Digital Edition of System News - 11/27/2015

Volume 15

Issue 2

November 2015

SYSTEMnews `` Shooting hoops is one way IMPaCT worker Orson Brown helps keep Patricia Quick active.

“Intrapreneurship”

Alive & Well at

UPHS

T he Innovation Accelerator Program supports a culture of experimentation.

CEO’s corner

Quick, rapid learning about what is working, paired with ongoing adjustments and tweaking....

Ralph W. Muller

CEO, University of Pennsylvania Health System

With Thanksgiving approaching, followed by the holiday season, this is the ideal time to reflect on the many joys and sources of happiness in our lives. It is also a good time to think about the less fortunate and how we can make their lives brighter.

Through two vital programs, Penn’s Way and Penn CAREs, our staff members demonstrate their generosity and compassion by way of donations and volunteer service that make a real difference.

Penn’s Way encompasses Penn Medicine charities, United Way, and the Center for Responsible Funding charities. This year it is operating in parallel with Chester County Hospital’s United Way Campaign.

Our 2015 Penn’s Way goal is $1.55 million, evenly divided between Penn Medicine and the University of Pennsylvania. Over 1,000 organizations and agencies in the greater Philadelphia region are eligible to receive donations through Penn’s Way. This year all Penn’s Way funds raised for Penn Presbyterian Medical Center will be distributed to the pharmacy discharge-medication program, which provides prescription medications to hospital patients in need at the time they are discharged. Donations to the Hospital of the University of Pennsylvania and (continued on page 6)

Inside Penn Medicine and Virtua Form Strategic Alliance............2 LG Health Expands....................2 Penn Medicine's Partnerships...............................2 Penn Medicine@Work..............3 Newsmakers..............................4

As executive director of the Penn Medicine Center for Health Care Innovation, David Asch, MD, MBA, PhD, enjoys an upclose view of an abundance of ideas for improving health care delivery and accessibility. The ideas usually have two things in common. First, they represent a significant opportunity to improve health care as currently delivered. Second, they need a little “lift and push” from innovation experts to reach fruition. That’s where the Center for Health Care Innovation comes in.

The Center, inspired by Kevin Mahoney, UPHS’s chief administrative officer, comprises more than two dozen staff members with backgrounds ranging from medicine to behavioral economics and operations management. Its mission is to promote “the rapid, disciplined development, testing, and implementation of new strategies to reimagine health care delivery.”

Since launching in 2012, the Center has spawned many attention-grabbing ideas and experiments, such as whether it is effective to pay people to quit smoking. Also garnering wide notice is its concept of automated hovering, a concept which includes strategies such as “smart” pill-bottle tops that alert caregivers if patients are skipping their medication.

The Center also supports "intrapreneurship" — employee engagement in entrepreneurial activity within a large organization such as Penn Medicine. For example, the Innovation Accelerator Program provides training and financial and technical support to promising start-up projects.

“The Innovation Accelerator Program offers Penn Medicine staff members the opportunity to put their ideas into action on a small scale at first,” Asch said. “It supports a culture of experimentation. Quick, rapid learning about what is working, paired with ongoing adjustments and tweaking, ensure that the entrepreneurial mindset remains strong.”

“We receive an array of interesting, original ideas,” said Center co-director Kevin Volpp, MD, PhD. “We home in on those that lend themselves to early testing, with a capacity to quickly adapt to the findings, refine, and iterate. This is an important complement to standard randomized control studies, which are of longer duration and which tend to use fairly static designs.

We’re approaching things from a different angle, one often used in the business world and until recently, not much in evidence in health care.”

“All of us at the Center wish we could formally support many more projects than we can now,” said Roy Rosin, MBA, chief innovation officer. “But we do our best to help even when a project hasn’t been officially selected.” For example, a team of physicians submitted a proposal to link an endoscopy machine to a Smartphone. This would enable sharing of endoscopy images with consultative colleagues and for teaching purposes, neither of which is currently practical. Though the Center couldn’t provide funding, staff members directed the physicians to a design team who are helping convert the idea into reality.

