As the COVID-19 pandemic emerged in the spring of 2020, many organizations were unsure of how to proceed with operations while ensuring a safe environment for staff. Unlike many places that could allow employees to work from home, health care organizations were placed in a unique, challenging position as they navigated hybrid work environments while ensuring safety for the many clinical staff who still needed to be at the bedside or care for patients in-person.
To help reduce the risk of COVID-19, a large element of safety planning focused on symptom tracking. Teams of experts at the University of Pennsylvania and Penn Medicine quickly came together to implement a system to screen for members of the Penn community who were potentially exposed to COVID-19.
Creating PennOpen Pass
A team of physicians and leaders from Penn Medicine and the University of Pennsylvania began to brainstorm how they could build an application that would serve as a daily electronic exposure screening system for the health system, known as PennOpen Pass. It would allow for individuals in the health system and at the University to answer a few brief questions on a mobile-friendly website to report if they had any symptoms or exposure that could pose a risk for others. If the individual was not exposed to any COVID-19 positive people nor experiencing any symptoms, they would get a green pass — and they could show their phones at campus building entry points and be allowed to come in. If the individual was experiencing any symptoms or had a recent exposure, they would get a red pass and be instructed with the next steps to take before they could safely return to communal campus settings.
The PennOpen Pass application was developed by Penn Medicine’s internal software development team, led by Glenn Fala, associate CIO of Software Development and IS lead for PennOpen Pass, and Greg Barendt, software architect and leader of the application development effort, and Susan McGarvey, an IS project manager. Fala noted that having this application built internally and not being reliant on an outside, third party was really a key component of the success. “We never knew what direction this pandemic would go, so it was helpful that we could make any changes we needed, whenever we needed,” said Fala.
Penn experts met in May 2020 to strategize how to expand PennOpen Pass not only for clinical staff and campus members, but for patients, visitors, and contractors.
The Center for Connected Care was tasked with helping to scale PennOpen Pass for the health system in deep collaboration with occupational medicine, infection control, student health, contact tracers, and campus wellness. Krisda Chaiyachati, MD, MPH, MSHP, Medical Director of Penn Medicine OnDemand within the Center for Connected Care and Clinical Innovation Manager at the Center for Health Care Innovation, would serve as the medical director and Ann Huffenberger, DBA, RN, NEA-BC, director of the Center for Connected Care, as the director of operations.
Within weeks, PennOpen Pass went live for health system patients, visitors, and contractors with great success. The application was fast and easy to use.
“The process felt like a whirlwind, since we rolled out an application much quicker than our typical process calls for. For example, PennOpen Pass rolled out while prototyping it and developing the clinical workflows to expeditiously guide users. But because of the urgency of the pandemic, we needed to build and fix the plane while flying it,” said Chaiyachati.
Key to the success of PennOpen Pass? Automating the program, which helped improve efficiency. For example, the initial triage of individuals with symptom or exposure concerns could be done before requiring human interaction. If an individual did wish to speak to someone, the Center for Connected Care’s team of nurses would clinically assess and further triage from there. From there, users would be connected to Penn Medicine nurses who would further guide those individuals with next steps, including testing, as needed.
“We put our main focus on making the process as efficient as possible. Around 30,000 people use PennOpen Pass every day. Every decision we make, we do it in a way that supports all entities while making sure the information can be easily interpreted and acted on,” Greg Kruse, associate vice president of strategic operations and operations lead for PennOpen Pass.
The Future of PennOpen Pass
Each week, the team meets, reviews data, and brainstorms ways to make PennOpen Pass more efficient. For example, the team analyzes the amount of time spent on the questionnaire and constantly looks for ways to reduce that time. The team also adjusts questions as research on symptoms evolve as well. For example, earlier this month, guided by the latest clinical evidence on the Delta variant, additional symptoms — runny nose and sore throat — were added to the daily screening questionnaire.
Symptom screening through PennOpen Pass is one element in a set of practices together protect the campus from COVID-19 spread, including facial covering, social distancing, and required vaccination for staff, faculty, students, and trainees.
As the Delta variant made its way to the United States, the Department of Health (DOH) and Occupational Safety and Health Administration (OSHA) mandated the use of a screening tool for all health care organizations, meaning PennOpen Pass was here to stay. To date, over 4 million screenings have been completed using the application.
While the entire future of the pandemic, and thus, PennOpen Pass, is not known, the team is optimistic that this application may pave the way and provide a solid foundation if there is ever a need for other screening tools.