The connected, creative innovator

Raina Merchant, MD, MSHP, realized early in her career that she had found her professional home at Penn Medicine.

It happened when, in 2012, she dreamed up the MyHeartMap Challenge, a crowdsourcing tournament to map the locations of automated external defibrillators throughout Philadelphia. An early-career Penn Medicine emergency physician and cardiac arrest researcher at the time, Merchant wanted to create a repository of the devices that could save the lives of people experiencing cardiac arrest—but she needed a lot of help to do it.

Merchant quickly found colleagues in the Perelman School of Medicine to support her. Then, she connected with Wharton faculty, who helped design the structure of the tournament. To build a mobile application with geo-tracking capabilities, Merchant turned to experts in the School of Engineering. Penn communications teams spread the word about the effort to rally the public to contribute to the project for a chance to not only save lives, but also win a prize for finding the most AEDs, and some university undergraduates assisted in developing clues to guide tournament participants.

Merchant remembered thinking at the time: “I can’t believe I’m at a place that has so much expertise to focus on a public health problem. We were so much stronger, and the project was more interesting, because we leveraged expertise across the university, from the students to the emeritus faculty with different disciplines.”

Now, more than a decade later, Merchant is bringing her spirit of collaboration to her newest role as vice president, chief transformation officer, and executive director of the Center for Health Care Transformation and Innovation at Penn Medicine.

“We need people who think differently, who bring expertise from other fields, to work alongside the scientists and the operations folks to think about complex issues,” she said. “Collaboration is part of the DNA here.”

Merchant grew up in Corpus Christi, TX, a gulf coast city prone to tropical storms and hurricanes. At an early age, she became interested in emergency preparedness, and how individuals might play a role in emergency response. She would eventually pursue a medical degree and, later, a residency in emergency medicine. Merchant arrived at Penn Medicine in 2007 as part of a fellowship that trains physicians in research, policy, and communications, now known as the National Clinician Scholars Program.

“I was totally inspired and excited by the roles physicians can play in health care leadership,” she said. “There are just so many different pathways for physicians to take.”

The fellowship taught Merchant how to set up rigorous studies to answer important public health questions—and how to implement her findings beyond an academic research paper and into practice.

“When I transitioned into a health system role, I was interested in having that same level of thought process about operational projects,” she said. “How do we, in a rigorous way, study what’s working or not?”

After the MyHeartMap Challenge, Merchant explored other ways technology could connect people to health resources and information. She became associate vice president for digital health in 2017.

Merchant also made mentorship a priority. She became co-director of Penn Medicine’s Robert Wood Johnson Clinical Scholars Program (now the National Clinician Scholars Program), the fellowship that first brought her to the health system. “How do we support and elevate people with different phenotypes, who are physicians, nurses, pharmacists, social workers, informaticists?” she said. “How do we build that next generation of people who are going to be doing this work?”

Merchant, who has mentored more than 100 people, won Penn Medicine’s Arthur K. Asbury Outstanding Faculty Mentor Award in 2024. “She’s always been very inclusive of lots of different trainees at various levels, whether it’s medical students or residents or even junior faculty,” said Shivan Mehta, MD, MBA, MSHP, Penn Medicine’s associate chief innovation officer and director of the Population Health Lab. “She enjoys bringing people into her center, and different projects.”

One of Merchant’s mentees was Kathleen Lee, MD, now associate chief transformation officer, who chose Penn Medicine for her emergency medicine residency because of its reputation as collaborative and innovative. She and Merchant became close collaborators when Lee was the director of clinical implementation in the Center for Health Care Innovation.

One of the highlights of that partnership, Lee said, was a 2019 project led in close collaboration with Penn Plastic Surgery and Home Health that transitioned much of the post-operative care for “free flap” surgery, in which a patient’s tissue is used to reconstruct the breast after mastectomy, to the home. The effort, augmented by text-message communication and a care package tailored to patients’ recovery needs, both improved patient satisfaction and made it easier for new patients to get appointments with breast surgeons.

