Addressing key issues and outcomes pertinent to hospitals and health systems.
Drs. Sindhu Srinivas and Adi Hirshberg, Maternal Fetal Medicine, Penn Medicine
With the move to value based care (VBC) and increased risk bearing contracts, proven solutions to reduce readmissions is critical. Leverage evidence based models to reduce readmissions in your context. Programs such as Heart Safe Motherhood have shown readmissions reductions from 5% to 1%.
While VBC is important, a significant portion of revenue is still dependent on procedures. Whether it is colonoscopy prep or post joint replacement surgery, programs such as Engaged Recovery After Surgery (ERAS) have been proven and shown to increase adherence while still achieving 80+ Net Promoter Score (NPS) ratings.
With evidence based remote monitoring protocols, programs such as CARE have enabled departments to increase capacity by up to 35% while increasing patient NPS ratings to 90+ and maintaining quality of service.
Why start from scratch when you can leverage pre-built, tested and evidence based programs?
With rapid implementation times and multiple available customization options (messaging content, frequency, languages), you will be able to reap benefits quickly while enhancing your relationship with your patients.
Programs addressing issues specific to women and pregnancy.
Women's health intervention after child birth to assist with new mothers with questions and provide support for breastfeeding.
Increase in breastfeeding due to support from text intervention.
Increase in provider and patient communication regarding newborn questions.
Weekly text message blood pressure monitoring for pregnant women without complications in order to replace office visits with at home monitoring.
Minimize the amount of in-person visits during pregnancy for healthy women.
Monitor patient blood pressures from home and intervene as necessary.
Blood pressure monitoring for pregnant women with a diagnosis of pre-eclampsia. They will be recruited via EPIC. The project/study leverages bidirectional messaging for BP monitoring and escalation to provider / care team on an exception basis. Rollout to Penn Hospitals
Increased guideline adherence by 80%
Reduced 7 day readmission by 80%
Reduce 7-day readmissions for hypertension among postpartum women and creating a national leadership model to meet ACOG guidelines
Increased guideline adherence by 80%
Reduced 7 day readmission by 80%
Programs addressing issues specific pre and post procedure protocols including home care, remote monitoring and discharge instructions
Text conversations to monitor drain outputs of patients who’ve received breast reconstructive surgery. These tailored conversations comply with 20 cc and 30 cc drain management. Texts ask patients their daily output to determine if they are at criteria and need a drained pulled from a home health nurse until they have no drains left.
Post-op visits reduced from 5 to 1
Per patient time savings of 15 hours
Significant contribution margin
New Home Health revenue
Text conversations to monitor patients’ ostomy output levels after an ileostomy procedure. Patients can send in output values throughout the day, whenever they empty their ostomy bag. We calculate their levels over varying hours to determine total output and compare against thresholds. If these reported outputs are above or below thresholds, the patient’s care team is alerted.
Ongoing Research & Analysis
Implementation of this novel ERAS pathway for patients undergoing elective spine or peripheral nerve surgery safely reduces patients’ postoperative opioid requirements during hospitalization and 1 month postoperatively. ERAS results in improved postoperative mobilization and ambulation.
Post-op intravenous opioid meds nearly eliminated
3x greater mobility on post-op day 0
Text messages sent to patients post-surgery to help with recovery. These text messages are sent over the course of 7-10 days depending on the type of procedure. The text content is tailored to reminding patients on how to clean wounds, drink fluids to stay hydrated, and inform them of any dietary restrictions in place after surgery.
Patient compliance increased to 90+%
Readmission reduction of 50-85%
Length of stay reduction of 20-30%
Solutions geared to improving patient experience, and ongoing quality and safety efforts
These modules allow patients to text message photos via Penn Medicine’s Way to Health (W2H) platform directly into the EPIC electronic medical record. Currently, patients are offered the choice to submit their photos through myPennMedicine, our patient portal, or text message prior to teledermatology appointments. Patients receive text messages upon scheduling that instruct them to submit their photos. If they choose the text message option, they receive step-by-step guidance (with links to example images).
Ongoing Research & Analysis
Solutions geared to providing care to patients during the pandemic
This is a mega trial with planned enrollment of 150,000 patients across Penn Medicine and Geisinger Health system. The intent was to simultaneously test out 19 different nudges to figure out how to increase flu vaccination rates. The secondary intent was to use learnings from this to inform COVID vaccination efforts. The best performing nudge increases uptake by 11% over previous year baselines. The study was replicated with Walmart with 800,000+ participants.
