What healthcare can learn from aviation security

For decades, every commercial air traveler was asked two standard questions:

  1. “Has your luggage been in your possession at all times?”
  2. “Has anyone given you anything or asked you to carry on or check any items for them?”

Eventually, this stopped after billions of passengers kept saying no. I remember the airlines and/or the Transportation Security Administration stopped asking these questions because they required resources (employee time) without adding to security. I couldn’t find much documentation about this process, so if you find some, please leave a comment.

I wish my doctor’s office would adopt this strategy. I recently had to verify my insurance information and identity three times for a simple doctor’s appointment:

  1. when making my appointment,
  2. upon check-in for my appointment,
  3. with the nurse who took my vitals during my visit,

I realize that my identity needs to be verified at each appointment to insure that my healthcare provider is treating the right person. However, most of the effort seems to be redundant checks to ensure that my insurance information is correct to facilitate billing.

The National Academies released a report entitled The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. The chapter entitled “Excess Administrative Costs” starts as follows.

Administrative costs in the United States consumed an estimated $156 billion in 2007, with projections to reach $315 billion by 2018 (Collins et al., 2009). With the time, costs, and personnel necessary to process billing and insurance-related (BIR) activities from contracting to payment validation on the provider side and the needs of payers to process claims and credential providers, significant redundancy and inefficiency arises from healthcare administration.


The recommendations don’t specifically mention that my service provider should not ask me if my insurance has changed three times or more for each visit, but it’s definitely consistent with the part about “significant redundancy.”

I don’t have the solution. I am just pointing out that the healthcare industry seems to be slower in fixing its inefficiencies than other industries. If you have the solution, let me know.

What are other opportunities for improvement in healthcare operations?


advanced #analytics for supporting public policy, bracketology, and beyond!

On Monday I gave a keynote talk at the tech conference WiscNet Connections (formerly known as the Future Technologies Conference) in Madison, Wisconsin.

The title of my talk was “Advanced analytics for supporting public policy, bracketology, and beyond!” I talked about advanced analytics as well as my research in aviation security, emergency response, and bracketology. My slides are below.

A digital device policy in the classroom

Every semester, it gets harder and harder for me to police student distraction in my classes. I set policies, they become hard to enforce, and then things spiral out of control. Lather, rinse, repeat. It seems to get harder each semester as we become even more connected to our digital devices.

This semester I am teaching two courses that are both lecture style. I often do in-class active learning activities that require a laptop or calculator. Students can work with one of their peers if they forget their laptop. I ask students to keep their laptops and cell phones away during class when we are not doing an activity that requires their use, but over time, the laptops come out.

Sometimes when class starts I remind students to put their laptops away until we need to use them. The laptop lids close, but half a dozen laptops reopen within 15 minutes of the announcement. I am losing the battle.

Laptops and cell phones are a distraction to everyone, not just the students who are using the laptops, and they interfere with everyone’s learning. I can handle some disrespect in the classroom but I become less tolerant when students are disrespecting their peers who want to learn.

I am experimenting with new ways to set and enforce policies. I firmly believe in focusing on student learning and treating students like adults. I think it’s better for me to set policies that trains students to deal with expectations they will encounter in other parts of their lives rather than stick with an unnuanced ban.

Below is a message I posted to my course discussion board. The statement (aside from the opening paragraph) will now be added to my course syllabus. I plan to introduce the cell phone use rubric periodically throughout the semester when things spiral out of control. Feedback is welcome.


I want to clarify the laptop policy in class. My ultimate goal is student learning, and the time we have in class is a great opportunity for us to learn. I know everyone is attached to their digital devices and it’s hard to put them down. (Confession: it’s hard for me, too). Here are some guidelines for device use in class.

Laptop and cellphone policy. Laptops and tablets should be put away and closed if we are not using them for an in-class example. Research* shows that laptop use in class leads to lower grades for those with the laptops and even lower grades for those who are sitting by the laptop users due to the distractions they provide. I ask that you respect your peers’ desire to learn and not engage in distracting behavior in class.

* Sana, F., Weston, T. and Cepeda, N.J., 2013. Laptop multitasking hinders classroom learning for both users and nearby peers. Computers & Education, 62, pp.24-31.

Here is an article about the research: http://www.huffingtonpost.ca/2013/08/14/laptops-in-classrooms_n_3756831.html

This is a guide for cell phone usage in class:


I’ve made a few memes that I use in class but they no longer work and my undergrads are no longer familiar with Star Wars episodes IV-VI! But I like them 🙂



Happy 10th birthday, Punk Rock Operations Research!

It’s been 10 years since my first blog post. Since then I’ve written 667 more posts that have received 1501 comments. Ten-percent of those comments were made by Paul Rubin. I am still blogging. I really love it otherwise I wouldn’t still be here. It’s hard for me to characterize why I love blogging so much, but hopefully my passion for it comes across in my blog.