“It was a very cohesive design process that ultimately led to amazing engagement rates with patients, a program that was well-loved, that had rapid adoption,” Lee said. Merchant’s “mentorship and guidance were critical in ensuring that this was a cross-functional effort … Her instinctual collaborative nature and her style of leadership are the way forward for transformation.”

In her new role, Merchant has partnered with Penn Medicine At Home to champion a home-health solution to an even more widespread challenge. The problem, at Penn Medicine as at other hospitals nationwide, is capacity. At the same time, research has shown that moving acute health care out of the hospital and into the home, when appropriate, can also benefit patients by lessening wait time, improving their experience through personalized care, and leading to better health outcomes.

Previous attempts to reduce emergency admissions by steering some patients to home care never expanded beyond a pilot, Mehta said. “It was a valuable project that got stymied by a variety of different issues,” he said. “She took the initiative to identify that this is something all of our patients should benefit from … You have to keep pushing.”

The solution that Merchant has now backed to scale up, called PATH, for Practical Alternative To Hospitalization, was originally developed by another of her mentees, Austin Kilaru, MD, MSHP, a Penn Clinical Scholars alum who is now an assistant professor of Emergency Medicine. “It has been incredibly rewarding to collaborate with Austin and the team on this project,” she said. “He is a trailblazer and an emerging leader at Penn Medicine.”

Merchant convened a large team that included leaders from Penn Medicine At Home, Penn Emergency Medicine, Penn Primary Care, and Information Services to implement PATH, which makes it easier for patients who come to the Emergency Department to be monitored at home, instead of admitted to the hospital.

Launched at Penn Presbyterian Medical Center under the leadership of the hospital’s CEO, Bob Russell, in September 2024, the program has a dedicated advanced practice provider who identifies appropriate patients and coordinates at-home health services, such as medication delivery, telehealth installation including a tablet and vital signs equipment, and, if needed, home nursing visits for blood draws or intravenous infusions.

In a few short months, PATH enrolled over 100 patients with acute illnesses including kidney injury, congestive heart failure, pneumonia, and others. The program has met its targets for delivery of high-quality care, low readmission rates, and high satisfaction scores from both patients and providers. The goal is to grow the initial set of disease conditions, expand the program to other emergency departments across the health system and, eventually, to help patients transition home after an inpatient hospital stay, to shorten the time they need to be in the hospital.

“We focus on scale and making sure we’re doing things that can move across all of the system,” Merchant said, “and potentially spread even outside of Penn.”

More broadly, Merchant’s project portfolio includes a host of efforts designed to take better care of Penn Medicine patients, and the people who care for them. Her team is working on a collaboration with the Abramson Cancer Center to improve support for patients with breast cancer from screening to survivorship, for instance, and partnering with the Penn Memory Center to support caregivers of people diagnosed with dementia.

In the areas of efficiency and workforce burden, Merchant often collaborates with Mitchell Schnall, MD, PhD, senior vice president for data and technology solutions, to align on transformation initiatives that involve technology. With Mahoney, they co-authored a paper published in the journal Frontiers of Health Services Management about how they determine whether to buy existing technology solutions from vendors or build new technology infrastructure within the health system.

An example is the internally developed Refill Express, an automated system that streamlined the process for patients to get specialty prescriptions filled. By the time the project won Penn Medicine’s Rick Demers Award for its significant contribution to pharmacy practice—it increased Penn Pharmacy revenue and its capacity to serve more patients—Merchant was starting to work on the next challenge.

Overall, the projects housed in Merchant’s Center for Health Care Transformation and Innovation span technology infrastructure, such as the behavior change Way to Health platform and related Nudge Unit infrastructure; population health, including centralized mammography outreach; and community health, such as neighborhood greening. Each area of innovation is unique, but all benefit from Merchant’s ability to convene the key stakeholders and persist in testing possible solutions to important problems.

“There isn’t a one-size-fits-all model. Something that might work in one setting isn’t always immediately transferable to another,” she said. “You have to understand local culture and workflows to make sure you can have a One Penn Medicine experience wherever you are.”