Becker's Hospital Review

38 INNOVATION 5 innovation leaders on how COVID-19 has altered digital strategy at Penn Medicine & more By Andrea Park A s the coronavirus pandemic continues to spread, innovation leaders at hospitals and health systems across the U.S. have been forced to reevaluate their existing strategies and reframe ongoing IT projects to assist with COVID-19 triage and treatment. Here, five of those leaders share with Becker's Hospital Review how they have done just that, moving quickly to divert their teams' most innovative initiatives to help address the pandemic. As Roy Rosin, chief innovation officer of Penn Medicine, put it, "I've been incredibly impressed by colleagues and teams across the health system — and in other systems, too — stepping up to do whatever they can in the face of this challenge, and their passion to help people and keep patients safe is making a difference." Editor's note: Responses have been lightly edited for length and clarity. Roberta Schwartz, PhD, executive vice president and chief innova- tion officer, Houston Methodist It is spectacular to see how a mature technological infrastructure can be enabled to assist a health system in tackling the COVID pandemic. Almost immediately, front-end websites and mobile sites were updat- ed on the latest information; companies such as Syllable, Buoy and Microso were working with chatbots and webbots to help field the volume that was called. Each day we have doubled our number of virtual visits, and on March 19, we saw over 1,000 patients via tele- medicine. Our virtual intensive care unit, developed by Caregility and MIC Sick Bay, was quickly turned on for our COVID-19 patients so that many of our providers can see the patients via virtual visits and not risk exposure in our ICU rooms. I couldn't be more proud of the technology infrastructure that is truly helping us serve the city. Michelle Stansbury, vice president of IT innovation, Houston Methodist Our physician organization immediately began working with Hous- ton Methodist's Technology Hub and our Center for Innovation to determine how every one of our newer technologies, as well as Epic, could be utilized to serve a surge of patients. Houston Methodist helped Epic to bring up the screening questionnaires for COVID-19 and helped the CDC bring their Digital Bridge pilot online with new COVID-19 codes. e Tech Hub and telemedicine operations team have trained over 500 physicians to quickly get them online to see their patients virtually, and now we have more than 750 physicians us- ing telemedicine. Web technology that we tested to bring visitors into the room using vICU and iPads was enabled as visitors were reduced in the patient rooms. It is incredible to see how quickly our physicians and employees are adopting technology that was in place in a more limited fashion and is now utilized by the masses for support of the COVID-19 patient surge. Roy Rosin, chief innovation officer, Penn Medicine (Philadelphia) COVID-19 presented immediate challenges for creative problem solving, and I've seen innovation at work across Penn. Teams are de- ploying novel algorithms to help with operational planning, remote monitoring to triage patients for efficient resource allocation to the pa- tients most in need of care and new strategies to keep sick or potentially infected patients safely separated from others. In addition, some of our earlier work — in particular, work that was designed to transition care to the highest value sites — has been re- fined as these interventions become more critical. A model that ef- fectively keeps chronic obstructive pulmonary disease patients out of the hospital has been ramped up and leveraged for other at-risk populations. Another team working on moving more cancer care to home settings has similarly focused even more intensely on how to more rapidly move to keep patients out of clinical spaces. So, mod- els that were seen as high-value care are also material levers for safety at this time. John Pigott, MD, chief innovations officer and head of strategic busi- ness development, ProMedica (Toledo, Ohio) From a system standpoint, innovative ways of conserving resources such as personal protective equipment and general medical and surgical sup- plies have been extremely important. ProMedica is doing this by limit- ing elective visits and elective surgeries. Follow-up care is being offered through telephone as well as telemedicine virtual visits. Concentrating care for coronavirus patients at a single site helps to limit exposure to other staff and patients and provides more efficient care coordination. From an innovations standpoint, we have been reviewing dozens of digital health tools for screening and patient care that does not require hospitalization. is can divert several patients away from the emer- gency department who do not need to be there. It can allow for limiting transmission to staff and other patients as well as resource conservation. ProMedica Innovations is forwarding to clinical leadership those solu- tions it believes to be most useful, practical and readily integrable into patient care algorithms. Daniel Durand, MD, chief innovation officer and chair of radiology, LifeBridge Health (Baltimore) At the moment, LifeBridge Health, like all providers, is focusing all of our efforts on "flattening the curve" and "raising the line." Flatten- ing the curve is in reference to efforts to avoid spread of the disease, through common sense measures like hand hygiene, but also through major societal and workplace measures such as social distancing, cancellation of large gatherings and virtualization of as much work activity as possible. Raising the line refers to increasing the capacity of our health systems to deal with the expected large number of cases — both "real" cases and worried well. To accomplish this, we have expanded operations significantly in our virtual hospital to triage as many patients at home and away from the hospital as possible. We were the first health sys- tem in Maryland to stand up drive-thru COVID-19 testing locations, and we are using our triage line to determine who is being referred to those sites for testing. Other steps we have taken to raise the line and increase health system capacity include canceling or postponing elective cases throughout our health system. Finally, we are using mo- bile phone technology to allow patients to monitor their symptoms and text us questions as they undergo self-isolation (for positives) and self-quarantine (for negatives) until they are symptom-free for speci- fied time periods in keeping with CDC guidelines. n

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