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INFORMS HEALTH NEWSLETTER

SPRING 1999



Published by the Institute for Operations Research and the Management Sciences
Health Applications Section

Table of Contents

Officers of the INFORMS Health Applications Section
Message from the Incoming President
Message from the Outgoing President
From our WEB site
Cincinnati INFORMS Abstracts
Reminder: FREE COPY Health Care Management Science Journal
Call for Abstracts
Snapshot Pictures from the Seattle Meeting


Officers of the INFORMS Health Applications Section
 

President

Sandra Potthoff
Department of Health Care Management
Carlson School of Management Room 3-140
University of Minnesota
321 19th Avenue South
Minneapolis, MN 55455
Work Phone: (612) 624-9019
Fax : (612) 624-8804
E-mail: pott001@tc.umm.edu
Office Term Expiring 12/31/1999

Vice President/President-Elect Program Director for INFORMS Philadelphia Meeting

Doug Samuelson
8711 Chippendale Ct.
Annandale, VA 22003-3807
Work Phone: (703) 978-5030
E-mail: dsamuel@seas.gwu.edu
Office Term Expiring 12/31/1999

Treasurer

H. David Sherman
Accounting Group
College of Business Administration
Northeastern University
Boston, MA
Work Phone: (617) 373-4640
Fax : (617) 373-8814
E-mail: hsherman@lynx.neu.edu
Office Term Expiring 12/31/99

Council

Timothy W. Butler
Dept. of Finance and Business Economics
School of Business Administration
Detroit, MI 48202
Work Phone: (313) 577-4802
Fax : (313) 577-0058
Office Term Expiring 12/31/99

Vivian Valdmanis
University of Oklahoma
Dept of HAP PO Box 26901th Admin & Policy
Oklahoma City, OK 73190
Work Phone: (405) 271-2114
Fax : (405) 271-1868
E-mail: vivian-valdmanis@uokhsc.edu
Office Term Expiring 12/31/2000

Jon Chilingerian
Brandeis University
Box 9110 Heller School MS035
Waltham, MA 02254-9110
Work Phone: (781) 736-3828
Fax : (781) 736-3985
E-mail: chilingerian@binah.cc.brandeis.edu
Office Term Expiring 12/31/2001

Webmaster

Sophie D. Lapierre
Dept of Mathematics & Industrial Engineering
Ecole Polytechnique de Montreal
Montreal, QC H3C 3A7
Canada
Work Phone: (514) 340-4711 ext. 5852
Fax : (514) 340-4173
E-mail: sophiel@crt.umontreal.ca
WEB Site: http://www.crt.umontreal.ca/~sophiel/
Office Term Expires 12/31/2000

Past Presidents

Yasar A. Ozcan
Williamson Institute for Health Studies
P.O. Box 980203
Virginia Commonwealth University
Richmond, VA 23298-0203
Work Phone: (804) 828-5224
Fax : (804) 828-1894
E-mail: ozcan@hsc.vcu.edu
Office Term Expired 12/31/1998

David L. Zalkind
2731 N. Norwood St.
Arlington, VA 22207-5344
Work Phone: (202) 994-5735
Fax : (202) 994-4068
E-mail: dlz@gwis2.circ.gwu.edu
Office Term Expired 12/31/1997

Vicki Smith-Daniels
College of Business
Arizona State University
Tempe, AZ 85287-4206
Work Phone: (602) 965-6473
Fax : (602) 965-5539
E-mail: vicki.smith-daniels@asu.edu
Office Term Expired 12/31/1996

Farrokh Alemi
Health Administration Program
Cleveland State University
2121 Euclid
Cleveland, OH 44115
Work Phone: (216) 687-4749
Fax : (216) 687-9354
E-mail: f.alemi@popmail.csuohio.edu
Office Term Expired 12/31/1995

Secretary/Newsletter Editor

Charles Shasky
Williamson Institute for Health Studies
P.O. Box 980203
Virginia Commonwealth University
Richmond, VA 23298-0203
Work Phone: (804) 550-0415
Fax : (804) 828-1894
E-mail: cshasky@hsc.vcu.edu
Office Term Expired 12/31/1999


Incoming Chair's Message

Sandra Potthoff

I have big shoes to fill in taking over the role of president of the Health Applications Section from Yasar Ozcan. Not only did Yasar get a new sponsored journal, Health Care Management Science, off the ground this past year, he always remembered to bring his camera to take pictures of all of us at every single meeting and INFORMS social to include in the newsletter. He has promised to continue in his role as official photographer. Next year?s fall meeting at Philadelphia will provide an opportunity for even more new faces to be featured in the newsletter. We are already organizing for the Philadelphia meeting, so start planning your presentation now and plan to attend the annual meeting so you, too, can have your picture here.

