This case examines the operational and strategic challenges faced by Charaka Hospital, a large private multi-speciality hospital in Kerala, in managing its outpatient department (OPD). Confronted with declining patient footfall, rising competition, and increasing patient dissatisfaction due to long waiting times, the hospital’s management explores data-driven approaches to improve throughput, optimize resources, and enhance patient experience. Using detailed OPD-level data on patient arrivals, appointments, and consultation times, the case highlights the trade-offs between service efficiency, quality of care, and revenue growth in a value-based healthcare environment. It invites readers to analyze waiting time variability, demand concentration across departments, and the role of forecasting and digital health solutions in redesigning OPD operations.