Abstract

Magnetic Resonance Imaging (MRI) services in high-complexity hospitals often suffer from operational inefficiencies, including suboptimal MRI machine utilization, prolonged patient waiting times, and inequitable service delivery across clinical priority levels. Addressing these challenges requires intelligent scheduling strategies capable of dynamically managing patient waitlists based on clinical urgency while optimizing resource allocation. In this study, we propose a novel framework that integrates a digital twin (DT) of the MRI operational environment with a reinforcement learning (RL) agent trained via Deep Q-Networks (DQN). The digital twin simulates realistic hospital dynamics using parameters extracted from a MRI publicly available dataset, modeling patient arrivals, examination durations, MRI machine reliability, and clinical priority stratifications. Our strategy learns policies that maximize MRI machine utilization, minimize average waiting times, and ensure fairness by prioritizing urgent cases in the patient waitlist. Our approach outperforms traditional baselines, achieving a 14.5% increase in MRI machine utilization, a 44.8% reduction in average patient waiting time, and substantial improvements in priority-weighted fairness compared to First-Come-First-Served (FCFS) and static priority heuristics. Our strategy is designed to support hospital deployment, offering scalability, adaptability to dynamic operational conditions, and seamless integration with existing healthcare information systems. By advancing the use of digital twins and reinforcement learning in healthcare operations, our work provides a promising pathway toward optimizing MRI services, improving patient satisfaction, and enhancing clinical outcomes in complex hospital environments.