

MIT student applies predictive modeling to improve emergency-room wait times - muzz
http://web.mit.edu/newsoffice/2013/student-profile-kuang-xu-0807.html

======
olympus
Not to make light of his work, but this is not that novel. Students have been
"improving" the medical field using queuing theory and simulation software for
years . I did it in my stochastics class when I got my master's degree in
Operations Research. The key translation from the article is "Xu emphasizes
that the work is still ongoing" which means that isn't implemented [yet] and
the 40 minute savings are just computer estimates.

What I would really like to see is an article titled, "Huge real-world
increases in medical efficiency directly attributed to student's work and now
saves hundreds of lives per year" \-- or something like that. I'm not very
good at creating titles.

Again, I want to emphasize that I don't want to make light of Mr. Xu's work
(stochastics might be my least favorite subject and gets complicated when you
create detailed models) and I wish him luck as he pursues his PhD.

~~~
tnash
Agreed. My sister is an IE for a major hospital. This is pretty much what she
does all day every day.

~~~
balsam
Academia (meaning anything post-masters) has a very nuanced understanding of
the word "novel". Skimming through the paper (linked below) it seems that the
novel part is that they "show that the amount of information about the future
has a signiﬁcant impact on system performance, in the heavy-traﬃc regime." Not
Elon Musk-novel perhaps, but definitely academia-novel.

[http://arxiv.org/abs/1211.0618](http://arxiv.org/abs/1211.0618)

------
DanBC
> _“In emergency rooms, you’re typically overloaded all the time. If you look
> at the statistics of the U.S. average waiting time, the total average time
> is on the order of a few hours. A lot of people leave without being seen by
> a doctor because they just get frustrated.”_

This suggests that some people use a weird definition of "emergency".

~~~
seanmcdirmid
People often feel so horrible they get desperate and stop thinking as
logically as they should. For example, a bad flue will make you delirious even
though, if you aren't very old or young, the best way to treat it is often
some ibuprofen, water, and just to sweat it out (disclaimer: I'm not that kind
of doctor).

I went to the emergency room this year because I was in pain and needed a pain
killer prescription for a bad abrasion (that I was self treating otherwise) at
3 AM in the morning. But in my case, the emergency room at the private
hospital I go to in China was quite deserted, and they even gave me a tetanus
shot for the trouble.

~~~
ceol
_> sweat it out (disclaimer: I'm not that kind of doctor)._

Yeah, if you're delirious from a flu (assuming you mean the fever), you need
to go to either your primary care physician or the ER. Do not try to "sweat it
out."

The ER will be more than happy to have you there even if you could have stayed
home. They know what they're doing; they're not going to let someone else die
to treat your sniffles.

~~~
seanmcdirmid
Sweating it out in the ER waiting room sucks versus sweating it out in bed at
home. Of course, it depends on how sick you are, and if you ask your doctor
they will always err on the side of caution.

...and an IV drip usually doesn't help that much, and its not good to have too
many of those.

~~~
ceol
An IV drip can mean the difference between life and death by dehydration.
Seriously, it's why doctors tell you to go to the ER if you can't keep any
liquids down when you have food poisoning or the flu. Couple that with the
fluid loss you're already experiencing from being sick, and it can turn deadly
_fast_. Not to be rude, but you have to be completely ignorant to say, "an IV
drip usually doesn't help that much." Unless you're talking about someone who
isn't dehydrated in the first place, in which case I'd agree, but most ERs
don't hook someone up to an IV for shits; if you're getting a bag, you're
probably dehydrated. (They don't want to waste their bags, IVs, nurses' time,
and risk infection on someone who doesn't need it.)

Even if you have a healthy immune system, if you're _delirious_ from a fever,
you should call your doctor ASAP.

Note: I'm not a doctor, this is not medical advice, yadda yadda. I've just
been living with Crohn's disease long enough to learn some of this from my own
visits to the ER.

~~~
seanmcdirmid
Most ERs in china will hook you up to an IV drip by default without even a
doctor's consultation first. And ya, it sucks.

But really, why do you think flu is so deadly? If you are very young, very
old, or have other medical conditions, fine, it makes sense to hit the ER. If
you are a healthy adult and just got hit with a bad one/two day flu, you are
able to keep your fluids in (beyond sweating them out), you don't need to hit
the ER even if you feel like crap... By delirious, I'm talking about shady
gradients anyways, I've never had more than sweating dreams where nothing
makes sense. Ya, there is a point where you should go the ER, but our
thresholds are fairly diverse.

