COVID-19 Response and the Rise of Telemedicine

Smriti Shah

The COVID-19 pandemic presents immediate challenges for creative problem solving and innovation. In addition to launching new projects, we have ramped up support for projects in our portfolio that are especially relevant in light of the new normal - interventions that leverage telemedicine, remotely monitor patients to keep them safe at home, or move care into the home altogether.

Just a couple of months ago, few could have predicted the extent of COVID-19’s effect on society. The ongoing global crisis has forced healthcare institutions and regulatory bodies to turn to alternative ways of providing healthcare while limiting exposure to the virus. Currently, telemedicine presents itself as the ideal solution by limiting patient displacement to hospitals and allocating hospital capacity to important cases, all while curbing the disease’s spread.

As companies and schools have adapted to the work from home solution, remote consultation is also becoming an increasingly attractive option in healthcare. The need for remote technologies has skyrocketed as medical professionals need to stay healthy and disease-free. This technology allows state-of-the-art healthcare to be more accessible without the need to wait hours in line.

That’s where we come in. Way to Health is an integrated, cloud-based platform that blends behavioral science with scalable digital technology to improve clinical outcomes and in turn, reduce healthcare costs. Our platform first stepped foot in the realm of telemedicine in 2010 and has since deployed over 175 evidence-based programs that are harmoniously embedded into clinician workflows and patients’ lives. Way to Health has the ability to provide both out-of-the-box remote monitoring and engagement solutions, while working closely with clinical care teams and leveraging concepts in user-centered design.

Our platform is now widely used by other universities, health systems, and health plans to deploy research trials and remote monitoring programs that are now the standard of care. Way to Health has powered innovation for multiple projects over the years and 2020 is no different. Way to Health has launched over a dozen COVID-19 response programs and is currently supporting 25 projects that are especially relevant in light of the new normal - interventions that leverage telemedicine, remotely monitor patients to keep them safe at home, or move care into the home altogether.

We have expanded remote care capabilities to keep patients receiving prenatal and postpartum care safe at home. By alternating between clinic and telehealth visits, we can decrease exposure risk for patients and providers. The programs under this umbrella leverage digital tools and remote monitoring to manage and support patients at home. Delivering safe, high-quality care while improving clinical outcomes is central to our mission. Leveraging evidence-based practices, programs powered by Way to Health continues to deliver effective results in our rapidly changing society. Read more below.

COVID Watch and COVID Pulse

COVID Watch enables patients who are confirmed or likely to have COVID-19 but not sick enough to need hospitalization to be monitored at home. Penn Medicine clinicians can enroll patients in the program directly from the electronic medical record. From there, Way to Health utilizes twice-daily automated texts to remotely monitor patients, with protocols for escalation to telemedicine or hands-on care when necessary. Expanding on the COVID Watch model, we recently launched COVID Pulse. Patients enrolled in the COVID Pulse program receive a home pulse ox device and teaching prior to discharge in addition to remote monitoring once they are back at home.

Related news: Text-Based Platform Helps Penn Medicine Watch Over COVID-19 Patients Safe at Home

CHCI staff: Neda Khan, David Asch, Mohan Balachandran, David Do, Doreen Lam, Krisda Chaiyachati, Christianne Sevinc, Kyle McGrogan, Michael Kopinsky, Mike McAllister, Cathy Reitz, Cat Reale, Caitlin McDonald, Jessica Sung, Rachel Djaraher, Michael Fortunato, Samantha Coratti, and Smriti Shah | Partners: Bill Hanson, Kevin Volpp, Nina O’Connor, Ann Huffenberger, Susie Day, and Anna Morgan

Remote monitoring for patients with chronic obstructive pulmonary disease

BreatheBetterTogether (BBT) is a hospital to home transition program that uses a customized inpatient dashboard to identify high-risk hospitalized patients with chronic obstructive pulmonary disease (COPD) and enroll them in daily monitoring program powered by Way to Health. The program prompts patients to share information about their symptoms daily. If a clinical decline is suspected, information is escalated to the care team, and personalized interventions are enacted. COPD patients are among the most vulnerable to COVID-19 infections. They are more likely to develop severe cases that require ICU-level care. In light of this, we have ramped up staffing and support for the BBT program to prepare for a likely increase in patient volume.

CHCI staff: Mike Begley and Tim Delaney | Partners: Vivek Ahya, Mike Sims, Colleen Cain, Scott Crespy, Steven Gudowski, Matt Walker, Margie Pierce, Kathy McCauley, and Geoffrey Bass

Protecting emergency departments from COVID-related surges

Members of our team provided design, regulatory, and coordination support to stand-up surge capacity in tents adjacent to emergency departments (ED) at the Hospital at the University of Pennsylvania and Penn Presbyterian Medical Center. The surge model aims to protect EDs from COVID-related volume surges, separate patients suspected of infection from others, and provide efficient and targeted care explicitly designed for the COVID-19 population (e.g., all staff ready in personal protective equipment, COVID-19 swabs and portable chest x-rays available, etc.). A Way to Health service has been introduced to register patients who present to the ED through text messaging rather than face-to-face interaction. Patients are prompted to send a picture of their insurance card and ID for virtual registration. Responses using the registration protocol are entered into the patient’s chart. This service reduces overall throughput time, encourages social distancing, and decreases potential exposure to fomites. The team is currently building a virtual discharge process to enable the delivery of discharge instructions and follow-up information via text message and MyPennMedicine. Expansion of the virtual registration and discharge capabilities to EDs system-wide will occur over the coming weeks.

Related news: Ahead of the Curve: Penn ER Tents at the Ready for COVID-19 Surge

CHCI staff: Kat Lee, Christina O’Malley, Lauren Hahn, Mike Serpa, Becca Pepe, Damien Leri, Stephanie Brown, and Vivian Williams | Partners: Ben Sun, Chris Edwards, and Phil Okala

Telemedicine and remote monitoring for prenatal and postpartum care

Pregnancy Watch is a remote monitoring intervention for pregnant patients exhibiting COVID-19 or influenza-like illness symptoms. Leveraging the model for COVID Watch, automated text messages are sent twice-daily to patients who are sheltering at home and tracking symptoms. Patients experiencing worsening symptoms like shortness of breath are escalated immediately to a pool of OB/GYN providers. This program is currently being offered at the Hospital of the University of Pennsylvania and Pennsylvania Hospital.