows + same-day cancella- tions) predictive model (c-statistic 0.71), or to a control arm where usual booking rules were applied. The primary outcomes were the average number and variance of arrived patients per session, after controlling by physician. In addition, physicians received a survey after each session to quantify how busy they felt during that session.
  
  
  RESULTS
  257 sessions were randomized to Smart-Booking and 262 sessions were randomized to control booking. Using a generalized multivariate linear model, the average number of arrived patients per session was higher in the Smart-Booking intervention arm than the control (15.7 vs 15.2, difference between groups 4.2; 95% CI, 0.08-0.75; P = .014).The variance was also higher in the intervention than control (3.72 vs 3.33, P = .38).The survey response rate was 92% and the physicians reported being similarly busy in each study arm.
  
  
  CONCLUSIONS
  Algorithmically generated double-booking recommendations of dermatology clinical sessions using individual physician assumptions and predictive modeling can increase the number of arrived patients without overburdening physicians, and is likely scalable to other settings.
authors.affiliation: 50 Staniford St, 7th Fl, Boston, MA 02114. E-mail: prcronin@partners.org.
authors.forename: Patrick R
authors.initials: PR
authors.lastname: Cronin
authors.forename: Alexa Boer
authors.initials: AB
authors.lastname: Kimball
mesh_terms: D000465:Algorithms; D000553:Ambulatory Care / Q000458:organization & administration*; D001071:Appointments and Schedules; D003880:Dermatology / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D015233:Models, Statistical