About Us

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CHOIR of the University of Twente (UT) is the Dutch knowledge center in the field of healthcare logistics / operations management in healthcare. We believe that innovations in business operations contribute to the challenges of healthcare institutions achieving improved services at lower cost and also improving the quality of work. By lowering the workload for professionals, it will be more attractive to work in healthcare. We generate innovations by developing knowledge and apply it in our three pillars: research, education and consultancy.

CHOIR is a multi-disciplinary cooperation between two general research institutes of the UT, IGS and CTIT, and representing the following disciplines:

• Operations research / operations research

• Logistics and Operations Management

• Purchasing Management

• Business analytics, information technology and management

• Quality & Safety Management

The researchers involved have expertise based on a fruitful tradition of research and innovation in industry, transport and ICT.


CHOIR innovates concepts of business operations in healthcare and translates existing innovations from other markets to healthcare. These include information technology, management principles as total quality and integral capacity management, safety management and lean production, and optimization of healthcare processes with mathematical techniques and simulations. Using these simulation and mathematical models, we can objectivity difficult decision trade-offs that healthcare management faces. For example, we can accurately predict, under all sorts of scenarios and a long horizon, the impact of new management models in practice via a safe simulation environment.

The CHOIR research agenda is determined by the demand we derive from healthcare organizations we cooperate with. Also our PhD candidates are always employed part-time at a healthcare organization to identify practical problems and to translate new research.

Besides research CHOIR also focuses on the development of education for various target groups within and outside the university.

From the research and education activities provided by CHOIR, we increasingly receive requests from healthcare institutions to implement the latest developments in healthcare business operations. The founders of CHOIR provide this service through the spin-off Rhythm and gives us the opportunity to put our research results direct into practice.


Healthcare institutions deal with major challenges through a constantly changing market. Both medical and technological innovations have driven a shift from inpatient to outpatient care, and increased the opportunities for healthcare delivery and thereby increasing the demand for care.

Comparing healthcare with industry, we found it striking that in recent decades the industry was able to deliver products of increasing quality, at lower cost and with greater diversity. Product and process innovation are now vital for production and there is no production company that can exists without. By making these spectacular developments in industry, society demands more cost effective (competitiveness) healthcare. As an answer, the Netherlands developed and implemented the managed care market. The question now is whether healthcare institutions, particularly hospitals, can manifest themselves on the market in such a way that this will eventually result in cost reductions, increasing quality and stimulates innovation.

Answering this question is not so simple. In addition to the principals of a free market (supply and demand), the managed market has more dimensions such as accessibility, solidarity and the separation of service and payment. In addition, the nature of the product as a service to people and the dependent relationship between customer and supplier results in a skewed distribution of knowledge and experience. Furthermore, healthcare institutions are characterized as knowledge centers, with self-operating teams. This may complicate change and adaptation of innovations.