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September 2021 Month in Review

Each month, we round up news stories and publications about work happening across CHCI. Read the latest issue and subscribe to have the Month in Review sent directly to your inbox.

CHCI
Can Yelp reviews help hospitals target racism?

Researchers from the Center for Digital Health and Penn's National Clinician Scholars Program leveraged natural language processing to narrow a pool of more than 90,000 Yelp reviews down to 260 reviews of 190 hospitals in 33 states that specifically mentioned "racism."

The study, published in JAMA Network Open, demonstrates that it is feasible to identify acts of interpersonal racism in health care in online reviews. The authors argue that hospitals should leverage this outlet to better understand how consumers perceive and report racism.

This work was featured in the Philadelphia Inquirer.

Philadelphia Inquirer
Creating agile technology to track COVID-19 risk

More than a year and a half and four million screenings later, experts from the University of Pennsylvania and Penn Medicine continue to make PennOpen Pass more efficient and effective. 

On the Penn Medicine News Blog, members of the team, including Krisda Chaiyachati, describe what it was like to "build and fix the plane while flying it" and shed light on plans for the application as the pandemic continues.

Penn Medicine News Blog
The pandemic's impact on statin prescriptions

In Circulation: Cardiovascular Quality and Outcomes, Atsushi Mizuno, Sri Adusumalli, and others describe their process to evaluate statin prescribing rates for eligible Penn Medicine patients before and during the COVID-19 pandemic when care was being delivered in-person and via telemedicine.

The team found that statin prescription rates were the same or higher during telemedicine visits compared to in-person visits, indicating that hyperlipidemia management could be an ideal candidate for telemedical care delivery. 

Circulation
Testing alternative pathways to hospitalization
The Acceleration Lab's PATH program has demonstrated that it can reduce patient time in the emergency department (ED), prevent inpatient hospital stays, and keep most patients from returning to the ED within 30 days. 
 
Learn more about this program, how it's expanding thanks to a Clinical Care Innovation Grant from Independence Blue Cross, and why it's more important than ever amid the COVID-19 pandemic in this article from the Philadelphia Inquirer. 
Philadelphia Inquirer
How to connect communities to colorectal cancer screening

Experts from across Penn Medicine are working to raise colorectal cancer screening rates and increase follow-up care uptake to drive down death rates and reduce inequities.

Efforts include partnering with local talk radio stations to raise awareness, working with community leaders to distribute at-home testing kits, deploying navigators to help patients overcome barriers, and leveraging new communications channels and insights from behavioral economics.

Learn more about these interventions and what's moving the needle in this article from Penn Medicine.

Penn Medicine
Introducing the new director of the Penn Medicine Nudge Unit

We are pleased to announce the appointment of Rinad S. Beidas, PhD, an internationally recognized leader in implementation science, as Director of the Penn Medicine Nudge Unit.

Learn more about Dr. Beidas in the official announcement from David Asch and Kevin Volpp.

Penn Medicine Nudge Unit
August 2021 Month in Review

Each month, we round up news stories and publications about work happening across CHCI. Read the latest issue and subscribe to have the Month in Review sent directly to your inbox.

CHCI
Lessons for the digital transformation of health care

Penn Medicine needed to scale telemedicine rapidly to ensure access while reducing infection risk amid the COVID-19 pandemic.

In Healthcare: The Journal of Delivery Science and Innovation, members of our team describe their process to rapidly develop and deploy Switchboard, a novel EHR-integrated web application equipped to facilitate secure virtual visits between providers and patients.

Healthcare
Exploring the effect of gamification with and without financial incentives

In JAMA Network Open, researchers from the Nudge Unit and the Center for Digital Health discuss how an intervention that leveraged gamification and financial incentives increased physical activity among veterans who were overweight or obese. The combination of gamification and financial incentives led to an increase of 1,200 steps per day and outperformed gamification alone.

JAMA Network Open
July 2021 Month in Review

Each month, we round up news stories and publications about work happening across CHCI. Read the latest issue and subscribe to have the Month in Review sent directly to your inbox.

CHCI
Higher COVID-19 mortality among Black patients linked to unequal hospital quality

A study led by researchers at Penn found that Black patients with COVID-19 have higher hospital mortality or discharge to hospice than White patients, largely because Black patients are more likely to be admitted to hospitals with worse outcomes for all.

