Case Studies » National Premier Dialysis Provider

Smart Scheduling

Automating a process with 5 quinvigintillion variables

Creating safer, more efficient scheduling across 2500 clinics.

In the dialysis healthcare industry, building optimal treatment schedules within a clinic is paramount to patient safety and efficient business operations. In most clinics, treatment schedules are built by the clinic managers—on paper—leading to potential conflicts or, worse, unsafe schedules for patients. It’s not an easy task. With dialysis treatment, there are many variables to consider, such as the patient’s habitual dialysis schedule, the available treatment chairs in a clinic, the time between appointments in a certain chair, the available technicians, the optimization of labor and treatment chemicals—it’s an extremely complex process. Using manual processes, it routinely takes days to optimize a single clinic’s schedule.

So when one of the nation’s premier providers of dialysis services wanted to optimize schedules across their 2500 clinics, an off-the-shelf solution would not suffice. With all the variables needed to optimize schedules within their scheduling solution, they would need to sort through 5 quinvigintillion options—5 x 1078—to find the best schedules for their clinics. Having worked with us in the past to extend the capabilities of their proprietary scheduling software, ScheduleWiseR, they gave Celerity a call.


  • Agile Development
  • Customer Centricity
  • Enterprise Agility
  • Operational Excellence

Scoping out a solution for safer patient scheduling

Ever since we first helped them implement and improve ScheduleWise, the client has been looking for a way to build in a one-click “easy button” for creating efficient schedules across all 2500 clinics. Patient safety is also a concern because dialysis is a life-maintaining treatment that requires consistent, time-sensitive scheduling. We began our mission by gathering data on what constituted an optimized schedule for this client based on more than 30 tactical, logistic, and patient-focused best practices identified by their scheduling staff. We also created an optimizer report, scoring schedules at each clinic to see what makes a schedule “good.” The results of these steps gave us an idea of what our developers—and their schedulers—were up against.

When we crunched the numbers, we found that all the considerations that needed to be programmed into the scheduling optimizer created five quinvigintillion combinations of possible solutions. So, Celerity leveraged combinatorial optimization, a computing approach that applies mathematical techniques to rapidly explore large volumes of data and identify the best answer.

Developing software to perform the most complex computations

Once we felt we had a good understanding of the requirements, scope, and possibilities, we began building the Optimizer Engine—the easy button the client was looking for. Using open-source Google OR-Tools for combinatorial optimization, we first built out all of the possible combinations of treatments that can exist, then we applied constraints to filter out all the combinations that do not work. Once we had all of the feasible solutions, we assessed each and assigned penalties to less desirable options so the engine could deliver the solutions with the lowest total penalty value.

“The new optimizer engine is having a major impact on our scheduling and operations.”
— Senior Vice President, National Premier Dialysis Provider

Delivering an easy button for schedule optimization

Our client is now able to optimize their patient schedules with the click of a button. Schedules that once took days to optimize now take minutes, freeing the schedulers’ time and energy for other tasks. In addition, costs across all 2500 clinics are reduced by optimizing appointments, staff, and clinical materials. Because our client is dedicated to creating a customer-centric, digitized organization, their self-developed (and now enhanced) scheduling tool, ScheduleWise, is creating real differentiation for their services in the marketplace.

Before Celerity

Manual optimization of clinic schedules

Up to 3 days needed to optimize one three-day schedule at one clinic

Error-prone system of optimization for critical, life-sustaining treatments

Cumbersome process with important scheduling details sometime falling through the cracks

With Celerity

“Easy Button” that automates optimization

Schedules optimized in minutes at each of the 2500 clinics

Safer, more patient-focused scheduling across all clinics

Flexible Decision-MakingConsistent scheduling and appointments, improving patient care, safety, and the success of treatments

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