Connecting an Award-Winning Cancer Information Website to our Electronic Health Record

OncoLink is an award-winning cancer information website that was developed and based at Penn Medicine. OncoLink provides up to date, evidenced-based oncology patient education and survivorship care plans. With the implementation of this project, important patient education tools are now integrated into the EHR, which provides both patients and clinicians with the ability to use OncoLink for access to:

• The survivorship care plan builder and the treatment binder (patient education materials) via the dropdown menu

• The documents customizer feature, which allows for documents to be built and saved directly to the patient record, eliminating the need to exit the EHR, create and print OncoLink documents, and scan them into the patient’s chart.

• PDF documents, that once created, are available from the media tab in the chart and to patients in the My Documents section in myPennMedicine.

HTTPS://WWW.ONCOLINK.ORG/

The Information Services team partnered with the Penn OncoLink team and vendor to make this a reality. The IS Project Management Office guided the project through the discovery, security, and implementation. Multiple specialties within the Information Services team worked to enable integration of this application with the EHR for both clinicians (in PennChart) and patients (in MyPennMedicine), and developed a tool to be used for statistical analysis by the OncoLink team.

Benefits:

• Integration of OncoLink education materials and survivorship care plans into PennChart resulted in time savings for clinicians, and improved documentation of education provided, assuring documents are labeled and filed correctly

• Reduced the average time it takes to complete the process of generating and filing a survivorship care plan from 14 minutes to 2.5 minutes

• Integration eliminates the need for downloading and scanning and the potential to introduce errors

• The first year of this integration has resulted in the creation of over ten thousand education documents for oncology patients

Post-Operative Staff Gain Immediate Access to Medications Administered During Bypass Surgery

Medications given throughout cardiopulmonary bypass were historically documented in the perfusion chart in Penn Medicine’s perfusion and patient safety systems. The systems were designed to support a wide range of extracorporeal therapies, including ECMO. The medication chart existed in operating room documentation and was not readily accessible to physicians, advanced practice providers, pharmacists, and nurses post-operatively.

By integrating an incoming medication administration documentation interface from the perfusion system into the EHR’s read only section of the patient medication administration record (MAR), patient safety risk was mitigated. This type of interface was the first deployed for Penn Medicine and a first for the vendor interfacing administered medication to an electronic health record.

Perfusionists, anesthesiologists, pharmacists, and other providers from the Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center collaborated on the selection of over 50 medications that were interfaced. Clinical staff who cared for patients post-operatively were enabled to view medications such as antibiotics and immunosuppressant administered to patients in the OR during cardiopulmonary bypass in the MAR. This is in addition to the usual location of the perfusion record. The achieved goal brought the information to a location in the EHR for a faster and easier view by clinical staff.

“Automated transfer of information from one part of the medical record to another is one of the implicit gifts of an electronic record. What many don’t realize, however, is that there are hundreds of medical devices and we’re slowly interfacing the most critical to the EHR. For example, an interface between the heart-lung bypass machine and PennChart has recently been completed and it both improves visibility about drugs administered in the operating room and cuts down on transcription errors. This is the result of a great collaboration between clinicians and information services experts.”

Dr. Bill Hanson

Penn Medicine at Home Expands Patient Outreach

Penn Medicine At Home offers a full range of health care needs from the comfort of home, or in a Penn Medicine hospice location. To expand the patient outreach program for Penn Medicine at Home patients, an interface was built between our EHR and the existing health engagement solution. Prior to the implementation, the workflow and business process for registering patients was manual and limited to a smaller set of home health patients. The previous process used EHR reports that needed to be manually executed daily, to determine the home health targeted audience. This process did not have automation for patient registration within the application as well as automated notification on status of upcoming patient’s scheduled appointments, appointment cancellations, and re-scheduled appointments for both ambulatory and home health patients.

To address these needs, the core IT team expanded the scope of the project to two interfaces to incorporate a scheduling interface that would include cancelled and re-scheduled appointments. Also, Penn Medicine at Home operational leadership determined that the additional custom report criteria would need to be expanded for daily home health census and discharge filings which resulted in additional accuracy to the daily patient engagement call list.