In the Washington Post, David Asch and Rachel Werner discuss the structural inequalities that result in disproportionate levels of care for Black patients and propose policies to stop the cycle of disadvantage.

The Washington Post
Characterizing COVID-19 related content on TikTok
A new study published in the Journal for Adolescent Health led by researchers at the Center for Digital Health characterizes content posted and shared by users on TikTok with the #coronavirus hashtag in the first several months of the pandemic.
 
Analyzing TikTok videos and other social media platforms can help inform public health messaging and mitigation strategies, and gauge public sentiment and knowledge.
Journal for Adolescent Health
Meet our 2021 Innovation Accelerator class

Our flagship program, the Innovation Accelerator, supports 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.

This year's projects are focused on improving sleep for hospitalized neurology patients, reducing admissions among patients discharged with enteral nutrition, and optimizing gynecologic oncology care.

Penn Medicine News Blog
Gamification boosts physical activity among diabetes patients

By making a game out of getting their daily steps in, new research from the Nudge Unit indicates that people with Type 2 diabetes could be nudged toward increasing their physical activity, with changes lasting for an entire year.

Penn Medicine News Blog
Consumer views on using digital data to help control COVID-19

A study led by researchers at the Center for Digital Health found that even amid the current pandemic, most U.S. consumers are opposed to their information being used on digital platforms to mitigate the transmission of COVID-19.

The study, published in JAMA Network Open, suggests that further efforts are required by public health departments to gain public trust for data usage.

JAMA Network Open
Hepatitis C screening rates double when tests ordered ahead of time

By sending eligible patients a screening order along with the usual reminder, researchers at the Acceleration Lab showed that they could double hepatitis C screening rates.

This finding and additional insights from the study, published in BMJ, could inform broader clinical efforts to increase screenings and optimize preventive care for other conditions.

Penn Medicine News Blog
Developing a COVID-19 surveillance system to enable a safe return to campus

In NEJM Catalyst, our team members describe the design, implementation, and continuous improvement of PennOpen Pass - a cost-effective, large-scale COVID-19 surveillance system created to support the safe reopening of Penn and Penn Medicine campuses in 2020.

NEJM Catalyst
How text-based nudges can boost flu vaccination rates

Many Americans fail to get life-saving vaccines each year. A multidisciplinary team including staff from the Nudge Unit conducted a megastudy to explore the effect of text-based nudges on flu vaccination rates.

The top-performing intervention reminded patients twice to get their flu shot at an upcoming doctor's appointment and indicated that it was reserved for them. Insights from this study, published in PNAS, could be leveraged in future campaigns to encourage vaccine adoption, including against COVID-19.

PNAS
Risks and rewards of at-home cancer treatments

In a three-part docuseries, Medscape profiles Cancer Care @ Home (CC@H), an alum of our Innovation Accelerator Program.

CC@H brings cancer treatments into patients' homes. The program increases clinic capacity while maintaining timely and effective care. CC@H patients report dramatically increased satisfaction, enhanced convenience and comfort, and a better overall health care experience.

Medscape
New emergency department program enables patients to recover at home

In Healthcare, staff from the Acceleration Lab discuss the feasibility of an intervention that offers emergency department clinicians a practical alternative pathway for patients initially designated for admission or observation. 

Penn Medicine News Blog
Can incentives motivate COVID-19 vaccinations?

Businesses have been offering incentives for employees to get the COVID-19 vaccine, but it doesn't seem to be driving vaccination uptake.

In this interview with AAMC, David Asch shares his thoughts on whether financial incentives work and explains how minor messaging tweaks can make a big difference.

AAMC
A how-to guide for equitable COVID-19 vaccination

We partnered with community leaders to launch highly effective COVID-19 vaccine clinics to rapidly increase the pace of vaccinations in communities of color in Philadelphia.

Learn about the novel no-tech and low-tech strategies we employed to ensure equitable care delivery in NEJM Catalyst.

NEJM Catalyst
Did the COVID-19 pandemic change activity among patients most at risk for heart disease?

A study led by researchers at the Nudge Unit revealed that stay-at-home orders put in place during the COVID-19 pandemic were associated with a significant decline in physical activity among adults with elevated risk for major adverse cardiovascular events.

