On-Screen, On-Demand, On-Time: The Future of Telemedicine at Penn Medicine

PHILADELPHIA – Telecom innovations have delivered Americans on-demand access to everything from music and television programs, giving them opportunities to video-chat with friends and family near and far, and ushering in the ability to meet with distant colleagues without the hassle of travel. At Penn Medicine, these same technologies have brought a new era of improved care at the hospital bedside, during outpatient visits, and even when patients are at home.

The new Penn Medicine Center for Connected Care centralizes the health system’s telemedicine activities including its almost 15-year-old Penn E-lert eICU for the critically ill, a tele-homecare service for the chronically ill, as well as a telemedicine service linking obstetricians to trauma surgeons caring for critically injured pregnant women, and a tele-urgent care service which eliminates the need for physical visits in some cases. The center addresses the ever-growing demand for easily accessible telehealth services. Located at Penn Medicine Rittenhouse in center city Philadelphia, it is the largest telehealth center in the region and one of the largest telehealth hubs in the country. Its 50 full-time employees work together to support patients 24/7 as well other Penn Medicine staff in a variety of settings across Pennsylvania, New Jersey, and Delaware.

Penn Medicine also provides a growing array of telemedical specialty services in fields such as transplant services, dermatology, ophthalmology, radiology, adolescent and young adult medicine, sleep medicine, and complex neurological conditions to patients at a regional, national, and international level. Other telemedical specialty services include post-operative surgical visits in various specialties as well as hematology oncology consultations and veteran’s mental health services. An additional suite of programs provide specialized, academic medical center-based services to patients who live outside Penn Medicine’s typical service region. For example, a telegenetics program through Penn’s Abramson Cancer Center provides genetic counseling for patients living with or at-risk of inherited conditions via remote video conferencing.

 “Patients today increasingly expect to engage with health care providers with the same clickable convenience as buying holiday gifts online or ordering a ride-sharing service from their phone,” said Penn Medicine’s Chief Medical Information Officer, C. William Hanson, III, MD. “Our telehealth services make it easy for patients to get the care they need where they need it. Telemedicine is also an important part of our health system’s strategic growth, connecting clinicians in different hospitals and ranging from real-time care of our critically ill patients to the expansion of our home care services for patients at increased risk of being readmitted to the hospital after they go home.”

Penn Medicine was one of the first health care systems to invest in telemedicine when the Penn E-lert eICU was first launched. The electronic intensive care unit, then only a budding concept in health care, was designed to serve as a complement to traditional care at the bedside. It provides 24/7 coverage for the most vulnerable patients by using two-way video and audio technology to monitor patients who are, for instance, at risk of falls or sepsis, and alerts for on-site providers to act fast when help is needed. Now, with service covering more than 250 critical care beds across the health system, the Penn E-lert eICU has grown to become one of the nation’s largest intensive care telemedicine programs – and a key driver for improving outcomes. For instance, teleintensive care has been shown to reduce both mortality and the length of hospital stays for intensive care patients.

A teletrauma program links a diverse team of specialty providers when every minute counts for patients who’ve suffered critical injuries. “The teleICU allows us to connect to top experts without having to have a patient physically moved to another location, and the availability of tele-obstetric services is a potentially lifesaving approach that we believe is absolutely necessary for our patients,” said John R. Gallagher, MSN, RN, the Trauma program manager for the division of Traumatology, Surgical Critical Care and Emergency Surgery at Penn Presbyterian Medical Center.

The newly launched Center for Connected Care also houses the Home Telehealth program, which provides post-hospitalization remote monitoring for more than 160 patients each month in their homes. Often, this work employs a concept known as “automated hovering,” which combines new technologies such as wireless devices that can track patients’ vital signs and other indicators with new reimbursement strategies that hold providers more accountable for keeping recently hospitalized patients from being readmitted. This program has successfully reduced readmissions by 35% in a medically complex patient population. Penn Medicine’s own employees benefit from the Center’s expertise, through the FirstCall program, which offers on-demand urgent care and scheduling for employees throughout Penn Medicine 24 hours a day and 7 days a week.

Telemedicine has also enhanced outpatient care and provided a more seamless experience for patients who must travel to Philadelphia for specialty care. Cancer patients preparing for bone marrow transplants, for example, are able to meet with their local physician at one of Penn Medicine’s regional entities and video-conference with the ‘remotely’ located transplant physician who will oversee their care at the Hospital of the University of Pennsylvania. These types of programs empower patients and caregivers to share in the decision-making process and actively engage with their care team while eliminating some of the obstacles associated with travel.

“Connected care allows us to bypass the constraint of needing the patient to come to us in order to get the best medical care,” Hanson said. “We’re bringing the highest level of care to the greatest number of people: the right care in the right place at the right time.”