I was struck at Seattle?s presentations that "cutting the fat out of health care" requires more than ever the skills that management scientists and operations researchers possess. The health care system has become like a high grade cut of meat - the fat is marbled throughout, not sitting around the edges simply waiting to be carved off with a butcher knife. The days of easily identifiable fixes - cutting costs by decreasing hospitalizations or length of stay - have ended. New ways to make health care more efficient are requiring the tools that we continue to use and improve upon, applying them to novel problems. As some examples, Seattle presentations included using LP to minimize set up times and tissue damage for radiation therapy beams, using hierarchical cluster analysis to define hospital service areas in Taiwan, and using quality adjusted DEA to identify best practice physicians.

The high quality of the presentations speaks to one of our latest section initiatives - the development of a prize, including recognition and monetary award - for the best paper presented at fall INFORMS conferences. We currently have a committee, David Sherman and David Zalkind, working out the specifics, and plan to begin the award at this fall?s Philadelphia conference. Winning papers presented would be invited to publish in the Health Care Management Science journal. If you have any suggestions for this committee, feel free to contact them. As this prize gets implemented, we hope to add a second best paper award specifically for students, so stay tuned.

I look forward to serving as the President of the Health Applications section, and will see you all in Philadelphia. Hopefully, El Niño typhoons will not keep our Taiwanese colleagues from joining us this coming year.



Outgoing President's Message

Yasar  A. Ozcan

Reflecting back to past twelve months INFORMS Health Applications Section (HAS) completed a very successful year in 1998. Our section's membership is steadily increasing; we are financially sound and academically strong having published first two issues of its new journal, Health Care Management Science. It gives me a great pleasure to say that "the state of the HAS is very good."

This has been achieved with the collective help of you, dedicated colleagues. I congratulate you for these accomplishments for HAS. While I am passing the leadership responsibilities to our very capable colleague Sandra Potthoff, we must remind ourselves to provide full support to our new team of officers whom are elected through mail ballot past year (see officers of HAS on page 2) for HAS? continuing march with excellence into the new millennium.

This support may come in various facets including: recruitment of new members, participation via presentation and/or attendance to Fall INFORMS meetings, organizing sessions, contribution to Health Care Management Science by submitting paper and/or serving as referee. In recognizing the section?s needs, Health Care Management Science dedicates a special issue to the papers submitted to all INFORMS-HAS Fall meetings.

Once again, I thank you for your confidence to bestow the leadership of this fine organization to me during the past year. It was pleasure to serving you.

Yasar A. Ozcan
 



From Our WEB Site:

http://www.crt.umontreal.ca/~sophiel/health/

Don't forget to prepare to attend one or more of the following meeting(s):
 

This newsletter would also like to publish your reviews and opinions with respect to the highlighted reference books and articles posted on the Web Site and any other related information sources. Additionally, please submit titles of your favorite references, texts, and online sources to the newsletter editor (cshasky@hsc.vcu.edu). Your input will serve as the basis for a critique column of our research toolbox.



FROM the CINCINNATI Meeting:

INFORMS Cincinnati 1999 Cluster:

Health Care Management & Policy; Health Service Delivery: Fiscal & Knowledge Management: The following three papers were presented.
 

SA07.1 Cutting Costs in Hospitals: The Impact on Patient Service
Linda V. Green; Columbia Business School, 423 Uris Hall, New York, NY 10027;
lvg1@columbia.edu

Using data from a major urban hospital, we explore the ramifications of various operational strategies that are being implemented in hospitals across the country. We develop insights on the impact of size, average length of stay, variability and organization of clinical services on occupancy rates and delays for beds.

SA07.2 How the Patient-Provider Relationship Impacts Patient Satisfaction
Tamara Stone; University of Missouri, Health Mgmt. & Informatics, 324 Clark Hall, Columbia, MO 65211; stonet@health.missouri.edu
Annamarie Mantese; University of Missouri, Health Mgmt. & Informatics, 324 Clark Hall, Columbia, MO 65211; mantesea@health.missouri.edu

We investigate 4 patient-provider relationship models and explore how various styles of interaction ultimately impact overall patient satisfaction with clinical care. We develop a method for identifying individual provider alignment with specific models. In addition, we systematically identify which patient-provider interactions best satisfy patient needs based on severity of illness.