The study's findings suggest that the pandemic could disproportionately reduce physical activity among minority and urban patients, further increasing disparities in preventative health behaviors.

Journal of General Internal Medicine
Study shows 60 percent of opioids go unused after common procedures

A study led by researchers at the Center for Digital Health showed that more than half of the opioids prescribed to patients undergoing orthopaedic and urologic surgeries went unused.

The team collected patient-reported data on pain and opioid use through an automated text messaging system and found that most opioids are taken in the first few days and may not be necessary to manage pain even just a week after a procedure.

The results of this study suggest that opportunities exist to tailor opioid prescriptions and reduce excess quantities of opioids prescribed.

JAMA Network Open
How Penn Medicine reimagined breast reconstruction

Penn Medicine's CARe program shifts care for autologous breast reconstruction from a high-touch clinic-based model to a digitally-enabled home-based strategy that ensures a more patient-centric return to independence.

In NEJM Catalyst, CARe's multidisciplinary team describes the iterative design approach they used to transform the recovery process to improve outcomes and quality of life.

NEJM Catalyst
Rapid implementation of a saliva-based COVID-19 screening program

Regular COVID-19 testing is a critical component for safe reopening. In NEJM Catalyst, members of the Nudge Unit team describe the design and implementation of Covid SAFE, a saliva-based SARS-CoV-2 surveillance testing program with automated screening and reporting.

NEJM Catalyst
March 2021 Month in Review

Each month, we round up news stories and publications about work happening across CHCI. Read the latest issue and subscribe to have the Month in Review sent directly to your inbox.

CHCI
Messaging can have a huge impact on vaccination rates

The Behavior Change for Good Initiative and the Penn Medicine Nudge Unit unveiled findings from two of the largest-ever research studies aimed at increasing vaccine adoption.

Conducted with patients from Walmart Pharmacy, Penn Medicine, and Geisinger Health, the studies revealed that text messages that reminded individuals a flu shot was “waiting” or “reserved” for them proved most effective - boosting vaccination rates by up to eleven percent.

Penn Today
Ensuring equitable access at community vaccination sites

On February 13, Penn Medicine partnered with Mercy Catholic Medical Center and faith leaders in West Philadelphia to administer more than 500 doses of the COVID-19 vaccine to high-priority groups in the community.

In this interview with WHYY, Kathleen Lee explains the low-tech and no-tech approaches the team employed to ensure equitable access to the clinic.

WHYY News
Can we nudge COVID-19 vaccination rates higher?

In Nature, Mitesh Patel shares suggestions for nudges that public health agencies can incorporate into COVID-19 vaccine-rollout to encourage uptake.

Sample suggestions include framing vaccination as the default, providing peer-comparisons, and making choices active and time-bound. Patel says testing approaches like these will enable institutions to identify successful strategies and determine efforts that perform poorly so that processes can be optimized.

Nature
February 2021 Month in Review

Each month, we round up news stories and publications about work happening across CHCI. Read the latest issue and subscribe to have the Month in Review sent directly to your inbox.

CHCI
Leveraging innovation methods to reduce avoidable ED visits

In Healthcare: The Journal of Delivery Science and Innovation, members of our team describe a 3-year journey to apply innovation principles to understand drivers of avoidable emergency department use, develop a telemedicine-based solution, and operationalize the service.

The final product, Penn Medicine OnDemand, is now a fully scaled virtual telemedicine practice operated by Penn Medicine’s Center for Connected Care.

Healthcare
Default opt-out of cardiac rehabilitation increases referrals

Cardiac rehabilitation can be life-saving but is historically underused across the country. Researchers from the Nudge Unit have devised a way to fix that.

In a new study, the team found that making doctors opt-out from prescribing cardiac rehabilitation instead of opting in increased referrals by roughly 70 percent.

Penn Medicine
Public health messaging in an era of social media

In JAMA, Raina Merchant, Eugenia South, and Nicole Lurie share four strategies to advance public health messaging amid the COVID-19 pandemic: deploying countermeasures for misinformation, surveilling digital data to inform messaging, partnering with trusted messengers, and promoting equity through messaging.

JAMA
Monitoring patients leads to a fourfold decline in rehospitalizations

Enrolling hip and knee replacement patients in HomeConnect+, an automated hovering program that remotely monitors patient recovery, led to a fourfold decline in rehospitalizations.

