A queueing approach for appointment capacity planning in primary care clinics with electronic visits

Electronic visits (e-visits), which allows patients and primary care providers to communicate through secure messages sent from patient portals, has enabled virtual care delivery as an alternative to traditional office visits for selected and non-urgent medical issues. In this study, we address the appointment capacity planning problem for care providers and administrators who are engaged in facilitating e-visits to improve care delivery efficiency and patient access. We model the dynamics of patient appointment backlog using discrete-time bulk-service queues, and develop novel numerical methods for incorporating patients rejoining and flexible provider capacity tailored to the service nature of e-visit. The analytically tractable model enables evaluating the impacts of service system intensity, effectiveness of e-visits, and popularity of e-visits on care delivery performance, and identifying the conditions favoring e-visit implementation. The insights obtained from the model provide guidance on service capacity design to maximize the potential of e-visits.