In December 2014, Dr. Anthony Furlan, chair of the Department of Neurology at University Hospitals Cleveland Medical Center (UH), faced a mandate from the hospital's executive leadership team. Specifically, all UH departments were directed to take steps within six months to reduce the waiting time for outpatient appointments-measured as the time to first available outpatient appointment-to no more than 15 days. For Furlan and his colleagues in neurology, achieving this target was a significant challenge, as the department's current time to first available appointment was 93 days. The case considers several alternatives for reducing waiting time in outpatient neurology without increasing the total clinical staff. The case allows students to evaluate opportunities for expanding the effective capacity of a complex service operation and to understand the tradeoffs between customer service and labor utilization.

In recent years, health care organizations have made sizable investments in information technology. They've used their IT systems to replace paper records with electronic ones and to improve billing processes, thereby boosting revenue. But so far, IT has been of little value in making medical care delivery more effective or less expensive. How can health care organizations change this? One key is to prioritize quality improvement over cost cutting. By harnessing IT to help design better clinical practices, it's possible to achieve better patient outcomes and better financial performance. It is also vital to gather good information--by using simpler, more-organic collection methods--and to make it actionable by applying analytics. Finally, many organizations will need to forge new business and operating models, expanding their IT staffs, revamping how their clinical staffs work, and creating new payment structures. The authors provide numerous examples of health care organizations that are taking these steps--and seeing impressive results.