SA07.3 Performance Measures of Provider Information Transfer: Who Knows Where Patients Get their Information?
Timothy B. Patrick; University of Missouri, Health Mgmt. & Informatics, 324 Clark Hall, Columbia, MO 65211; patrickt@health.missouri.edu

We examine patients' sources of clinical information while receiving treatment. In addition, we identify what patients and providers consider as reliable sources of clinical information. Finally, we measure the quality of provider to patient information transfer in terms of whether providers know where patients are obtaining their information.

In Health Care Research: The following papers were presented.

SB07.1 In Response to the Market Pressures: Complying with the Certification Requirements
Neset Hikmet; University of Rhode Island, Dept. of MSIS, Coll. of Bus., 7 Lippitt Rd., Kingston, RI 02881-1309; neset@uriacc.uri.edu
Karen Abrahamson; University of Rhode Island, Dept. of MSIS, Coll. of Bus., 7 Lippitt Rd., Kingston, RI 02881-1309;
Maling Ebrahimpour; University of Rhode Island, Dept. of MSIS, Coll. of Bus., 7 Lippitt Rd., Kingston, RI 02881;

Joint Commission on Accreditation of Health Care Organizations (JCAHO) certification requirements as well as market pressures is requiring the health care providers (HCP) to streamline their operations. These pressures are especially felt on the not for profit community HCPs. In the case study, the wait time analysis is used to evaluate the amount of time patients are waiting during their visit to the facility.

SB07.2 Knowledge Management for Epidemiological Research
Henry Linger; Monash University, Sch. of Info. Mgmt. & Systems, PO Box 197, Caulfield East VIC, 3145 , Australia; henry.linger@sims.monash.edu.au
Frada Burstein; Monash University, Sch. of Info. Mgmt. & Systems, PO Box 197, Caulfield East VIC, 3145 , Australia;

Lack of continuity is a problem for survey-based epidemiological research. Our framework provides a means for recording developmental, conceptual, and other supporting information and documentation which is traditionally poorly conserved. We illustrate the components of the framework using a major Australian epidemiological project as a case study.

SB07.3 Design & Use of g Statistical Control Charts in Infection Control
James C. Benneyan; Northeastern University, MI & ME Dept., 334 Snell Engineering Ctr., Boston, MA 02115; benneyan@coe.neu.edu

Several approaches to the design and application of SPC to infection control, needle stick, and heart surgery complication data are examined, with particular emphasis on use of events-between g control charts, statistical design issues, and their operating characteristics.

SB07.4 Health Care Revenue Management
Jon A. Higbie, Jr.; Talus Solutions, 4751 Best Rd., Atlanta, GA 30337; jhigbie@talus.net
Elizabeth Higbie; Georgia State University, Dept. of Physical Therapy, Atlanta, GA 30303;

Revenue management is an emerging business discipline with many successful applications in the airline, broadcasting, and hospitality industries. Issues related to the adaptation of revenue management techniques to the healthcare industry are explored and a model for the management of physical therapy resources is presented.

SB33.2 Making the Connections: Linking Community Operational Research to Health
Leroy White; South Bank University, Faculty of Health, London, SE1 0AA , UK; whitel@sbu.ac.uk

A London Health Authority used community OR to help develop best practice across the public and voluntary sectors, taking account of people's expressed needs. This case study illustrates how Operational Research can empower local communities to inform and influence health service planning and provision.

MA13.4 Group Models For Psychiatric Emergency Room Admissions Decision Making
Jeryl L. Mumpower; National Science Foundation, 4201 Wilson Blvd., Arlington, VA 22230; jmumpowe@nsf.gov
Bruce B. Way; New York State Office of Mental Health, 44 Holland Ave., Albany, NY 12229; way@iris.rfmh.org

A multi-disciplinary team supported a group of psychiatrists, mental health professionals, clients and patient advocates to develop a prototypical computerized best-practice guideline for use in psychiatric emergency admissions decision making. Key tensions in group model building, especially between rationality and consensus, are discussed in terms of competing values theory.

