The Center for Health Care Innovation (CHCI) is Penn Medicine’s hub for research, design, and custom software development. Four teams made up of researchers, engineers, designers, clinicians, and project managers develop, test, and implement new applied health informatics strategies for approaching health care challenges, frequently collaborating with other Penn Medicine groups including Web Applications, Information Services (IS), Clinical Effectiveness and Quality Improvement (CEQI), and the Office of the CMIO.
CHCI designs, tests, and implements innovative platforms that become the infrastructure for special projects at Penn Medicine. For example, Switchboard and Way to Health facilitated major telemedicine and COVID-19 patient monitoring projects during the global pandemic.
One of CHCI’s four teams, the Acceleration Lab, aims to make significant improvements to patient health and clinician experience by empowering clinicians to apply a scientific approach to solving complex health care problems. When Penn Presbyterian Medical Center staff approached the Acceleration Lab asking for help in supporting emergency department (ED) patients struggling with Opioid Use Disorder (OUD), team members created and implemented the Center for Opioid Recovery and Engagement (CORE).
Penn Presbyterian staff had recognized that few patients received evidence-based interventions for OUD — especially medication-assisted treatment and access to peer support from a certified recovery specialist (CRS) — even though these resources were readily available at the hospital.
A key challenge to solve before CORE team members could counsel patients, encourage them to initiate medication-assisted treatment, and follow up with them after discharge, was identifying patients at risk of OUD in near real-time. The Acceleration Lab developed a specialized algorithm to do just that, applying it to EHR data to identify patients with OUD, as well as patients who have indirect indicators of OUD that may be hidden within their chart. This algorithm was then used to notify CORE team members of potential patients who would benefit from their services, enabling them to reach those patients in the hospital and after discharge. Since its inception, the CORE program has prevented an estimated 180 overdose deaths each year. As many as 68% of patients are in treatment for OUD after 30 days, compared to less than 5% before CORE was launched.
A second team at CHCI, the Nudge Unit deploys best practices around behavior change, complementing other Penn Medicine efforts in clinical decision support. Behavior change models like the ones designed and implemented by the Nudge Unit can promote the use of defaults in the electronic health record, for example, and redesign other workflows to reduce friction in the paths that clinicians should take.
A third team at CHCI, the Center for Digital Health, uses unconventional data sources to provide alternative approaches to care.
CHCI’s fourth team, Way to Health (W2H), has developed and implemented a web-based platform that uses text messaging to facilitate patient engagement in their care. The W2H team recognizes that understanding human behavior is key to making advances in the standard of care for patients.
Innovation is a team sport—to move the needle in a large health system, informatics work needs to be collaborative and integrated. CHCI supports the work of the Center for Applied Health Informatics by collaborating with other Center groups and addressing large scale issues facing the health system through their system of rapid prototyping, piloting, and validation, for solutions that have a positive impact on the health system.