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Supporting the Dutch Healthcare System with AIMMS-based Optimization During the COVID-19 Pandemic

  • 11 May 2020
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Supporting the Dutch Healthcare System with AIMMS-based Optimization During the COVID-19 Pandemic
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This article is based on an interview with Erwin Hans, Professor of Operations Management in Healthcare at the University of Twente and Co-Founder of CHOIR and Rhythm B.V. Erwin is helping care givers address the challenge of critical care capacity and is looking for motivated students with AIMMS know-how to join the effort! 

AIMMS and I have a long-standing relationship. As a former student of applied mathematics at the University of Twente, an institution where I now teach, I completed my graduation project under the supervision of AIMMS’ founder, Johannes Bisschop. Jan, as we call him, was my thesis supervisor. My path in OR started at the Energy Research Foundation in the late 90s. During my time here, I conducted my master’s research on the liberalization of the European electricity market. Specifically, I developed an AIMMS-based model to understand how electricity transport, post liberalization, would impact prices. After completing my research, I took on a PhD position in logistics. Two years after I completed my PhD in 2001, my career took a different turn. Through a friend, I met an operating room manager at the Erasmus Medical Center in Rotterdam. As we talked about my work, he made me realize that I could have a big impact if I applied my OR know-how in healthcare. Since then, I’ve been devoted to this task, helping healthcare organizations apply optimization to improve their practice.

Quickly, I started involving other colleagues in my research and together with Richard Boucherie, professor in Stochastic OR at UT we founded CHOIR - the Center for Healthcare Operations Improvement and Research at University of Twente. CHOIR’s mission is to help healthcare organizations and professionals improve the quality and efficiency of their care delivery with applied academic research, rooted in OR/OM and data science. Rhythm B.V. is a spin-off of CHOIR and ORTEC. We founded Rhythm in cooperation with Nikky Kortbeek and Bart Veltman (ORTEC) in order to put CHOIR’s research into practice through consulting and decision support tools. Most of our work is fueled by demand. Namely, questions coming from practitioners themselves. AIMMS has been a useful tool to answer these questions across the years. That’s also the case in this critical moment.

Rethinking our focus in view of COVID-19

As you can imagine, COVID-19 made us rethink our research focus. CHOIR and Rhythm are composed by a group of 35 academics and OR professionals. Many of them are (current and former) PhD students. With the pandemic unfolding, we decided to allocate most of our time to new logistics challenges that emerged because of the coronavirus. We launched a press release to offer our services and received a lot of requests from hospitals and home care organizations. Thuiszorg West Brabant (TWB) was one of those organizations.

TWB is a large home care organization located in Roosendaal, in the south-western part of the Netherlands. They were dealing with the challenge of “care giver continuity” or (persoonscontinuïteit in Dutch). What this means is that they were looking to reduce the number of different care givers a client is faced with. In a large organization like TWB, there tends to be a lot of rotation between care givers and you need to manage personnel with different specialties. But having different care givers in a single day increases the risk of contamination. They wanted to optimize home care planning and routes to reduce the number of different faces at the door while providing the right level of care. This presented us with a skills assignment, routing and scheduling problem. AIMMS is very suitable for this type of challenge.

AIMMS-based planning for home care amidst COVID-19

We decided to use AIMMS to implement a model to solve this problem and are in the process of validating the solution. This type of problem has several constraints, so we will fine-tune the model further. Planning at a home care organization is often very manual and may result in poor solutions. Planners need to consider labor regulations as well as different schedules, skill sets and routes.

The use of a tool like AIMMS allowed us to rapidly prototype model variants to address this planning challenge effectively and provide user-friendly solutions to the client.

Our hope is that these solutions will guarantee quality of care and service, while balancing the burden for care givers.

Recovery scenarios for Dutch healthcare

Besides this specific project, we are helping hospitals study scenarios for recovery. The situation for the Dutch healthcare system is volatile. At the time of writing, our intensive care capacity is still running at less than 100%. In other words, it’s busy in IC units across the country, but the number of people who need treatment is still manageable. With restrictions easing up, hospitals want to make sure they are prepared to handle a second wave of infections. We want to avoid a situation where doctors have to choose which patients to treat because the IC unit cannot handle more people. So, we are studying different scenarios to assess this.

At the same time, non-urgent care is still on hold. There is a huge, invisible backlog of elective treatments and it’s unclear when hospitals will be able to deliver these and to what extent. Healthcare organizations will face difficult questions when it’s time to boot up. For example, decisions about allocating staff and balancing costs. It’s hard to know what demand will look like after the pandemic. We have developed advanced models for forecasting patient flows and are using those models to calculate impact across the healthcare chain. We can do very advanced modeling about how demand will move through the system and are working closely with hospitals to answer these questions. AIMMS is playing a critical role here as well.

You can contribute too

We currently have open positions for students that want to help us address the capacity challenge in healthcare, including a 4-year role for a PhD student. Are you a student with AIMMS experience?  Take a look at our careers page for more information and reach out!


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