Community health pathways modeling and scheduling under uncertainty

Scheduling and coordinating constrained resources in community healthcare settings at a centralized Pathways Community HUB is challenging due to limited resources and the inherent dynamics of the processes and the organizational structures. In this work, we introduce a stochastic programming (SP) approach for connected community health for optimally scheduling community health pathways (CHPs) under uncertainty in resource availability. A CHP is a standardized tool that details multiple steps of a healthcare-related service and the required resources for each step. The SP methodology was implemented and applied to data for a real Pathways Community HUB for a U.S. county involving several CHPs, community health workers, physicians, and other resources. The computational results are promising and they show that client access times depend on the HUB resources uncertain future availability and the level of client demand, with high client demand resulting in relatively longer access time. The study reveals that schedules provided by a deterministic approach where resource availability is assumed to be known can be too optimistic. Several managerial insights are learned from this study, including the observation that the SP model provides client schedules that are equitable across the same type of community health workers.