Innovation Accelerator Program
The Innovation Accelerator Program is designed to support faculty and staff from across Penn Medicine in their efforts to develop, test, and implement new approaches to improve health care delivery and patient outcomes. Working closely with mentors from the Acceleration Lab and the Center for Digital Health, teams move through three phases of work with the ultimate goal of bringing successful innovations to scale.
Phase one: It might work.
In phase one, teams work to better understand the problem, rapidly test potential solutions, and define how to measure success. At the end of phase one, teams present to health system leadership for the opportunity to receive additional investment to take their ideas to scale.
Duration: Six months (November to April)
- Training: Teams attend a series of workshops to learn high-impact methods for rapidly validating solutions
- Mentorship: Innovation advisors from the Acceleration Lab and Center for Digital Health dedicate 40% of their time to the project
- Funding: Teams have access to up to $10,000 to test and develop their concepts
- Recognition and additional support: At the end of phase one, teams present their work to health system leadership for the opportunity to receive additional investment
Phase two: It does work.
In phase two, teams move from conducting small experiments to testing on a larger scale. Teams are challenged to demonstrate sustained impact and secure the resources and stakeholder support necessary to move their solution towards implementation.
Duration: One year (July to June)
- Training: Teams attend a series of workshops to learn approaches and skills for bringing innovations to scale.
- Mentorship: Innovation advisors continue to dedicate time to the project. Allocation varies by project.
- Funding: Teams have access to up to $50,000 to move work forward.
Phase three: How we work.
Leveraging knowledge and momentum from previous phases, teams work with stakeholders to secure the permanent infrastructure necessary for their intervention. Teams “graduate” when they achieve sustainable implementation at scale for their solution.
Duration: Varies by project
- Gap resources as needed (funding, staff support, leadership advising).
- Develop and execute a strategy to operationalize your intervention at scale with resources independent of the Center.
- Identify clear metrics and infrastructure for accountability and continuous improvement.
Improving communication and success rates for patients undergoing in vitro fertilization treatment
Fertility treatment requires time-sensitive care coordination. Patients undergoing ovulation induction (OI) with intrauterine insemination (IUI) face unique challenges. The process requires frequent visits by both patient and partner for ultrasound, bloodwork, and other procedures, and the variability of menstrual cyclicity makes predictable scheduling difficult. Patients also experience a lot of anxiety during the process, given low success rates per cycle. Existing systems for communicating with fertility patients fall short. Written instructions are ineffective due to the complexity of individual OI cycles, and lag time associated with phone calls and MyPennMedicine leads to heightened patient anxiety, fatigue with health system navigation, and attrition. Inappropriate follow-through can lead to increased patient frustration, time away from work, dropout rates, and medical costs, as well as decreased success per attempt. This project seeks to test augmented solutions to streamline communication around OI, namely: medication instructions, scheduling, and documentation in Epic. Implementing a more efficient process has the potential to reduce errors, increase the number of patients who complete their treatment cycles promptly, and alleviate burdens for patients and clinical staff. A solution that works here could be scaled to other settings such as more complex fertility treatments i.e. IVF, where communication is critical for the management of patients undergoing an intense period of medical treatment. A model that works here could also be applied to other intensive treatment regimens, including surgery, chemotherapy, and transplant.
Team: Anuja Dokras, MD, PhD, Director, Polycystic Ovary Syndrome Center; Suneeta Senapati, MD, MSCE, Assistant Professor, Obstetrics and Gynecology; Marissa Weiss, MD, Clinical Fellow, Obstetrics and Gynecology
Enhancing the quality, efficiency, and experience of life-extending cancer care
Each year, about 1.7 million Americans are diagnosed with cancer. Within a year of diagnosis, 75% of those with advanced cancer end up in the hospital; one in six are hospitalized three or more times. And nearly everyone who needs chemotherapy spends hours a week in physician offices or outpatient clinics. Medicare pays almost $30 billion on beneficiaries with cancer in their first year of diagnosis, and patients incur significant out of pocket costs. Hospitalizations comprise 25-50% percent of spending, and cancer drugs and their administration account for a good portion of the rest. Today, nearly all life-extending cancer treatment is delivered in outpatient or hospital settings. However, often, cancer treatment can be given safely, effectively, and less expensively at home. This project brings together leaders from the Penn Center for Cancer Care Innovation at the Abramson Cancer Center, Penn Medicine’s Cancer Service Line, Penn Medicine at Home, the Hospital of the University of Pennsylvania, Penn Medicine’s Managed Care Contracting and Payer Relations Department, and the Division of Hematology and Oncology in the Department of Medicine to accelerate Penn’s home infusion program for cancer drugs and test a cancer treatment at home program. The team will start by moving low-complexity infused and injectable cancer drugs to the home setting and will establish and field an evidence-based cancer treatment at home program to reduce unnecessary emergency visits and hospitalizations. Delivering cancer treatment at home has the potential to enhance patient experience and satisfaction while maintaining or improving cancer care quality, to increase the efficiency and productivity of cancer care delivery across Penn’s health system, and to lower health care spending for payers and patients.