Increased uptake by 11% over baseline
Text messaging effectiveness
In a concerted effort to address racial inequities. Penn Medicine partnered with Mercy Health, local pastors and the community in West and Southwest Philadelphia, to set up a community vaccination clinic. The goal was to vaccinate 500 individuals who met the 1A or 1B criteria set forth by the city. Way to Health provided the texting and IVR backends to enable registration and appointment scheduling prior. 557 patients were vaccinated. The next clinic on Feb 27th intends to vaccinate 750. The one after that will hopefully vaccinate 1500.
7500 citizens vaccinated over 6 clinics
Zero wait times
Patients scheduled and pre-registered (no lines)
NPS score of 90+ (1330+ responses)
Given that testing availability will likely continue to be constrained, symptom tracking based testing could lead to earlier case identification. At the same time, sentinel surveillance will be a critical tool for identifying pre-symptomatic, asymptomatic or mildly symptomatic spread that may evade symptom-based surveillance. Together, this approach provides ability to rapidly identify new cases and conduct contact tracing. This is an RCT that aims to (1) Evaluate the feasibility of a saliva-based screening COVID viral testing program (2) Compare behavioral strategies to improve study enrollment (3)Understand the relationship between daily symptom tracking and identifying infection,
COVID tests are conducted in advance of procedures or as part of occupational health. These results needed to be communicated to patients in a timely manner. While they were also communicated via the patient portal, immediacy is critical and not all patients have the app installed and activated. Phone calls from a nursing team were expensive and time consuming. An automated system to communicate negative test results (the majority) was put into place to optimize resources while ensuring patient communication.
2100+ results communicated
Increased installs of patient app
COVID Pulse was designed partly in response to reports that some patients with Covid-19 have little dyspnea, despite concerning hypoxemia (low blood oxygen). This program enrolls patients from emergency departments with depressed oxygen saturations, providing them with pulse oximeters, and escalates to care based on declines in measured oxygen saturation.
Enhanced monitoring of patients
Objective escalations based on PulseOx readings
$2.5M PCORI award
A variant of the COVID Watch program that automatically checks in specifically with cancer patients at risk for complications of COVID-19 who are self-isolating at home. Patients are monitored 24x7 via text message and escalations managed by an oncology nursing team with full Epic integration.
80+% patient engagement
Patient NPS score of 100
A Penn Medicine program that automatically checks in with patients at risk for complications of COVID-19 who are self-isolating at home. Patients are monitored 24x7 via text message and escalations managed by a nursing team with full Epic integration.
Staff hour reduction to just 64 per day
$2.3 Million savings over 100 days
Patient NPS score of 80
A variant of the COVID Watch program that automatically checks in specifically with pregnant women at risk for complications of COVID-19 who are self-isolating at home. Patients are monitored 24x7 via text message and escalations managed by an hospital specific nursing teams with full Epic integration.
80+% patient engagement
Patient NPS score of 76
Covered 208 patients over six months
Vaccinations are critical to getting the country back on track. This program was designed to reach out to patients who either did not have a patient portal account or have a valid email address on file. The intent here was to try and reach out to patients that Penn Medicine interacted with sometime during the last three years and offer the vaccine based on their availability. The program also asked if they already had received the vaccine or were hesitant. The program reached over 300,000 patients and for the people for whom we had accurate information and indicated interest, the conversion rate was around 60%.
12,000+ appointments scheduled
Please drop us an email with any context you can provide and we'll reach out to schedule a conversation.
Way to Health capabilities are grouped into modules. Configure them to address your specific needs and combine them together to quickly build, test and deploy interventions. Choose your deployment model - pilot, standalone or scaled and EHR integrated.
Communication with patients or study participants is key to engaging them. Choose from a variety of communication techniques or combine them tailored to a patient's behavior. Texts can be sent out based on set schedules and / or rules. These configuration rules can be as simple as responding with a personalized "Great job, John" or as complex as evaluating blood pressure values and generating an in-basket message to the physician.
The platform integrates directly with a number of biomedical devices to capture vitals directly from the patient / participant. The kinds of vitals captured include blood pressure, medication adherence, sleep tracking, weight, blood glucose and many more continue to be added. Additional devices are added quickly on request.
Setup multiple arms for studies including a control arm. The platform also offers multiple computerized randomization of participants, including the configurable choices for stratified, blocked, weighted, and adaptive randomization strategies. Ongoing management of participants via a "triage" view is also available out-of-the-box.
All programs - research studies as well as clinical projects - are available to be built upon. The programs can be copied over in a couple of clicks and then modified as needed. This can accelerate RCT and clinical deployments and reduce launch time from months to days or weeks.
Games and social media are significant drivers of human behavior. The platform allows patients to earn points, level up, use lifelines and more. These features can be combined with peer competition or support.
All interventions require recurrence based on a defined period - hours, days, weeks or months or off an event (such as admission). Research studies or clinical deployments both require this to be further tailored by each arm or patient. The platform has been designed to support these use cases and more.