Some of my most read posts include the following:

fitting three car seats in a Honda Civic: an exercise in decision-making under uncertainty
why my cookies turned green: a post on chemistry
snowblowing is NP-complete
what is the conditional probability of being struck by lightning?
ode to lab notebooks
How can ice cream trucks be profitable when gas costs $4 per gallon?
plantains and coupon collecting
werewolves and star wars: two exam questions
on vampires and stochastic processes
so you’re thinking about graduate school in operations research
how to win at Russian Roulette
what is the (conditional) probability of exploding when filling your car up with gas?

While not one of my most popular posts, chocolate chip cookies are Poisson distributed is one of my recent favorites that many people have mentioned to me.  I also like happiness is assuming the world is linear,” what I do for diversity and inclusion in the classroom,”  and about a dozen other posts I cannot remember. I also like my posts about teaching with technology, sports, and March Madness.

Since starting Punk Rock OR, I started a podcast that I should revive, an “In the News” section, and another (Badger Bracketology).

If you are at the Analytics conference, wish my blog a happy birthday!

What is your favorite Punk Rock OR post?




Laura McLay -> Laura Albert: OR Punk Rocker changes her name

My name has changed back to my birth name. It’s a long story. The short story is that I started a new chapter in my life, and I am much happier.

I have decided to change name name in professional circles fully back to Laura Albert. It’s been about a year and a half since the divorce was finalized and about a year after legally changing my name. There is no timeline for when to make these changes. It’s a process. I’m working at the pace that feels right to me.

My twitter handle has changed to @lauraalbertphd. If you follow my old handle on twitter, then you already follow my new handle.

I appreciate Lara Hogan’s excellent blog post and article about changing her name post divorce. These are the best articles I could find about the topic. I appreciate that it took her two years until she was ready to make the change professionally because she was already known by her married name and had several fears about losing recognition and having awkward encounters with colleagues and acquaintances. I can relate. It’s a pain to go through a name change at this stage of my career, but returning to Laura Albert feels right to me. Changing my name is part of getting myself back, and that part feels great. But I still have fears. Having a one year lag between changing my name legally and changing it professionally helped me give my new name a test drive and get through the transition in my personal life, which then gave me the confidence to change my name professionally. Yet I am still afraid that no one will recognize me with a different name.

I’m asking you to accept that I’m going by Laura Albert now and to do your best to adapt to the new name. In many places online, I will be “Laura McLay” for awhile or forever. That’s OK. I am sure I will be accidentally called “Laura McLay” for years to come, and that’s OK too.

I live in Madison with my three daughters. We are a great team, and being a single mom is pretty awesome. I joke that our house is like Paradise Island, where I am an Amazon raising three Wonder Women on an island of all girls. Their dad lives out of state, which means I am the sole parent for most of the year. I’m happy to say my daughters and I are thriving. Many of you know all of this. The support you have given and continue to give to me means the world to me. Thank you 🙂

“operations research is an applied discipline whose journals should be restricted to problems of immediate practical interest”

Recently, Melissa Moore, Executive Director of INFORMS sent me an interesting paragraph from the TIMS/ORSA Action Minutes-Joint Council Meeting, April 22, 1974. It is from the proposal for a Journal of Mathematical Operations Research and was discovered when doing research for the obituary for Kenneth Arrow.

“Some feel operations research is an applied discipline and that the attention of its journals should be restricted to problems of immediate practical interest. While we recognize the importance of practical applications, we also think it is essential to the long run vitality of operations research that support be given to high level innovative mathematical work in the field on difficult and important problems. A deeper understanding of the complexity of decision making in large organizations requires new and sophisticated mathematical ideas. Indeed it is from the insights gained in such work that the applications of tomorrow are likely to draw.”

How times have changed! The top journals in operations research most definitely focus on new and sophisticated mathematical ideas. In fact, Mathematics of Operations Research exclusively publishes theory foundational studies with significant mathematical content and relevance to operations research and management science.

You can read about a few of the important contributions made in these journals in these blog posts:

constructing a NCAA basketball tournament bracket is NP-hard

I continue to receive a lot of questions about Wisconsin’s 8 seed (read the blog post here). The NCAA men’s basketball selection committee doesn’t just assign seeds to teams, it also puts the teams into the bracket, which involves assigning a team a seed, assigning other teams to the regions, and assigning locations to each game. This is an NP-hard problem that involves balancing several interdependent decisions.  You can formulate the problem as an integer programming model subject to many assignment and distance constraints. Cole Smith, Barbara Fraticelli and Chase Rainwater published a paper on optimization models to design good tournaments that balances these constraints while getting the seeds right. As far as I know, the committee constructs the bracket by hand.