Team: Justin Bekelman, MD, Director and Callie Scott, MSc, Managing Director, Penn Center for Cancer Care Innovation at the Abramson Cancer Center; Lindsey Zinck, RN, MSN, OCN, Associate Chief Administrative Officer and Jennifer Braun, MHA, BSN, RN, Corporate Director of Quality Improvement & Patient Safety, Penn Medicine Cancer Service Line; Sandra Jost, MSN, RN, Chief Clinical Officer, Sarah Johnson, MBA, Chief Operating Officer, and Cassandra Redmond, PharmD, MBA, Director of Pharmacy, Penn Medicine at Home; Rebecca Trotta, PhD, RN, Director of Nursing Research and Science and Donna Capozzi, PharmD, Associate Director of Ambulatory Services, Department of Pharmacy, Hospital of the University of Pennsylvania; Maura Weikel, Senior Contract Manager, Penn Medicine Managed Care Contracting and Payer Relations Department; and Beth Gilbert, PA-C, and Amy Laughlin, MD, Division of Hematology and Oncology in the Department of Medicine
Improving genetic testing to increase precision cancer care
Precision oncology medicine often requires the genetic information necessary to dictate the highest impact on care. Ovarian cancer is a common gynecologic cancer that typically presents at an advanced stage with a poor prognosis. The SOLO-1 trial (2018) was a groundbreaking study that was practice-changing for the management of newly diagnosed ovarian cancer. Women with a known genetic mutation are now approved to receive “maintenance” PARP inhibitor after completion of chemotherapy, which has been shown to decrease the risk of disease progression or death by 70%. All ovarian cancer patients are recommended to undergo genetic testing. However, recent data shows that only 30% of ovarian cancer patients do so. This project seeks to increase the rate of newly diagnosed ovarian cancer patients undergoing genetic testing by standardizing and streamlining the process. The team plans to test the efficacy of genetic testing templates in the EHR, “best practice” alerts, and a more seamless ability to incorporate and view testing results. For patients who qualify, prompts to schedule a consultation and discuss PARP inhibitors will be introduced. Progress in this arena could translate to a variety of other cancers such as pancreatic and prostate that are currently awaiting approval for PARP inhibitors.
The 2018 Innovation Accelerator class is co-sponsored by UnitedHealthcare, supporting their priority of enabling high-value care delivery models.
Studies show that 25-40% of general medical cases involve psychiatric comorbidity and that patients with a previous mental health diagnosis have an increased length of stay by 22%, even when adjusted for disease type. Data from the Hospital of the University of Pennsylvania (HUP) indicates that only 7% of cases were identified as involving psychiatric comorbidity in 2018. The MEND project aims to introduce processes to identify patients with psychiatric comorbidities upon admission, deliver enhanced inpatient care, and help patients navigate toward ongoing care after discharge. The team hypothesizes that their approach will not only improve patient outcomes and provider experience; it will be financially sustainable.
Team lead: Cecilia Livesey, MD, Assistant Professor of Psychiatry, Perelman School of Medicine; Medical Director of Strategy and Integration, Department of Psychiatry
Emergency Department (ED) visits for opioid use disorders (OUD) provide a critical opportunity to link patients to medications for addiction treatment (MAT). The initiation of MAT in the ED more than doubles successful treatment at 30 days compared to a discharge referral alone. Last year, there were approximately 1,200 encounters for OUD in the EDs at HUP and Penn Presbyterian Medical Center (PPMC), 20% of which were overdoses. However, only a small number of patients received MAT in the ED or primary care setting, despite appointment availability. The CORE project seeks to ensure ED patients receive appropriate treatment for OUD by implementing timely initiation of MAT and introducing a concierge model to link patients to outpatient care.
Team lead: Julie Dees, MA, LPC, Director of Behavioral Health Services, Penn Presbyterian Medical Center
Many new mothers want to be in the comfort of their own home recovering and bonding with their babies as quickly as possible after delivery. Studies show that it is safe to discharge healthy mothers and newborns earlier than the current length of stay at HUP without increases in complication rates. To better meet the needs of new mothers and their babies, the Healing at Home team is redesigning the postpartum experience by providing patient-centered support services in the home. Services include concierge texting, lactation support via telemedicine or home visits, expedited discharge, medication delivery, complimentary meal delivery, and private in-home nursing visits.