The program's first two rounds saw an average of 75 applications, eight of which were chosen as winners. One would develop software and a mobile app to encourage appropriate antibiotic use by providing real-time data directly to providers, minimizing the risk of dangerous pathogens developing resistance to life-saving antibiotics. “In an era of increasing antibiotic resistance, the iAntibiogram software has been transformative in how we think about using more personalized susceptibility data to inform antibiotic prescribing,” said Keith Hamilton, MD, HUP's director of Antimicrobacterial Stewardship. The iAntibiogram has an average of 3,087 searches per month, whereas the prior website on which the data was displayed got an average of 29 pages views per month.

The Move to ICD-10..................5 Awards and Accolades.............6

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Record Turnout for the 5K for the IOA............................6

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Penn Medicine and Virtua Form Strategic Alliance This fall, Penn Medicine and Virtua Health formed a strategic alliance to create easier access to care by growing programs in South Jersey supported by both organizations, and by facilitating access to advanced care provided by Penn. The alliance includes programs for cancer and neuroscience.

“We are excited to have the opportunity to work with our colleagues at Virtua to provide the greatest number of options for South Jersey patients with cancer and neurological conditions,” said Ralph W. Muller, CEO of the Health System.

Virtua is an integrated delivery system comprising three acute hospitals, surgical centers, group practice physician offices, urgent care clinics, and rehabilitation centers. Virtua is nationally recognized as a high quality health system, receiving Leapfrog “A” grades for all hospitals and a Press Ganey Award for Patient Satisfaction.

Both organizations will continue to function independently but with a stronger emphasis for expanded partnerships on certain initiatives. The alliance will initially focus on cancer and neuroscience programs. Virtua will become a premier member of the Penn Medicine Cancer Network. Penn Medicine’s Radiation Oncology patient quality and safety program will be available across all existing Virtua hospital sites. “This collaboration will support and strengthen Virtua’s delivery of cancer care which includes programs focused on prevention, diagnosis and treatment,” said Rich Miller, president and CEO of Virtua.

The neuroscience collaboration will include treatment of diagnoses such as stroke, Parkinson’s disease, brain injury and dementia. Penn doctors will perform surgery at Virtua Memorial Hospital in Burlington County, so patients no longer have to leave the area to obtain specialized surgical procedures.

The alliance will also help reduce duplication of resources, increase efficiencies and decrease health care costs. It will foster collaboration among the medical professionals of both organizations, ensure delivery of care in the appropriate setting, eliminate gaps in care and improve access to services.

LG Health Expands

Penn Medicine’s Partnerships

Lancaster General Health will invest up to $60 million to improve its inpatient experience and the staff 's ability to provide patient care with a six-story expansion of Lancaster General Hospital (LGH). The expansion will rise eight stories and include 60 new private inpatient rooms, with space for 80 additional rooms as needed. These new private rooms will enable LG Health to convert 71 existing semi-private rooms in other parts of the hospital to private rooms or other facilities. Private rooms reduce the risk of infection, help nurses and healthcare workers do their jobs efficiently, provide adequate spaces for family members to participate in patients’ healing process, and afford a greater measure of privacy for bedside treatments and sensitive discussions with healthcare personnel.

Which Type of Affiliation Works Best?

Lancaster General Health is also upgrading the power plant at Lancaster General Hospital with a cogeneration system that will improve power reliability, save energy, reduce emissions and lower operating costs. The “LGH Energy Center” will update and improve the hospital’s current energy plant as well as add new state-of-the-art Combined Heat and Power equipment. The new system will generate 71 percent of the hospital’s electric energy and 84 percent of the hospital’s steam on-site.

“When a natural disaster disrupts power and our community is in need, people turn to hospitals to be the light on the hill,” said John Hartman, senior director of facilities management at LGH. “This needed upgrade will help ensure we’re able to meet the community’s needs today and in the future.”

Over the past several years, Penn Medicine’s footprint has expanded significantly, beyond Philadelphia and into the surrounding areas of Southeast and Central Pennsylvania and Southern New Jersey. These connections — with physician groups, hospitals and health systems across the region — help ensure better coordination of care, management of patient populations, and cost`` Penn Medicine has expanded its footprint across Southeastern Pennsylvania and New Jersey, with outpatient facilities throughout the region, hospitals in effective patient care services in the communities we Southern Chester County and Lancaster, and a new alliance with Virtua in South Jersey. serve. But what is the strategy behind this growth?

