David Rea: Automating Fairness

When David Rea was working on his Ph.D. in business administration at the University of Cincinnati, his focus was mainly statistical. Then, administrators of a local hospital system approached him with an operational challenge that had the potential to improve human well-being. Since then, much of his work has focused on solving problems that present both technical and human-related challenges.

“My field is traditionally very focused on efficiency, which makes sense considering that it comes out of manufacturing principles,” says Rea, now a faculty member in the Decision and Technology Analytics Department of the College of Business. “If a widget waits for a while, or gets lost in the system, as long as your overall efficiency is high, that’s OK. In my work, I’m asking: How do you take those same principles and apply them to situations where efficiency is not the only central objective?”

The local hospital system administrators were looking to manage the allocation of physicians’ clinical time across the different emergency medicine departments they operated throughout the city. While the hospital needed to ensure optimal service levels, it also wanted to accommodate physicians’ location preferences. With physician burnout an ongoing challenge affecting the health systems nationwide, administrators were looking to balance operational needs with a need to ensure their employees’ job satisfaction.

Could Rea help them identify allocations that would be both operationally efficient and be received well by the medical staff?

“You’re essentially trying to automate a fair process,” says Rea. “And the problem with that is that people have differing perceptions of what makes something ‘fair.’”

Aligning Food Distribution to Community Need

Rea is now working on a long-term project focused on improving efficiency and equity in food distribution. Allocation is, once again, the theme.

“We are still looking at a resource,” says Rea. “Instead of physicians allocating their time to locations, we are looking at how food is being allocated across a region.”

Rea has found one major difference between working with a hospital system and working with regional nonprofit
food organizations: a severe lack of data. Building a data infrastructure is a key first step in the process and one that he expects will take a while.

To understand the local or regional need, explains Rea, nonprofits rely on data from the American

Community Survey, a federal program from the Census Bureau that annually collects data on a variety of topics. The data is aggregated state by state to provide a picture of each area’s need. According to Rea, it takes about two years before the states receive the data.

“Food distribution organizations are trying to use this data to decide where to allocate their resources,” says Rea, “but they’re doing it with this data that is not really reflective of the problem at hand.”

Rea hopes to combine the government data with information he gathers from regional food distribution organizations. This, he says, could provide a real-time picture of the region’s needs. The next step would be for the organizations to utilize the analysis to help make the most effective use of resources. Once the data infrastructure is built and the model to analyze it developed, Rea would then seek to make it scalable and replicable.

“There are some very clear justice aspects to how those food distribution decisions are being made,” says Rea.

Then, he says, there are these highly skilled crews that staff vehicles known as “mobile ICUs.” A nurse practitioner or a nurse is usually onboard to provide care to the patient. These crews are reserved for the much-less-frequent high-acuity cases. So those crews may not be doing as much work as the crews staffing the more day-to- day transportation.

“Ultimately, the question is: How do you take these scarce resources and allocate them in a way that is fair?”

Developing a way for cash-strapped nonprofit organizations to invest in data infrastructure presents an inherent challenge, says Rea. Organizations want to ensure that every dollar is going toward the mission of providing food to people who need it.

Adds Rea: “An investment in infrastructure could ensure that those dollars can be used more efficiently to get food to people and ensure the best use of scarce resources.”

David Rea’s research aspires to improve human well-being inside service systems. His work integrates predictive and prescriptive analytics methodologies, largely focusing on operational problems in the delivery of basic-needs services. Rea has a Ph.D. in business administration from the University of Cincinnati.