Resources
Dispatch vs. routing: a working glossary
Vendors in the home-care logistics space use the same words to mean different things. This glossary fixes the terms so you can ask vendors the right questions and read product documentation without translating.
Dispatch
The act of assigning a specific clinician (or other resource) to a specific patient visit at a specific time.
Dispatch is the assignment decision. In practice, dispatch combines several sub-decisions: who, when, in what order, with what equipment. Dispatch decisions can be made manually by a coordinator, semi-automatically with a dispatch tool that surfaces options, or fully automatically by an optimization engine.
Routing
The geographic ordering of visits along a clinician's day, given the visits already assigned to that clinician.
Routing is a sub-problem of dispatch. Once you know which clinician sees which patients, routing decides what order to see them in to minimize drive time while honoring time windows and break requirements. Some products do routing without doing dispatch (they take assignments as given). True dispatch optimization solves them together.
Scheduling
The longer-horizon decision of which patients to schedule for visits on which days.
Scheduling lives upstream of dispatch. A care plan that says "daily nursing visits for two weeks" gets scheduled into a calendar. Daily dispatch then decides who actually shows up. Some vendors blur the two; treat them as separate decisions because they happen on different cadences and against different constraints.
Sequencing
The exact ordering of activities within a single home visit.
Distinct from routing (which sequences visits across a day), sequencing applies to the order of tasks during a visit: vitals, medication, dressing change, documentation. Most dispatch products do not address visit-level sequencing, which is left to the clinician. Capillary Health handles cross-visit sequencing only.
Credential matching
Ensuring the assigned clinician has the credentials and scope to perform the required services for the assigned visit.
An RN cannot perform a procedure that requires a physician. A credential-matching system encodes the requirements of each service type and the credentials of each clinician, and refuses to assign a clinician to a visit whose requirements they do not meet. This is non-negotiable in regulated home-based care; manual dispatch is where credential-mismatch errors creep in.
Time window
A fixed start and end time during which a visit must occur.
Examples include scheduled IV antibiotic doses, post-discharge call windows, and lab draws timed to medication administration. Time windows are hard constraints in dispatch optimization. Solvers that handle time windows explicitly produce different (and usually better) plans than ones that treat all visits as flexible.
Continuity of care
The preference for the same clinician to see the same patient across multiple visits.
Continuity drives clinical outcomes and patient experience. A dispatch engine that scores continuity will, all else being equal, prefer to assign the same RN to a patient who has seen them before. Most spreadsheet-based dispatch fails on continuity because tracking it across days requires bookkeeping the coordinator does not have time for.
Workload balancing
Distributing visits, drive time, and complexity across clinicians so no one is consistently overloaded.
Without explicit workload balancing, optimization tends to load up the most efficient clinician with the heaviest schedule. That produces good metrics for one day and burnout over a quarter. A balanced solver penalizes over-assignment and produces routes that are more sustainable.
Re-optimization
Re-running the dispatch solve mid-day to absorb cancellations, no-shows, and add-on visits.
The morning plan starts breaking by 9 AM. A re-optimization engine takes the current state of the day (visits completed, in progress, missed, newly added) and produces an updated plan with the smallest possible disruption to clinicians already in motion. Re-optimization is what separates a planning tool from an operational tool.
Multi-resource visit
A visit that requires more than one resource type, sometimes in a specific order.
An IV antibiotic infusion requires a pharmacy courier to deliver the drug, then an RN to administer it. The two resources have to converge on the same patient in a specific order, with the pharmacy delivery preceding the nursing visit. Multi-resource coordination is significantly harder than single-resource routing and is often where general-purpose routing tools fall over.
Acute Hospital Care at Home (AHCAH)
The CMS waiver program under which hospitals can provide inpatient-level care in a patient's home.
The regulatory framework for hospital-at-home in the US. See the Hospital-at-Home and CMS waiver resource for the details. Operationally, AHCAH programs have stricter dispatch requirements (multiple daily nursing touches, daily provider evaluation, emergency response capability) than non-AHCAH home-based care.
OSRM
Open Source Routing Machine. The travel-time engine commonly used to compute drive times between home addresses.
OSRM converts geographic coordinates into drive times based on the underlying road network. Dispatch optimization needs accurate, fast travel-time queries, and OSRM is the open-source standard. Capillary Health uses OSRM with regional OpenStreetMap data tuned for the markets it operates in.
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