A Novel Simulation Framework for Evaluating and Optimizing Oncology Outreach Policies in a Regional Cancer System

Area of Science:

• Healthcare Operations Research
• Health Services Research

Background:

• Oncology outreach addresses cancer workforce shortages by utilizing traveling oncologists.
• Current methods for evaluating and optimizing these outreach strategies are limited.

Purpose of the Study:

• To develop and apply a simulation framework for evaluating and optimizing oncology outreach strategies.
• To estimate patient travel time savings by reallocating visits from a central hub to satellite locations.

Main Methods:

• A simulation framework was developed to evaluate outreach strategies within a hub-and-spoke cancer system.
• Patient visits were sampled and assigned to oncologist/site pairs to estimate travel time differences between original and reallocated visit distributions.
• 5000 simulations were run to identify optimal reallocation percentages maximizing patient travel time savings.

Main Results:

• Simulation identified St. Johnsbury, VT, and Manchester, NH, as key sites for increased oncology outreach.
• Reallocating 45% of new medical oncology visits to St. Johnsbury saved 140 hours; reallocating 50% of radiation oncology visits to Manchester saved 55 hours.
• Patient travel time savings per shifted visit ranged from 1.07 to 1.13 hours.

Conclusions:

• Simulation modeling provides a robust method for assessing the effectiveness and uncertainty of oncology outreach strategies.
• This approach can support administrative decision-making and inform investments in outreach policies for health systems.