Intra-day Dynamic Rescheduling under Patient No-shows

Abstract

Existing work on appointment scheduling assumes that appointment times cannot be updated once they have been assigned. However, advances in communication technology and the adoption of online (as opposed to in-person) appointments make it possible for appointments to be flexible. In this paper, we describe an intra-day dynamic rescheduling model that adjusts upcoming appointments based on observed no-shows. We formulate the problem as a Markov Decision Process in order to compute the optimal pre-day schedule and the optimal policy to update the schedule for every scenario of no-shows. We also propose an alternative formulation based on the idea of 'atomic' actions that can solve for the optimal policy more efficiently. Based on a numerical study, we estimate that using intra-day dynamic rescheduling can lead to a 5-7% decrease in expected cost when compared to static scheduling.