How do our leaders decide which type of relationship and arrangements work best as we work to cement and expand our role as the region’s leading health system? Phil Okala, SVP for Business Development, shared with System News some of the considerations that go into mapping out these plans.

Penn Medicine has many different types of affiliations, a strategy that is increasingly common in today’s health-care environment, especially after the passing of the Affordable Care Act. The type of affiliation Penn Medicine forms with a specific partner varies according to the needs of both parties, Okala said. “We form a strategic partnership with one organization, a full consolidation with another, or, in some cases, as we have done many times, an outpatient facility in a specific location,” he said. “The idea is to make sure that we maintain a distributive network of partnerships and facilities, predominantly on an outpatient basis across the region, thereby ensuring ease of access by our patients to the array of services we provide."

How does leadership decide which type of affiliation partnership would work best? In many situations, there is already some working relationship with the partner at some level, usually through our doctors in the management of patients. Such was the case with Chester County Hospital. “Many of their physicians knew our physicians or trained here,” he said. “Many of our patients also live in Chester County so there was already a high level of familiarity between our physicians and those at Chester County Hospital. The merger simply strengthened our presence in that community and improved the collaborative relationships of physicians, nurses and patient care teams across quality, education and many other domains.”

The situation was similar with Lancaster General Health. “For a long time LGH was a successful affiliate in our Penn Cancer Network, so there was a level of physician-to-physician communication and co-management of patients,” Okala said, adding that the geographic adjacency of Lancaster County to Chester County eases patient travel and coordination of care.

“These important factors and others influence thinking around partnerships,” he said. “Our previous relationship of working collaboratively in managing patients was very important in the case of both Chester County Hospital and Lancaster General Health. By the time the board of trustees at both organizations decided they were interested in becoming part of a bigger health system, we knew our organizations were culturally compatible and so we were interested in exploring the opportunity.”

In strategic alliances, such as the recent collaboration with Virtua (see article above), both organizations are working together to provide convenience, high quality, and cost-effective care to patients while maintaining their respective independent leadership and governance decision-making. “As we share protocols, best practices and work together in many areas, the relationship will only grow and get stronger, to the benefit of our patients and the community” Okala said.

Keeping in line with our guidelines for partnerships, the alliance with Virtua is mutually beneficial. Between 25 and 30 percent of Penn Medicine patients — and a significant number of our employees — come from South Jersey. “It is where our colleagues and patients live. We always want to make sure we’re attuned to community needs so having a strategic partner in this community was critical,” Okala said. “It allows more of our patients and employees living in the area to receive care closer to home. We know that patients generally prefer to be closer to friends and family for support when they are sick. But if a patient needs advanced medical care that is not be available at Virtua, starting with cancer and neurosciences, we are putting systems in place to coordinate how that care gets delivered at any of our hospitals in a very coordinated way to allow patients return back home quickly. ” While Penn Medicine leadership takes many factors into consideration when deciding which strategy works best, “we try to maintain a consistent theme, providing the right level of care at the right location and by the right type of care provider, cost efficiently,” Okala said. “These relationships help us accomplish that.”

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penn medicine

work

Penn Medicine Military Friendly® Employer Penn Medicine has earned the 2016 Military Friendly® Employer designation by Victory Media, publisher of G.I. Jobs® and Military Spouse. Companies competed for the elite Military Friendly® Employer title by completing a data-driven survey, with data independently tested by EY (Ernst & Young) based upon the weightings and methodology established by Victory Media and its Advisory Board.

Criteria for the survey included a benchmark score across key programs and policies, such as the strength of company military recruiting efforts, percentage of new hires with prior military service, retention programs for veterans, and company policies on National Guard and Reserve service.

