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Cancer Care @ Home

In late 2019, a multidisciplinary team of experts, brought together by the Penn Center for Cancer Care Innovation, began to explore if home cancer treatment could, for appropriate drugs and patient populations, take the place of inpatient or outpatient administration.

 

Cancer care @ home (CC@H) is an evidence-based, patient-centered program that enables life-extending cancer treatment to be delivered in the home. CC@H patients report dramatically increased satisfaction with care, enhanced convenience and comfort, and a better overall health care experience. Providers are excited to be able to offer CC@H as an option for their patients. And for the health system, CC@H increases capacity while maintaining timely and effective care.

Featured innovators:

Justin Bekelman, MD
Director, Penn Center for Cancer Care Innovation

Lindsey Zinck, RN, MSN, OCN, NEA-BC
Associate Chief Administrative Officer, Operations Cancer Service Line

Desiree Harmon
Cancer Care @ Home patient

Joan Doyle, RN, MSN, MBA
CEO, Penn Medicine at Home

Fast Track to Fertility

Nationally, one in eight couples has trouble getting pregnant. Infertility can lead to substantial distress due to the emotional, physical, financial, and logistical burden it places on patients. Most patients have been trying to get pregnant for at least a year, if not several years, before seeking fertility care. By the time they make an appointment, the emotional stakes can be high, and patients are very eager to get started.

Fast Track to Fertility (FTF) reimagines the fertility intake process to enable patients to start personalized treatment sooner. The program engages patients fast. When patients call for an appointment, they are first connected with a nurse practitioner (NP) for a telehealth visit. NPs obtain information about the couple’s medical history, provide education, answer questions, and explain the infertility workup process.

After this visit, patients receive prompts and reminders via text message to complete the various tests required for workup. This automated engagement supports patients in navigating the complicated, time-sensitive, and cycle-dependent process and complete the workup in the shortest possible time.

With FTF, patients come to their first physician visit with completed workups - setting the stage for more productive and personalized visits and enabling treatment plans to be put in place sooner. In the original pilot, FTF reduced the wait time for an initial appointment by about 88 percent. It also decreased the time it took couples to complete their workup by more than 50 percent, with most patients completing workup within one menstrual cycle. Patients reported high satisfaction, better clarity, and time saved.

Featured innovators:
Anuja Dokras, MD, PhD
Professor, Obstetrics and Gynecology

Suneeta Senapati, MD, MSCE
Assistant Professor, Obstetrics and Gynecology

PreAct

Historically, more than 75% of ovarian cancers would eventually recur, at which point they are not curable. But recent FDA approvals for a new class of oral drugs called parp inhibitors have resulted in significantly improved survival for newly diagnosed ovarian cancer patients.  

However, the effectiveness of these treatments is dependent on genetic and tumor mutations. A complex process of multiple genetic and tumor tests, each of which can take weeks to complete, must be completed within four months of diagnosis to ensure optimal treatment. At baseline, the vast majority of patients newly diagnosed with ovarian cancer started the genetic testing process. Still, only about half completed it in time, with drop-offs happening at numerous points along the way.

Precision Medicine Activated (PreAct) is a model that combines elements of technology and high-touch follow-up to optimize the genetic and tumor testing pathway for providers and patients.
 
PreAct makes the process of completing genetic and tumor testing easy during a time of high stress. Most importantly, the selection of the appropriate parp inhibitor, based on testing, can enable patients to stay in remission up to three times longer and, in some cases, lead to a cure.
 

Featured innovators:
Ashley Haggerty, MD, MSCE
Chair, Gynecology Quality Improvement Committee

Danielle McKenna, CGC
Certified Genetic Counselor
Basser Center for BRCA, Mariann and Robert MacDonald Cancer Risk Evaluation Center

Right Air

Chronic obstructive pulmonary disease (COPD) causes millions of Americans to suffer years of intolerable shortness of breath. With the help of the Health-Tech Design and Development Program, Jake Brenner created Right Air, a respiratory device that fits like a shell over the anterior chest and abdomen and offloads the work of breathing.

By assisting with the work of breathing, Right Air reduces the feeling of shortness of breath, enabling patients to once again engage in life.