The new workflow benefits have increased patient satisfaction as the home health engagement program has become automated and scaled for the entire Penn Medicine at Home division. Also, the program has enhanced the quality of care. In addition, the elimination of manual processes has allowed home health resources to focus on patient care and patient well-being rather than manual tasks required to facilitate patient engagement workflow.

Pulmonary Function Testing Results Move Directly into the EHR

Penn Medicine identified an opportunity to realize operational efficiencies by installing a new respiratory diagnostic system that follows the most up-to-date standards in pulmonary testing. It promotes higher levels of accuracy, is less intrusive, and less stressful for patients at the Hospital of the University of Pennsylvania and at the Perlman Center for Advanced Medicine. Once installed, the new system was integrated into our electronic health record that brought about the following benefits:

• Increased documentation in the EHR

• Reduced administrative burden - allowing pulmonologists to focus on clinical decision-making and patient consult

• Increased reviewing and reporting consistency

• Improved care quality and patient safety

Connecting Sleep Study Data to Penn Medicine’s EHR

Sleep study data was integrated into our electronic health record to maximize workflow efficiency for caregivers. The new interface was designed to ingest sleep lab reports and discrete data results. The project also included new hosting infrastructure changes and the addition of virtual machine servers to support the test environment. The legacy system required a server refresh along with alignments to the new test environment. The new observational results template was revised, along with updated flow sheets. Providers were enthusiastic to gain a more efficient system and an improved ability to focus on care management with this fully integrated process and additional result data visibility in the EHR.

Otorhinolaryngology Integrates their Inventory Management Software with the EHR

Penn Medicine identified an opportunity to reduce cost and improve operational efficiencies by integrating EHR demographics information to an inventory management software system for otorhinolaryngology and plastics, with the future ability to add dermatology and optical services.

The integration brought the following benefits:

• Eliminated the need for manual processing, resulting in better patient care

• Reduced patient waiting time

• Improved workflow, reduced inefficiencies, and increased user satisfaction

• This integrated inventory management software benefitted all departments using the software

• Optical and Dermatology requested department activation to join the integration channels

Penn Medicine Pioneers the First Use of a Cutting-Edge Anesthesia Medication Injections System

Penn Medicine has pioneered the first use of a cutting-edge medication injections system with electronic health record interoperability in a clinical setting. Successful implementation of the IV bolus anesthesia medication injections system was introduced in the operating theaters at the Hospital of the University of Pennsylvania, Perelman Center for Advanced Medicine, and Pavilion facilities. The results of the IT implementation and clinical study informs future design improvement to the system, which is intended for widespread clinical use in the United States.

Since this was the first implementation of the EHR interfaces programmed into a production environment, our team completed a collaborative retrospective review of the technical implementation. This case study described implementation activities, outcomes, and the clinical impact of the project.

This implementation provided robust support for Penn Medicine’s hypothesis that anesthesia providers would find the technology helpful to enhance the quality of their medication management. It also identified several implementation recommendations that were broadly applicable to hospitals collaborating with vendors to implement new technologies having interoperability.

Radiation Oncology at Penn Medicine Princeton Health Moves to the EHR

Early in 2022 the radiation oncology department at Penn Medicine Princeton Health went live on the health system’s EHR with clinical documentation. This implementation required a system build and end-to-end testing and training. This direct connection to the electronic health record eliminated the use of a third-party system to perform hospital billing.

This project also introduced Penn Medicine’s new dictation application directly to the EHR for all Radiation Oncology patients. Use of the enterprise dictation system eliminated the previous carrier that had a turnaround time of up to 24 hours and required providers to manually add a progress note to the chart while waiting for transcription results. Use of the enterprise dictation system has enabled Princeton Health providers to dictate in the EHR in real time, improving the quality of the documentation and providing a significant cost savings to the health system by eliminating the need for double documentation.

Good Shepard Penn Partners Opens Therapy and Fitness Facility

Good Shepard Penn Partners, the official therapy provider for Penn Medicine, opened a therapy and fitness facility at Pennsylvania Hospital. The renovated space on the 7th floor was successfully re-apportioned and equipped with printers and workstations to provide the required functionality within a rehabilitation space. Additionally, wireless access was realized throughout the location to provide Wi-Fi coverage as clinicians moved through the space with their laptops. Security cameras and a telecom system were also installed.