“Companies that have earned the 2016 Military Friendly® Employer award have exceptionally strong hiring programs and meaningful careers for transitioning service members and spouses,” said Daniel Nichols, Chief Product Officer of Victory Media and Navy Reserve veteran. “Our Military Friendly® Employers are moving the needle beyond answering ‘why hire military’—they are truly aligning their jobs and recruiting efforts with Military Friendly® educators to translate military competencies into civilian jobs.”

Penn Medicine recognized its employees who served their country and have taken up a new mission, caring for our patients. Everyone is encouraged to share stories of military service and recognize colleagues who have served in the U.S. Armed Forces with the hashtag #CombatToCare. To see stories shared by your colleagues, visit PennMedicine.org/CombatToCare.

Linda Collins, U.S. Air Force

Senior Buyer, Corporate Purchasing “This was taken about Nov 1973 at my home base Richards-Gebaur AFB, Missouri. I remained there for 4 years doing my purchasing duties, advancing in rank and receiving a cherished base-wide nomination, Non-Commissioned Officer for Calendar Year 1975.”

Shannon Campbell, U.S. Army

Project Manager, Real Estate, Design & Construction, UPHS “This is me on the DMZ between North and South Korea. Our daughter, Hayden, and I picking my husband Regan up from the airport for his mid-tour leave from his tour in Iraq in 2005-2006.”

Stephen James, U.S. Air Force

Radiation Specialist, HUP Radiation Oncology

“This picture was taken in 2004 at the 37th Expeditionary Bomb Squadron in Diego Garcia BIOT during Operation Enduring Freedom. Issuing a B1-bomber pilot his sidearm preflight before a 14 hour mission over Afghanistan.”

Rei-Yun Chiang, U.S. Navy

Clinical Assistant, Urology Department, Perelman Center for Advanced Medicine “I was a Hospital Corpsman 3rd Class in the United States Navy. This picture is of me in South Carolina, getting ready for deployment to Kuwait in support of Operation Iraqi Freedom, in 2007.”

C o n gr a tu l a tio n s

Hospice Volunteers Honored for Outstanding Service Timothy Lee, a volunteer at Penn Wissahickon Hospice, was one of four outstanding volunteers recognized by the National Hospice and Palliative Care Organization. The "Volunteers are the Foundation of Hospice Awards" recognize hospice volunteers who best reflect the universal concept of volunteerism in its truest sense — serving as an inspiration to others.

With help from the local community and support from Penn Hospice, Timothy took part in organizing an interdisciplinary revitalization of an underutilized children's room at Penn Hospice at Rittenhouse in Philadelphia. The project brought together over 85 volunteers from schools and organizations across Philadelphia to create a safe place and creative space for children whose families were receiving hospice care.

(To read how Timothy created a welcoming room for children, go to http://bit.ly/1WMQqAt.)

The First Clinical Leadership Academy Focused On Healthcare Value In Our Region Penn Medicine kicked off the first inter-professional Clinical Leadership Academy (CLA) in September with an exciting topic — Healthcare Value in the Philadelphia Region. Interested participants heard the perspectives of two seasoned leaders from our region who have a great deal of experience working with employers — Steve Wray, Executive Director, The Economy League of Greater Philadelphia, and Mike Casey, Senior Vice President, Aon Hewitt. Penn Medicine leaders and CLA participants participated in an interesting discussion about the issues driving patient choice and the challenges of defining and managing value in our digital world.

Physician and nurse leaders from all five entities participated both in person and via a live webcast. We plan to host two more sessions this year — one this winter and a final session in the spring of 2016. For more information and to download the CLA presentations, visit http://uphsxnet.uphs.upenn.edu/UPHSQualityPtSafety on the UPHS intranet.

to the Winners of the 2014-2015 Healthy Rewards Leadership Event The 2014-2015 Healthy Rewards program year ended successfully in April with over 6,000 employees participating in the program. The program has four levels, each offering a different incentive with the opportunity to earn up to $200, win a Fitbit, and win a recognition event with leadership. Throughout the year, the program offered many different activities. A few of the program highlights were the Wellfocused Walk-Off, Re-Think Your Drink Campaign, and a fun Summer Grilling Throw Down recipe challenge in which the winners recipes were featured in the hospital café’s.

