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Abstract

Appointment scheduling is a great challenge in healthcare operations management. Appointment rules (AR) provide medical practitioners with a simple yet effective tool to determine patient appointment times. Genetic programming (GP) can be used to evolve ARs. However, directly applying GP to design ARs may lead to rules that are difficult for end-users to interpret and trust. A key reason is that GP is unaware of the dimensional consistency, which ensures that the evolved rules align with users' domain knowledge and intuitive understanding. In this paper, we develop a new dimensionally aware GP algorithm with dimension repair to evolve ARs with dimensional consistency and high performance. A key innovation of our method is the dimension repair procedure, which optimizes the dimensional consistency of an expression tree while minimizing structural changes and ensuring that its output dimension meets the problem's requirements. We formulate the task as a mixed-integer linear programming model that can be efficiently solved using common mathematical programming methods. With the support of the dimension repair procedure, our method can explore a wider range of AR structures by temporarily breaking the dimensional consistency of individuals, and then restoring it without altering their overall structure, thereby identifying individuals with greater potential advantages. We evaluated the proposed method in a comprehensive set of simulated clinics. The experimental results demonstrate that our approach managed to evolve high-quality ARs that significantly outperform not only the manually designed ARs but also existing state-of-the-art dimensionally aware GP methods in terms of both objective values and dimensional consistency. In addition, we analyzed the semantics of the evolved ARs, providing insight into the design of more effective and interpretable ARs.