Studies show that 25 to 40 percent of patients admitted to the hospital for a medical condition also have a psychiatric issue. But for many cases, psychiatric conditions often go unidentified for days, and when left untreated, these conditions can cause disruption to ongoing patient care. With this in mind, a team of Penn Medicine clinicians developed a solution to identify patients with psychiatric issues upon admission, deliver enhanced care during their hospitalization, and connect patients to ongoing mental health care after discharge. The solution proved to be eight times more effective at identifying patients with psychiatric conditions and is primed to improve outcomes for all patients – including those without a psychiatric condition – and save the health system tens of millions of dollars per year.
As a participant in Penn Medicine’s Innovation Accelerator Program, the Mental Health Engagement, Navigation & Delivery (MEND) team is just one of four groups that has been working for the past six months with mentors from Penn’s Acceleration Lab to test and develop their concept. Later today, MEND team lead Cecilia Livesey, MD, an assistant professor of Psychiatry, and team leads from the other three projects will take the stage at Pitch Day 2019 to present the impact they’ve made for patients, providers, and the health system during their initial pilot phases.
Since the inception of the of the Innovation Accelerator Program in 2013, 30 projects tackling some of health care’s toughest challenges have been funded. Several have been woven into clinical practices across the health system and are now expanding to health care facilities across the nation. Those include 2014 winner Heart Safe Motherhood, which uses text-based remote monitoring to identify new moms at risk of developing dangerously high blood pressure following delivery, and 2013 winner the IMPaCT model for health care which uses Community Health Workers to provide social support and health system navigation to low income patients.
Center for Opioid Recovery and Engagement (CORE)
Philadelphia has the highest rate of opioid overdose deaths of any major city in the nation, and visits to the emergency department present a critical opportunity for patients with opioid use disorder (OUD) to be linked to care. While traditional addiction treatment approaches had low success rates, medication for addiction treatment (MAT) has been found to be highly effective, but those with OUD ere rarely connected to MAT. The CORE team, led by Julie Dees, MA, LPC, director of Behavioral Health Services at Penn Presbyterian Medical Center, designed and implemented a care model that automated identification of patients with OUD, then facilitates bedside consults from certified recovery specialists with a “warm” handoff to follow-up care. Through CORE’s efforts, MAT administration has more than doubled and nearly 70 percent of patients connected to a certified recovery specialist remained engaged in treatment a month later.
Healing at Home
New mothers are often eager to get home after giving birth so they can be with family and bond with their baby. Studies show that it is safe to discharge healthy mothers and newborns earlier without increases in complication rates. To better meet the needs of new mothers and their babies, the Healing at Home team designed an expedited discharge process and redesigned the postpartum experience by providing patient-centered support services in the home such as the arrangement of an in-home visit by a nurse just days after returning home. In addition to reducing hospital stays by roughly one day for new mothers and their babies, team lead Jessica Gaulton, MD, MPH, a fellow in Neonatology at Penn and Children’s Hospital of Philadelphia and a clinical innovation fellow in Penn’s Center for Digital Health, says that using text messages helped the clinical team preempt “Dr. Google” which patients often rely on for questions related to a new baby’s health and well-being, and their own recovery. Using a text-based app, the care team was able to identify critical patient needs and key questions post discharge in order to enable new mothers to not just get home sooner but to confidently stay at home safely.
Hepatocellular Carcinoma (HCC) is the most common type of liver cancer in adults. Typically stemming from a chonic liver disease or hepatitis B- or C-related cirrhosis, the condition is extremel difficulty to detect. As a result, 60 percent of patients are not diagnosed until the disease has reached an advanced stage. This team created a new approach along with an electronic dashboard that identified patients at risk for the disease and sped screening, increasing screening among at-risk patients by 26 percent. And while this system is set to dramatically improve outcomes for those predisposed to HCC, team lead Tessa Cook. MD, an assistant professor of Radiology, says it appears to be applicable to other conditions, like aortic aneurysms and lung nodules, where increased screening rates would allow for effective care to be delivered earlier.