Scheduling tool cuts chemo wait times

June 28, 2011

SmartBook gives patients quicker access to treatment

VANCOUVER - Over the last year, Vancouver’s branch of the BC Cancer Agency has reduced the number of days patients wait for their first chemotherapy treatments, dramatically decreased the size of waiting lists and vastly improved notice to patients of their appointments. The secret to this success is Chemo SmartBook, a new scheduling system that was recently awarded an Excellence in BC Health Care Award from the Health Employers Association of British Columbia in the category of top innovation — health authority.

The inspiration for Chemo SmartBook came after the “incredible shock” when Martin Puterman’s wife was diagnosed with breast cancer more than 10 years ago.
While she was undergoing treatment, Martin and his wife found out that patients often did not discover they had an appointment until the day before they had to begin treatment.

“You just can’t believe how awful it is, and how much of a shock that is,” Puterman said Monday. “To add to that, the anxiety of, ‘did they actually remember my appointment?’ is very stressful.”

Puterman, a professor in operations and logistics at the University of B.C.’s Sauder School of Business, used his wife’s experience as motivation to put together a team of researchers to improve the complex task of scheduling chemotherapy. (He did not want to reveal his wife’s name for this story.)

Until a year ago, chemotherapy scheduling was all done by hand on paper. Last year, newly diagnosed cancer patients were likely to wait an average of 11 days for their first chemotherapy treatment at the Vancouver Centre of the BC Cancer Agency. This year, thanks to the new software launched in June 2010, they’re likely to wait just five days, Puterman said.

Not only that, but the new tool has reduced the number of patients who receive fewer than seven days notice of an appointment by 58 per cent and decreased the number of waiting-list patients by 84 per cent.

“Typically patients wouldn’t get notified until about a day in advance of when their appointment was,” Puterman said. “That was very stressful for patients, in particular they might have to arrange for someone to bring them to the agency, or if they had to coordinate child care or arrange to take time off work.”

Puterman’s wife, who was in her early 50s when diagnosed, is still going to the BC Cancer Agency for chemotherapy treatments more than a decade later. Ten years of navigating the world of chemo motivated Puterman to improve the system.

“The goal now is that people will be notified a week in advance of what time their appointment is,” he said.

Chemotherapy is extremely complex, with more than 600 different protocols for different people and types of cancer. Some are daily, some are once a month, with others being three days in a row every two weeks, or just about any conceivable permutation, Puterman explained.

“[Chemo SmartBook] automates a very complex process,” said John French, senior director at the BC Cancer Agency. “All of that was very time consuming and now it’s all done by this sophisticated system.”

French, who was a member of the team that developed SmartBook, said it has been a successful collaboration.

“It has allowed our staff to better focus on patient care, which makes their job much more rewarding and enhances our patients’ experience, ultimately improving patient satisfaction,” French said.

Chemo SmartBook uses techniques similar to those driving the complex schedules of airlines and manufacturing companies, Puterman said. It automatically assigns patients to nurses, balances workloads, alerts pharmacists of daily schedules and meets patient appointment preferences. The agency delivers 15,000 chemotherapy treatments to more than 2,000 patients each year.

Puterman hopes to see the tool implemented in other chemotherapy centres in North America and says it could be used to schedule almost anything.

sherlock@vancouversun.com

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