Team lead: Jessica Gaulton, MD, MPH, Neonatology Fellow, Children's Hospital of Philadelphia & Hospital of the University of Pennsylvania; Clinical Innovation Fellow, Penn Medicine Center for Digital Health
Over 6,000 patients at Penn Medicine are at risk for Hepatocellular Carcinoma (HCC). Of those diagnosed with HCC, 60% are diagnosed too late to be cured. The American Association for the Study of Liver Diseases recommends screenings every six months with ultrasound. However, data shows less than 40% of patients are screened. As with other cancers, HCC survival rates are heavily dependent on early detection. This project seeks to leverage a customized dashboard to identify Penn Medicine patients at risk for HCC. From there, a designated liaison will apply interventions such as bulk ordering and the creation of pending orders, coupled with a series of behavioral nudges to maximize the number of screens both ordered and completed in the HCC population.
Team lead: Tessa S. Cook, MD, PhD, Director, 3-D and Advanced Imaging Laboratory; Co-Director, Center for Practice Transformation; Assistant Professor of Radiology, Hospital of the University of Pennsylvania
Penn Acute Care at Home (PATCH)
Nearly 400 patients living in West Philadelphia receive high-quality home care services from Penn Care at Home each month. This population of complex and chronically ill patients also requires frequent acute care services from busy Penn hospitals. The PATCH program seeks to help home care patients remain where they want to be: at home. By exploring multiple aspects of the patient journey - from symptom onset to treatment in the ED - PATCH aims to decrease hospital admissions by detecting illness earlier, preventing ED visits for conditions that could be managed at home, and facilitating ED discharge to home.
The 2017 Innovation Accelerator class was co-sponsored by UnitedHealthcare, supporting their priority of enabling high-value care delivery models.
Supporting Older Adults at Risk (SOAR)
Traditionally, older hospitalized adults are discharged when medically stable and once post-discharge care is organized. This approach causes patients to stay in the hospital beyond what is medically necessary waiting for services to be arranged. This delay compromises patient safety and overall health status and leads to increased hospital cost. The SOAR project aims to test a transitional care model with strong prior evidence of improved outcomes that “flips” assessment of post-discharge needs to the home setting, moving patients to home sooner with care and support that keeps them safe upon earlier discharge.
Team lead: Rebecca Trotta, PhD, RN, Director of Nursing Research and Science
Penn Medicine Virtual Care
Studies have shown that telemedicine video visits can increase provider capacity, improve patient satisfaction and reduce costs. However, the state of Pennsylvania does not have telemedicine parity reimbursement law. The Penn Medicine Virtual Care project aims to test a self-pay concierge service model for telemedicine video visits in partnership with Independence Blue Cross. The goal is to prove that evaluation and management services can be completed through video visits for the right clinical use cases while enhancing access and establishing a solid business model.
Team lead: Janice Hillman, MD, PENNCare Adolescent and Young Adult Medicine, Penn Medicine at Radnor
Advanced Heart Care at Home
Heart failure (HF) is projected to affect more than 8 million people from 2012 to 2030. The costs associated with HF are approximately $30.7 billion annually, a large proportion of which is accumulated as patients approach the end of life. The care of HF patients during end of life is suboptimal in comparison to other populations, and there are high rates of hospitalization. Inadequate and lack of timely symptom management results in emergency department (ED) visits and readmissions. The Advanced Heart Care at Home team is developing a heart failure program to improve symptom management for advanced heart failure patients, facilitate teamwork among palliative care and cardiology providers, and increase more timely referrals to hospice.
Team leads: Nina O'Connor, MD, Chief of Hospice and Palliative Care, Penn Medicine and Esther Pak, MD, Fellow in Cardiovascular Medicine
Chronic Obstructive Pulmonary Disease (COPD) is the 3rd leading cause of death in the U.S. and hospitalizations for COPD exacerbations are associated with high morbidity and significant short-term mortality. Nationally, inpatient treatment for COPD exacerbations accounts for approximately 13 billion dollars in direct costs. Approximately 20% of patients admitted to the hospital with COPD are readmitted within 30 days, and it’s estimated that 10-50% of readmissions may be preventable. The BreatheBetterTogether team is working to develop a multidisciplinary cost-effective transitional care program for COPD patients. The program will include evidence-based interventions targeting high-risk hospitalized patients who are discharged to home.
The 2017 Innovation Accelerator class was co-sponsored by UnitedHealthcare, supporting their priority of enabling high-value care delivery models.
- IMPaCT, establishing a sustainable and exportable business model for an evidence-based CHW model for care
- ARRTE, monitoring follow-up on radiologic findings using an informatics application
- Teledermatology, increasing access to improve patient outcomes
- Teqqa, generating real-time antibiograms to limit antimicrobial resistance
- Care Management for VAD patients, exploring how self-testing can improve patient outcomes