Joint visit in primary care clinics: Modeling, analysis, and an application study

Hyo Kyung Lee, Xiang Zhong, Jingshan Li, Albert J. Musa, Philip A. Bain

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


To improve patient flow and reduce provider workload, joint visit has been proposed and implemented in many primary care clinics. In such systems, the provider and medical assistant (MA) visit the patient jointly; while the provider diagnoses and interacts with the patient, the MA handles necessary documentation work. This article introduces Markov chain models of patient flow with joint visits, and investigates the system behavior under different scenarios. To reduce the state space dimension, convergent iterative procedures are proposed. The study is extended to the non-Markovian case by introducing empirical formulas based on the mean and coefficient of variation (CV) of service times. The results have been validated with good accuracy. To illustrate the applicability of the methods, an application study at Dean East Clinic is presented.

Original languageEnglish
Pages (from-to)93-109
Number of pages17
JournalIISE Transactions on Healthcare Systems Engineering
Issue number2
Publication statusPublished - 2018 Apr 3
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2018 “IISE”.


  • iteration
  • joint service
  • length of visit
  • Markov chain
  • patient flow
  • Primary care

ASJC Scopus subject areas

  • Safety, Risk, Reliability and Quality
  • Safety Research
  • Public Health, Environmental and Occupational Health


Dive into the research topics of 'Joint visit in primary care clinics: Modeling, analysis, and an application study'. Together they form a unique fingerprint.

Cite this