Therapy and fitness services include:

• Occupational Therapy

• Lymphedema Therapy

• Physical Therapy

• Pelvic Floor Therapy

• Hand Therapy

• Cancer-Related Fatigue

• Joint Replacement

• Shoulder Pain

• Spine (Neck and Back)

• Sports Performance

• Women’s Health (Pregnancy)

• Foot and Ankle Injuries

The Perelman School of Medicine’s education programs develop the next generation of leaders in medicine and biomedical research. To attract the most qualified students and trainees, The School of Medicine and Penn Medicine Medical Group (PMMG) engage the most outstanding educators and researchers in teaching and training where educational relationships are fostered with the University and Penn Medicine network. We maintain and reward outstanding educators by providing an environment that promotes creativity and rewards teaching excellence. The Perelman School of Medicine, its faculty, and its alumni share a commitment to lifelong learning.

Penn Medicine enhances its status as a world leader in advancing medical science by continually improving the quality and impact of its research. The areas that Penn Medicine emphasizes are the fundamental mechanisms of biology and human disease; the translation of discoveries into novel approaches for the diagnosis, treatment, and prevention of disease; and the evaluation of medicine’s impact on the health of the public.

Center for Cellular Immunotherapies Gains Efficiency from New Technology Based Workflows

The Center for Cellular Immunotherapies (CCI) has interacted with many investigators in nearly all departments of the Perelman School of Medicine. Together, they have been translating novel immune-based therapies from bench to bedside. Because of their central position, they engaged with IS support in many areas to execute their fast-paced research initiative while maintaining accuracy, efficiency, and quality.

The Penn Medicine Lab Information Management Systems (LIMS) team partnered with CCI in multiple areas to support equipment maintenance, sample routing, and inventory management. The equipment capabilities ensured monthly calibration and maintenance were completed and documented for equipment used in creating product. From a quality standpoint, sample routing has been used to track samples and create a chain of custody throughout the process. Management of inventory ensured that materials were ordered and used correctly to avoid exhaustion, expiration, or supply waste.

By implementing several workflows into the lab system, benefits have been plentiful. The CCI team has increased productivity, collaboration, and communication by logging into a central location to complete all work. Dashboards of all workflows have provided the lab with top level details to address urgent needs first. Work orders were created to complete equipment calibration or maintenance. Samples were tracked with a full audit view and reporting capabilities. Full inventory tracking and barcoding prevented shortages or use of expired materials while providing traceability from initial source to final use. The capabilities provided by IS in using the enterprise LIMS system enabled high-quality research with reduced waste.

Penn Medicine Institute for Immunology Uses Tech to Advance Research Initiatives

An immune health project initiated at the onset of the COVID-19 pandemic and merged with the Penn Institute for Immunology (IFI) to form a key immunology core. Technology was needed to support this newly combined team with collaboration tools among key functions including the clinical research operations, the central processing unit, and partner investigators throughout Penn Medicine during this rapidly developing time in research and patient care.

Our laboratory information management systems (LIMS) and immune health teams adopted a strategy that would get COVID-19 sample tracking into our lab system quickly, with early deployments and further enhancements designed as other needs became more understood. Lab application expansions included calendaring of research collections and integration with a new iPhone app, named SpeciTracker, that was developed by the IS application development team. The app streamlined communication with the lab for research visits conducted in patients’ homes. In addition, billing integration with the iLab system was added for automated billable service reporting. Finally, the collaborative sharing of specimen inventory, participant data, and assay information through integration with the Pennsieve analytics platform was launched.

Through the nimble adoption of technology provided by IS, the immune health group has been able to gain high efficiency in sample processing and data tracking. Teamwork and communication have been the hallmarks of this partnership. An increase in data quality and a reduction in time spent on reporting through the new iLab and Pennsieve integrations with the lab system have allowed for higher throughput in the lab. Early adoption and continuous improvements have positioned the Penn Institute for Immunology as a group that thrives due to their willingness to leverage technology.