Congratulations to the winners of the Leadership Recognition Event. These 25 winners were entered in to a raffle for reaching 6,000 points in the program and are receiving special recognition and prizes. The winners of the Leadership event are: Dawna Gillespie, Tawney Ayers, Ashley McMillan, Earl Marsh, Nicole Juszczyk, Dai Meeks, Robin English, Cara Curley, Erica Payne, Sarah Samuels, Jeannie Austin, Aisha Komara, Nyree Lyons, Kathleen DiRocco, Danielle Auxer, Kimberly Clark, Christian Gagliardi, Yolanda Bryant, John McClellan, Thomas Hall, Pamela Gurley, Larry Taylor, Susan Decker, and Irvene Haskins.

Thank you to all who participate in the Healthy Rewards Program and for choosing to live a lifestyle that promotes better health and well-being. The better care we take of ourselves, the better we will be able to care for patients, our families, and the community.

It’s never too late to start participating in the Healthy Rewards Program for the 2015-2016 program year! The more activities you participate in, the more points you accumulate, and the more incentives you can earn! Log in today at PennMedicine.limeade.com to join in on the fun!

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Penn Medicine

NEWSmakers / / / Tackling All Health Care Challenges During Papal Visit to Philly Pennsylvania Hospital was featured in multiple media outlets for its preparations to ensure the smooth delivery of health care to the region and visitors who came to Philadelphia to see Pope Francis. John Wierzbowski, MSc., MPH, director of Safety and Emergency Management at PAH, commented on hospital preparations to Modern Healthcare, on 6ABC, and in an Associated Press article. Patty Inacker, LCSW, MBA, director of Operations of the Hall-Mercer Community Mental Health Center at PAH, was also featured on 6ABC, discussing Hall-Mercer’s vital role in providing round-the-clock on- and off-site psychiatric first aid throughout the weekend. The Philadelphia Inquirer also referenced the organ transplants, a mix of liver and kidney surgeries that took place at the Hospital of the University of Pennsylvania.

/ / / Race to a Cure for Blindness The gene therapy work of Samuel Jacobson, MD, PhD, professor of Ophthalmology, was included in a Time magazine feature on cuttingedge cures for blindness. Jacobson and team have been able to arrest the progression of the genetic condition LCA, which renders patients blind by midlife, through the injection of a healthy gene into the eye to act in place of the diseasecausing gene. “Even though the improvement of vision is not forever, I think we must reckon with the truth to advance progress,” Jacobson said. “Is it all done? No. Is it a major start? Yes.”

/ / / Could Changing the Brain Help Smokers Quit?

The Philadelphia Inquirer featured the work of Caryn Lerman, PhD, senior deputy director of Penn’s Abramson Cancer Center, who recently received the National Cancer Institute Outstanding Investigator Award. Her research explores how the brain’s cognitive control system can be enhanced to improve self-control over behaviors that contribute to cancer risk. As part of this $6.5 million grant, she is testing whether cognitive activities aimed at strengthening brain functioning or treating the brain with a low level of electricity can make it easier for people to withstand smoking and eating cravings.

/ / / Our Microbiome and Our Health The trillions of bacteria and fungi in our bodies make up our microbiome. We’re just beginning to understand the critical role this plays in our health. Researchers now believe our “body bugs” influence autoimmune diseases, allergies, obesity, mental health and more.

Radio Times embarked on an informative discussion with Tracy Bale, PhD, a professor of Neuroscience in the School of Veterinary Medicine and in the department of Psychiatry in the School of Medicine, Gary Wu, MD, a professor of Gastroenterology, and Frederic Bushman, PhD, a professor of Microbiology.

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/ / / What Medicine Could Learn from Your Facebook Posts Raina Merchant, MD, assistant professor of Emergency Medicine and director of Penn's Social Media and Health Innovation Lab, joined WHYY Radio's The Pulse to discuss what the content we post to social media could reveal about our health, and how to harness that data.

/ / / Are the Kids All Right? When Breast Cancer Runs in the Family CBS News and HealthDay reported on a new study, led by Angela Bradbury, MD, an assistant professor of Medicine, which examined the psychosocial development of girls from families with a history of breast cancer or a known genetic risk for it, compared to girls without a family history of the disease. The study found that girls from breast cancer families have higher levels of anxiety about their risk for the disease.