~~~
ceol
At least a few thousand people die from the flu each year.[0] I've just been
responding to your original post. You said "delirious", which is an actual,
serious medical condition associated with high fever and dehydration.[1] Then
you told people to "sweat it out", which is a myth.[2] I'm just trying to
correct some of these misconceptions so someone doesn't read it and think that
being delirious is completely normal and you should try to lose even _more_
fluids.

[0]: [http://www.cdc.gov/flu/about/disease/us_flu-
related_deaths.h...](http://www.cdc.gov/flu/about/disease/us_flu-
related_deaths.htm)

[1]:
[http://en.wikipedia.org/wiki/Delirium](http://en.wikipedia.org/wiki/Delirium)

[2]: [http://www.insweb.com/health-insurance/5-common-flu-
season-h...](http://www.insweb.com/health-insurance/5-common-flu-season-
health-insurance.html)

------
cyanoacry
I'm a little suspicious of how much of this is press-piece fluff, given that
they make the assertion that his algorithm reduces times by 40 minutes, which
is 10%. This means that the average waiting time is 400 minutes, or over 6
hours.

While I've seen one report[1] that claims this, data from recent sources[2,3]
give me median/mean times of around 50-180 minutes, which is much more
reasonable.

Does anybody know which is right, and if there's a real paper that lists these
findings? I'd be very surprised, as other commenters have noted, if such
optimization work wasn't being done already.

[1]
[http://www.cnn.com/2011/HEALTH/01/13/emergency.room.ep/index...](http://www.cnn.com/2011/HEALTH/01/13/emergency.room.ep/index.html)

[2] [http://www.medicare.gov/hospitalcompare/Data/emergency-
wait-...](http://www.medicare.gov/hospitalcompare/Data/emergency-wait-
times.html)

[3]
[http://www.cdc.gov/nchs/data/databriefs/db102.htm](http://www.cdc.gov/nchs/data/databriefs/db102.htm)

------
pavanred
I had worked on analysis of data from National Highway Traffic Safety
Administration (NHTSA), the number of traffic accidents based on factors such
as weather, time of the day, month, year, weekdays, weekends etc and found
very definitive patterns in the number of traffic accidents. Though that was
post analysis, it does look quite interesting to use features such as weather,
day of the week etc to predict the rush at the emergency rooms.

------
philip1209
This is quite similar to the TACO system that started managing operations for
all Taco Bell locations in the late 80's by predicting the number of
customers, running a queuing model to determine the number of workers
necessary, and using an integer programming model to schedule specific
employees: [http://zimmer.csufresno.edu/~sasanr/Teaching-
Material/MIS/DS...](http://zimmer.csufresno.edu/~sasanr/Teaching-
Material/MIS/DSS/DSS%20at%20Taco%20Bell.pdf)

Queuing theory is fascinating and applicable to many real-life situations. For
class, I built this queue simulator [1] that suggests the number of cashiers
necessary for a restaurant (e.g. a Panera or Starbucks) based on the number of
customers per hour, the average service time, and the goal customer checkout
time by using an M/M/c [2] model:

[http://queue.philipithomas.com/](http://queue.philipithomas.com/)

[1] It's technically not a simulation because it solves the problem
analytically, but here is a simulation-based approach I also wrote:
[https://github.com/philipithomas/M_M_1](https://github.com/philipithomas/M_M_1)

[1]
[http://en.wikipedia.org/wiki/M/M/c_queue](http://en.wikipedia.org/wiki/M/M/c_queue)

------
btilly
The scariest part of the article is that he's cutting 10% off of the wait
time, and that's 40 minutes.

This means that normal wait times were around 7 hours!

~~~
willchilcutt
I worked in Suzhou for a month and I can tell you they are terrible at things
like this. When I was there they had just began working on a subway, but they
were doing construction all at once throughout the city. This meant that two
lanes were closed on nearly every block just for construction. A ten minute
bus ride would take an hour in the horrible traffic.

~~~
seanmcdirmid
The researcher is from Suzhou, this article has nothing to do with Suzhou,
however.

Oh, and you should have just walked.

