When Penn Medicine opened its drive-through COVID-19 testing site in a Radnor parking lot on a mid-March Monday, site lead Tracey Commack, MBA, Penn Medicine Radnor’s associate executive director, had one big worry: how would patients get their test results?

To prevent the spread of the potentially deadly virus, people who came to Radnor for testing had minimal contact with Penn providers: they registered over the phone, held up their identification to be photographed from a safe distance and stayed in their car for a nasal swab. Many of those tested weren’t even Penn Medicine patients, Commack said, and they left the site with no evidence they’d ever been there. “It was a weird way to practice medicine,” she said.

On daily debrief calls with the Penn Medicine Center for Health Care Innovation, which played a key role in the design and logistics of the Radnor testing site and a sister location in West Philadelphia, Commack asked for help closing the loop with patients by ensuring they would receive their test results. “In the beginning,” she said, “it was so chaotic with the results.”

By Wednesday (two days after the site opened), the innovation team delivered. Using Way to Health, Penn Medicine’s patient engagement software platform, the team built an automated text message program that gave the testing site’s patients a phone number to call for their results and other follow-up information. “We connected them with someone to call,” Commack said. “That took this weight off my shoulders.”

A Track Record of Innovation

Penn Medicine had a long track record of innovation —building tools and designing processes that rethink health care delivery. Now the Health System’s innovative learnings and platforms were being deployed in the all-hands-on-deck fight against COVID-19. The 10-year-old Way to Health platform, along with the provider-facing data platform Agent, were among the building blocks laying the foundation for new pandemic-era solutions. And many of these changes and innovations are here to stay, offering convenience and safety for our patients.

“We built programs based on the future, and a lot of the future involves using technology and telemedicine,” said David Asch, MD, MBA, executive director of the Innovation Center. “Because we were fundamentally focused on that future — and that future is part of the present response to COVID — we’re able to help.”

But Penn’s COVID-19 innovation work is about more than high-tech developments, Asch said. It has also depended on mobilizing a passionate staff that was willing to try something new. Innovation is a team effort, he said, and the center has joined up with stakeholders from throughout Penn Medicine. “This required enormous effort from many groups within the organization,” he said.

Keeping Tabs on COVID Patients at Home

COVID Watch keeps patients self-isolating at home connected with Penn nurses.

Penn’s nurses are one such group. COVID Watch, a text message program that monitors patients with COVID-19 symptoms as they self-isolate at home, is staffed by redeployed Penn nurses, some of whom were unable to continue hospital work during the pandemic and instead provide clinical service from home. “We recruited a set of nurses to provide coverage for the program 24/7,” said COVID Watch clinical lead Anna Morgan, MD, a Penn Medicine primary care doctor who focuses on population health and care management. “We all want to be able to contribute to COVID and we all have to find our way of doing it.”

COVID Watch, which was also enabled by Way to Health technology, lets patients send a text message relaying a concerning symptom, such as difficulty breathing, and receive a call back from a nurse within an hour, Morgan said. The nurse’s telephone assessment will determine the patient’s next step, whether it’s a trip to the hospital, a primary care visit or a telemedicine checkup using Penn Medicine OnDemand, a platform also developed by the innovation center.  Once reserved for Penn employees, the Center for Connected Care had already begun to expand that program shortly before the pandemic.

COVID Watch also borrowed principles from BreatheBetterTogether, a 2017 innovation center partnership that remotely monitors patients with chronic obstructive pulmonary disease, said Neda Khan, an applications specialist for the Way to Health platform. These principles include texting language, she said, and automatically disabling texts for patients who are admitted to the hospital. “We’ve taken some really great features of BreatheBetterTogether,” Khan said, “and tailored them to patients who may be COVID positive.”

Now live across all of Penn Medicine, COVID Watch has inspired other iterations, such as Pregnancy Watch, which tailors the COVID Watch protocol to expectant mothers and their clinicians. Pregnancy Watch is run by Adi Hirshberg, MD, and Sindhu Srinivas, MD, Penn obstetricians who, with the help of the innovation center in 2014, created Heart Safe Motherhood, remote blood pressure monitoring program for new mothers with preeclampsia.

Meals Delivered to Staff … Safely

Other COVID-19 innovations at Penn focus not on patients, but on the providers caring for them. Ryan Schumacher, an innovation associate at the Innovation Center, wanted to make shift meals more convenient for hospital staff and more streamlined for the Health System. And, as a self-described foodie, Schumacher sought to help Philadelphia’s eateries, who saw crushing declines in business during the pandemic. “We tried to create something that would be beneficial for all,” he said. “Nourished is what came out of that.”

Hospital staff can use the Nourished platform to purchase a subsidized shift meal from a local restaurant, which then delivers dozens of individually-packaged meals to the hospital at once, reducing visitors to help prevent disease spread. Options are limited to keep the process simple for providers and predictable for partner restaurants: one eatery offers just a few selections per meal.

Nourished started as a text message platform using Way to Health technology. Team members Cathy Reitz, Caitlin McDonald, and Jessica Sung modified existing functionality to launch an initial pilot to test demand for the service. “We couldn’t have asked for a better platform to have internally,” Schumacher said. To add the functionality Nourished needed, the team developed the program into a web application.

Typically, innovation center projects take six months to several years to go from concept to scale, Schumacher said. Thanks to the COVID-19 health crisis, Nourished got there in a matter of weeks. “Everything is incredibly accelerated right now,” Schumacher said. “Everyone understands the urgency of this. Everyone is making the time.”

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