Below are the official rules for the final part of constructing the tournament called “Building the Bracket.” The emphasis is mine–I boldfaced the major rules that constrain how the bracket is built. There are a lot of rules, so many that even identifying a feasible solution may be difficult. Near the end: “A team may be moved up or down one (or in extraordinary circumstances) two lines from its true seed line when it is placed in the bracket if necessary to meet the principles.” I suspect Wisconsin was given an 8 seed to conform to all the rules. It’s worth pointing out that Wisconsin’s low seed was ultimately unfair to top seed Villanova, who had an extremely second round opponent (sorry not sorry, ‘Nova). Optimization models and algorithms could have constructed a bracket that was more fair to the teams.


Sixteen levels are established (i.e., the seeds, 1 through 16) in the bracket that cross the four regions, permitting evaluation of four teams simultaneously on the same level.  Teams on each seed line (No. 1, No. 2, No. 3, etc.) should be as equal as possible.

Each region is divided into quadrants with four levels in each, permitting the evaluation of four different sections within each region against the same sections in each of the other regions.

The committee will assign all four teams in each bracket group (seeds 1, 16, 8, 9), (4, 13, 5, 12), (2, 15, 7, 10), (3, 14, 6, 11) to the same first-/second-round site. There will be two ”pods‟ at each first-/second-round site which may feed into different regional sites.

Each of the first four teams selected from a conference shall be placed in different regions if they are seeded on the first four lines.

Teams from the same conference shall not meet prior to the regional final if they played each other three or more times during the regular season and conference tournament.

Teams from the same conference shall not meet prior to the regional semifinals if they played each other twice during the regular season and conference tournament.

Teams from the same conference may play each other as early as the second round if they played no more than once during the regular season and conference tournament.

Any principle can be relaxed if two or more teams from the same conference are among the last four at-large seeded teams participating in the First Four.

To recognize the demonstrated quality of such teams, the committee shall not place teams seeded on the first four lines at a potential “home-crowd disadvantage” in the first round.

The last four at-large teams on the overall seed list, as well as teams seeded 65 through 68, will be paired to compete in the First Four games on Tuesday and Wednesday following the announcement of the field. (If allowed, the last at-large team on the seed list  will be paired with the second-to-last at-large team on the seed list. The other First Four games will consist of the third-to-last at-large team on the seed list playing the fourth-to-last at-large team on the seed list, as well as seed 65 versus 66; and seed 67 versus 68).

The winners of the First Four games will advance to a first- and second-round site to be determined by the committee during selection weekend. In the event a First Four site is also a first- and second-round site, the winners of the First Four games may be assigned to that site, regardless of the days of competition.

Teams will remain in or as close to their areas of natural interest as possible. A team moved out of its natural area will be placed in the next closest region to the extent possible. If two teams from the same natural region are in contention for the same bracket position, the team ranked higher in the seed list shall remain in its natural region.

A team will not be permitted to play in any facility in which it has played more than three games during its season, not including exhibitions and conference postseason tournaments.

A host institution’s team shall not be permitted to play at the site where the institution is hosting. However, the team may play on the same days when the institution is hosting.

Teams may play at a site where the conference of which it is a member is serving as the host.

A team may be moved up or down one (or in extraordinary circumstances) two lines from its true seed line (e.g., from the 13 seed line to the 12 seed line; or from a 12 seed line to a 13 seed line) when it is placed in the bracket if necessary to meet the principles.


Procedures for Placing the Teams into the Bracket
(a procedure for ensuring that the regions are roughly balanced)

1. The committee will place the four No. 1 seeds in each of the four regions, thus determining the Final Four semifinals pairings (overall 1 vs. 4; 2 vs. 3).

2. The committee will then place the No. 2 seeds in each region in true seed list order. The committee may relax the principle of keeping teams as close to their area of natural interest for seeding teams on the No. 2 line to avoid, for example, the overall No. 5 seed being sent to the same region as the overall No. 1 seed. The committee will not compromise the principle of keeping teams from the same conference in separate regions.

3. The committee will then place the No. 3 seeds in each region in true seed list order.

4. The committee will then place the No. 4 seeds in each region in true seed list order.

5. After the top four seed lines have been assigned, the committee will review the relative strengths of the regions by adding the “true seed” numbers in each region to determine  if  any  severe  numerical imbalance exists. Generally, no more than five points should separate the lowest and highest total.

6. In “true seed” order, the committee then assigns  each  team  (and,  therefore,  all teams in its bracket group—e.g., seeds 1, 8, 9, 16) to first-/second-round sites.

7. The committee will then place seeds Nos. 5-16 in the bracket, per the principles. The four  teams  assigned  to  the  seed  line,  5 through 16, will have the same numerical

Additional Considerations

1. If possible, rematches of non-conference regular-season games should be avoided in the First Four and first round.

2. If possible, after examining the previous two years’ brackets, teams or conferences will not be moved out of its natural region or geographic area an inordinate number of times.

3. If  possible, rematches from the previous two tournaments should be avoided in the first round.

You can read the official rules for selection and seeding for the men’s tournament is here. I did not find nearly so many rules or information about selecting and seeding the women’s tournament.

Go Badgers!