Just three percent of HomeConnect+ patients returned to the hospital after surgery, compared to 12 percent of patients not enrolled in the program. 

Penn Medicine
Secure funding and support for your innovative project

Have an idea to transform health care? Need help getting it off the ground? We are currently accepting applications for our Innovation Accelerator Program and Health-Tech Design and Development programs.

Visit the Acceleration Lab website to learn more about the support we offer teams and start your application today.

Acceleration Lab
You're more likely to die of COVID if your hospital is crowded and stressed

According to a study published in JAMA Internal Medicine, COVID-19 mortality in hospitals seems to be lower when the prevalence of COVID-19 in the surrounding community is lower.

David Asch and Rachel Werner discuss the study's findings and call for citizens to do their part to keep case rates down in this op-ed for USA Today.

USA TODAY
Study uncovers inequity in access to telemedicine

A study published in JAMA Network Open found that older people, minorities, non-English speakers, and those with lower incomes face inequities in accessing telemedicine for primary care and specialty ambulatory care during COVID-19.

The authors urge that as health systems develop and refine their telemedicine practice, they prioritize those who have been historically marginalized.

JAMA Network Open
How health systems can build a culture of anti-racism

In Penn Today, Eugenia South, Paris Butler, and Raina Merchant discuss how health systems can use their power, might, and resources to foster racial equality. 

Penn Today
Digital health tools offer new opportunities for personalized care

Digital health interventions often fail to create sustained behavior change for patients. A key reason for this is that many programs offer a one-size-fits-all approach to diverse populations with different motivations and values.

In Harvard Business Review, Mitesh Patel and Shirley Chen explain how behavioral phenotyping could be applied to make digital health solutions more personalized and effective. The piece references several Nudge Unit studies as examples.

Harvard Business Review
Sneak preview of what's in store for the Nudge Unit in 2021

It's a new year, and the Penn Medicine Nudge Unit has a lot in store for 2021.

In this blog post, Mitesh Patel previews studies the team will be releasing results from soon, including the largest-ever communication research study aimed at increasing flu vaccinations. The team hopes the results of the study will be well-timed to assist with encouraging COVID-19 vaccinations.

Mitesh Patel Blog
PCORI approves $23 million for seven COVID-19 research studies

Funding has been awarded from the Patient-Centered Outcomes Research Institute to evaluate the use of COVID Watch.

The study will assess COVID Watch with and without the use of fingertip pulse oximetry and explore whether the program reduces disparities in care among Black and Latino patients.

Penn Medicine
Mining social media to make sense of the COVID-19 pandemic

Social media platforms can be leveraged to identify trends across the country. With this in mind, researchers from the Center for Digital Health have launched a tool to track self-reported COVID-19 symptoms and real-time sentiment trends on Twitter.

The dashboard, created in partnership with the World Well-Being Project, pulls around 4 million coronavirus-related tweets a day using the Twitter API. Users can view confirmed cases and deaths per capita, top symptom mentions, changes in language about stress, anxiety, and overall sentiment of the pandemic, and more.

Twitter Developer
Insights and outcomes from the first 3,000 patients on COVID Watch

In a piece in NEJM Catalyst, our team members explain how COVID Watch, an automated text messaging system powered by Way to Health, remotely monitors patients with presumed or confirmed COVID-19 at home and quickly connects worsening patients with human care.

NEJM Catalyst
Increased demand for advanced care planning

It is estimated that one in five adults who develops COVID-19 symptoms will end up in a hospital, and one in 20 may experience respiratory failure requiring a mechanical ventilator.

While many Americans put off or forgo filing advanced directives altogether, COVID-19 has pushed the need for these essential documents to the forefront. In a study published in JAMA Network Open, our team members discuss how directive completion on Penn Medicine's homegrown platform, Our Care Wishes, has increased fivefold since the pandemic hit.

Penn LDI
Five lessons from Penn Medicine's crisis response

Investment in innovation enabled Penn Medicine to respond quickly and effectively to the COVID-19 pandemic. Leveraging an iterative process, we worked with clinical and operational teams from across the health system to design, validate, and scale much-needed services with urgency, decreasing deployment time from months to days or hours.

In Harvard Business Review, members of our team share lessons from Penn Medicine's crisis response.

Harvard Business Review