Featured innovator: Jake Brenner, MD, PhD, Founder of RightAir, Attending Physician, Pulmonary, Allergy & Critical Care, Hospital of the University of Pennsylvania

Heart Safe Motherhood

Preeclampsia is a disorder of pregnancy characterized by high blood pressure (hypertension) and high levels of protein in the urine. Hypertension is a leading cause of maternal morbidity and mortality in the U.S. and a leading cause of 7-day readmissions for obstetrics patients.

Professional association guidelines published by the American College of Obstetricians and Gynecologists (ACOG) recommend two points of monitoring for at-risk patients, 72 hours and seven to ten days post-discharge after delivery. Unfortunately, many patients do not attend postpartum visits, making it difficult for providers to obtain the data needed to make informed clinical decisions.

Heart Safe Motherhood (HSM) is a first-of-its-kind text-based program for postpartum blood pressure monitoring. HSM enables patients to track their blood pressure from the comfort of their home and communicate with their care team without visiting a doctor’s office. Only patients with concerning blood pressures or symptoms may be asked to come in for an appointment.

HSM drives better maternal outcomes, improves patient experience, and reduces the total cost of care for women with pregnancy-related and chronic hypertension in the immediate postpartum period. It is the standard of care for obstetrics patients at the Hospital of the University of Pennsylvania, Pennsylvania Hospital, and Princeton Medical Center. Improved blood pressure ascertainment and reduction in hypertension-related readmissions have been observed at all three hospitals.

Featured innovators:
Sindhu Srinivas, MD, MSCE
Director of Obstetrical Services, Hospital of the University of Pennsylvania
Vice-Chair of Quality and Safety, Department of Obstetrics and Gynecology 

Adi Hirshberg, MD
Attending Physician, Maternal Fetal Medicine
Hospital of the University of Pennsylvania

Keriton

In any one of the neonatal intensive care units (NICUs) in the U.S., collectively helping the nearly 500,000 babies annually requiring special care in the first months of their lives, nurses spend close to 13,000 hours each year managing breast milk. That's 13,000 hours per NICU - the annual equivalent of six full-time nurses - spent on what nurses call "bartending." Not feeding, just monitoring, labeling, printing, and logging infant-specific nutritional data.

Keriton is a HIPAA-compliant breast milk management system designed for nurses and new moms - by nurses and new moms. The 4-in-1 app allows for easy tracking of breast milk inventories, helps moms and care providers stay in touch via text and photos, auto-generates lactation analytics, and has even been proven to increase milk production.

Keriton is an excellent example of what can be achieved when faculty and staff from the University of Pennsylvania and Penn Medicine collaborate across disciplines. Keriton was transformed from a prototype born at PennApps Hackathon to a top pediatric health innovation in less than two years. 

Featured innovators:
Laura Carpenter, BSN, RN, IBCLC
Lactation Consultant
Hospital of the University of Pennsylvania

Vidur Bhatnagar, MBA
Founder of Keriton

Cancer Screening Navigation Program
Colorectal cancer is the second most common cause of cancer deaths in the U.S. Although clinical practice guidelines widely recommend colorectal cancer screening, screening rates among Americans aged 50 to 75 hover around 67 percent nationally and in Pennsylvania.
 
The Penn Medicine Colorectal Cancer Screening Navigation Program improves colorectal cancer screening rates in the Philadelphia community by providing education, scheduling and preparation support, transportation assistance, and personalized access to patient navigators who assist patients from the first phone call to the completion of their screening.
 

Since the launch of the program in early 2012, almost 1,000 patients have been screened, and five cases of colorectal cancer have been identified. In addition, 42% of the program patients have had pre-cancerous polyps removed through colonoscopy, leading to a meaningful reduction in the burden of colorectal cancer in the Philadelphia community.

Featured innovators:
Michael Kochman, MD, AGAF, FASGE, FACP
Wilmott Professor of Medicine, Divison of Gastroenterology
Perelman School of Medicine

Carmen Guerra, MD, MSCE, FACP
Associate Professor of Medicine, Division of General Internal Medicine
Perelman School of Medicine