MD03.1 Challenge of Quality & Costs in Health Care Delivery: International Challenge of Improving Quality & Costs in Health Care Delivery
William P. Pierskalla; UCLA, Anderson Sch., Ste. F407, 110 Westwood Plaza, Box 951481, Los Angeles, CA 90095-1481; wpierska@anderson.ucla.edu

Managing the quality and costs of health care services delivery is a challenge in every nation. Part of the challenge stems from the explosion of technological and knowledge processes. Part stems from the difficulty of trying to measure what, for many years, has been thought of as intangible outcomes. Part stems from the lack of consistent information and information systems. Part stems from the cultures of the country and the lack of physicians' interest in changing their behavior. And part stems from the virtually unlimited demand for improved health. We will address current knowledge and research on these issues related to the quality and costs of care and will raise questions as to some of the many things needed to be done.

SB10.2 A Review of the Value-of-Information Approach for Managing Health & Environmental Risks
Kimberly M. Thompson; Harvard University, Sch. of Public Health, 718 Huntington Ave., B-206, Boston, MA 02115; kimt@hsph.harvard.edu

Recent national panels highlighted the importance of using a VOI approach when performing analysis to support decision making. To date there has been little synthesis of the many examples of applications exist and important methodological advances have been made. This presentation reviews the literature and focuses on remaining analytical challenges.

SC07.4 A Multicriteria Clinical Decision Model for Antibiotics Selection
Jim Iluga; Clinique Ste. Elisabeth, Ave. Beau Rivage 10, Genval, 1332 , Belgium; bestsprl@hotmail.com
Bertrand M. Mareschal; Universite Libre de Bruxelles, Blvd. du Triomphe, CP 210/01, Brussels, 1050 , Belgium;
bmaresc@ulb.ac.be

There is no consensus on a quantitative approach to assist physicians in selecting the most appropriate antiobiotics in nosocomial infections, as most indicators focus on specific characteristics of the antibiotics. We present a multicriteria model based on the PROMETHEE methodology that considers several criteria such as efficiency (clinical, bacteriological), tolerance, costs, etc.

SC10.3 Gaussian Influence Diagram Techniques for Clinical Program Design
Bill Poland; Pharsight Corporation, 800 West El Camino Real, Ste. 200, Palo Alto, CA 94040; bill.poland@pharsight.com

Decision analysis gets unwieldly when a sequence of decisions is interspersed with learning about continuous uncertainties. Illustrating with the design of programs of clinical trials for investigational new drugs. I describe an effective approximation transforming all marginal distributions to normals and using the efficient inference of the Gaussian influence diagram.

MC30.1 Hold Everything! Evaluating Policies for Protecting Blood & Plasma Supplies
Edward H. Kaplan; Yale University, Sch. of Organization & Mgmt., Box 208200, New Haven, CT 06520-8200; edward.kaplan@yale.edu
Glen Satten; National Center for HIV, STD & TB Prevention, Ctrs. for Disease Control, 1600 Clifton Rd., NE E48, Atlanta, GA 30333;

In spite of advances in testing technologies for detecting infections such as HIV, HBV and HCV, occasionally infectious blood or plasma enters the supply on account of false negative screening errors. We will consider a holding policy for further reducing the number of infectious units that enter the supply.

MC30.2 A Queueing Analysis of the Paired-Kidney Exchange Program
Stefanos Zenios; Stanford University, Grad. Sch. of Busi>


Transfer interrupted!

n@leland.stanford.edu

The paired-kidney exchange program is expected to increase the supply of living kidneys through exchanges between pairs of donors and recipients. We analyze this program using a multiclass stochastic population system that explicitly captures the exchange process. Asympototic analysis leads to closed-form expressions for the stationary waiting time.

MC30.3 Resource Allocation for Epidemic Control over Short Time Horizons
Margaret L. Brandeau; Stanford University, Dept. of IE/EM, Stanford, CA 94305;
brandeau@stanford.edu
Gregory S. Zaric; Stanford University, Dept. of IE/EM, Stanford, CA 94305-4024;
zaric@stanford.edu

We develop and solve a model for the optimal allocation of resources for epidemic control over a short time horizon. The goal is to minimize the number of infections averted, subject to a budget constraint.

MC30.4 Modeling & Analysis of a Virus that Selectively Kills Tumor Cells
Lawrence M. Wein; MIT, Sloan Sch. of Mgmt., E53-343, Cambridge, MA 02139; lwein@mit.edu
David H. Kim; ONYX Pharmaceuticals, 3031 Research Dr., Richmond, CA 94806;

ONYX has developed a replication-competent adenovirus that kills p53-deficient tumor cells. We develop, analyze and validate a spatial mathematical model, which consists of 6 partial differential equations along with a moving boundary condition, of a virus-infected tumor. An approximate analysis reveals a 3-dimensional traveling wave of infection.

WA29.1 Estimating the Relationship Between Technology Investment & Hospital Service Quality: Proposing & Testing a Structural Equation Model
Lynn Ling X. Li; Butler University, Coll. of Bus. Admin., Indianapolis, IN 46208-3485; lli@thomas.butler.edu
Guangping Huang; Zhong Shan University, Guangshou, 510275 , China;

As US hospitals and health care organizations become more competitive, investments in technology and quality improvement are keys to survival. The general theory is that hospital technology drives quality. Included in this study are clinical and information technologies. To test the theory, a structural equation model is suggested and evaluated.

WA24.5 Error-Grid Analysis & Warranty Evaluation of Blood Glucose Meters
Boris Kovatchev; University of Virginia, Health Sciences Ctr. Drawer F, Blue Ridge Hospital, Charlottesville, VA 22901;

Error-grid analysis is a statistical method for evaluation of the accuracy of portable devices for home blood glucose monitoring, based on assumptions for clinical proximity between the meter readings and reference solutions. Data are automatically recorded by most blood glucose meters and the method uses it for periodic scanning of the accuracy of the device.
 
 

The previous author's presentations reveal a great depth and breadth of the problems facing our health care sector. For those who may have attended the Cincinnati meeting, we would welcome your insights gleaned from the presentations. For those unable to attend, what methods or perspectives of analysis do you find most intriguing? Write to you newsletter editor cshasky@hsc.vcu.edu and we will publish your comments.



!!!!!!!REMINDER!!!!!!

The journal, Health Care Management Science, can be previewed via free electronic specimen copy and the WEB site; http://www.baltzer.nl/hcms/hcms.asp and the journal?s home page is located at; http://www.vcu.edu/haeweb/hcms/hcms.html.
 

Volume 1 (1998) 1 (as a promotional offer, the acticle pdf 's can be viewed without a user name and password) at http://www.baltzer.nl/hcms/contents.html

Please review the sample contents. We think you will want to order a subscription as well as publish your work in this high quality journal.



Call for Abstracts

INFORMS-KORMS Seoul 2000 International Meeting

INFORMS-KORMS Seoul 2000 International Meeting will be held in June 18-21, 2000. I have agreed to serve as cluster chair for health care sessions. I am organizing an invited cluster of HEALTH Applications for INFORMS-KORMS Seoul 2000 International Meeting which will be held in June 18-21, 2000. If you are planning to attend this conference and would like to submit an abstract, please send an e-mail to ozcan@hsc.vcu.edu indicating your intent. In order to organize this event, we need to have abstracts fielded by August 1999. More information about the conference will become available, but I need to know preliminary details (authors, title, and abstract) as soon as they become available. We need session chairs and invited contributors to this conference. I would like to know who is planning to attend INFORMS-KORMS 2000 and planning to present a paper. For those interested, I will send you the necessary electronic forms to start abstract submission process. The abstract fee will be approximately $100 and will be counted toward registration.
Yasar A. Ozcan

Yasar A. Ozcan, Ph.D.
Editor-in-Chief
Health Care Management Science
P.O. Box 980203
1008 East Clay Street, Room #213
Virginia Commonwealth University
Richmond, VA 23298-0203 U.S.A.

Tel: 804-828-5224
Fax: 804-828-1894
ozcan@hsc.vcu.edu
http://www.vcu.edu/haeweb/hcms/hcms.html


Snap Shots from the Seattle Meeting


An inspired group of attendees!
 
 

Presidents Row: Yasar Ozcan (Past), Sandra Potthoff (Present), Doug Samuelson (Future)
 
 

Leadership: Doug Samuelson (future President), Sandra Potthoff (President), and H. David Sherman (Treasurer)
 
 

Left to Right: H. David Sherman, Eric Volman, Yasar Ozcan, Sandra Potthoff, Doug Samuelson, David Zalkind, Liam O?Neill, and Timothy Butler.
 
 

Hands Full! Doug Samuelson and Sandra Potthoff
 
 

Taking Careful Notes: Eric Volman (foreground), Liam O?Neill (background)
 
 

Presenting Home Care Conclusions: Michael Carter
 
 
 
 

Liam O?Neill presenting Central Bed Scheduling
 
 

Stretch Break! (left to right): Yasar Ozcan, Sandra Potthoff, Liam O'Neill, and Timothy Butler.
 

inf orms


 
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