/ / / Infants Celebrate Halloween at HUP’s Intensive Care Nursery HUP’s tiniest patients celebrated their first Halloween last month, dressed in costumes with their loved ones and care team in the intensive care nursery. Many of these babies were born with very low birth weight and need special attention before they can go home, so their parents and staff dressed them up and held a party in their honor, NBC10 and Philadelphia Magazine reported.

/ / / Patients Desperate for Organs Resort to Unusual Efforts to Find Them Some transplant patients are known to decamp to states where organs are more accessible. David Goldberg, MD, MSCE, assistant professor of Gastroenterology, contends that proposals to redistribute the existing organ supply are “a Band-Aid on a gaping wound,” he told the Pittsburgh Post-Gazette. He and others suggest that the transplant system redouble efforts to increase the number of families donating organs.

/ / / Marriage May Aid Recovery From Heart Surgery, Study Finds Married people who have cardiac surgery may fare better than those who are divorced, separated or widowed, according to new Penn Medicine research led by Mark Neuman, MD, MSCE, an assistant professor of Anesthesiology and Critical Care and a Senior Fellow at the Leonard Davis Institute for Health Economics. In the study, people who were not married had about a 40 percent greater risk of either dying or developing a new disability during the first two years after the surgery, the team found. The research was covered by media outlets from around the globe.

/ / / Pay Patients to Take Their Pills New research in which cash rewards were offered to help people lower their cholesterol levels showed the program was only successful when both the doctor and patient were paid to work together to achieve a common goal. Authors David Asch, MD, a professor of Medicine and Medical Ethics and Health Policy, and executive director of the Center for Health Care Innovation at Penn Medicine, and Kevin Volpp, MD, PhD, a professor of Medicine and Health Care Management, vice chair of Health Policy, and director of the Center for Health Incentives and Behavioral Economics at Penn Medicine, are quoted in news stories from outlets across the nation.

/ / / Using Brain Science To Understand The Terrible Teens The Diane Rehm Show featured a conversation about how the latest in brain science is changing our understanding of the teenage years. Frances Jensen, MD, chair of Neurology and author of the book, "The Teenage Brain: A Neuroscientist's Survival Guide to Raising Adolescents and Young Adults," was one of three guests on the subject.

/ / / Penn Neurosurgeon Marks 1,000th Deep Brain Surgery Penn neurosurgeon Gordon Baltuch, MD, PhD, a professor of Neurosurgery and director of the Center for Functional and Restorative Neurosurgery at Pennsylvania Hospital, just completed his 1,000th Deep Brain Stimulation (DBS) procedure. The procedure helps tame the tremor and uncontrollable movements of Parkinson's disease when medications fail. The results can transform a life. Patients "usually get an extra four to six hours of good time in a day," Baltuch explained to WHYY Radio.

Baltuch's milestone places him among the most prolific DBS surgeons and researchers in the world.

Visit the Penn Medicine news website at www.PennMedicine.org/news

THE MOVE TO

“Normally we work on developing or changing one system to accommodate a need and then test it to ensure that the new functionality doesn’t ‘break’ anything in other systems,” said Amy Trenton, senior project manager in Information Services. “This project required that we identify what changes were necessary in multiple systems and test them all to ensure all they worked as expected and were ICD-10 compliant.”

A Major Effort Results in a Smooth Coding Transition The International Classification of Diseases (ICD)is a global clinical cataloging system created by the World Health Organization that standardizes descriptions of diseases and procedures. It allows the world to compare and share important health information. As of October 1, 2015, all hospitals were required to switch over to ICD10, an undated version that better reflects the advances in technology, the discovery of new diseases, and the increase in medical knowledge than its predecessor. “ICD-9 lacked sufficient clinical detail to identify the complexity or severity of diagnoses.” said C. William Hanson, MD, the Health System’s chief medical information officer. “ICD10 is a better measure of quality, safety and efficacy of care.”

ICD-10 has almost 19 times as many procedure codes and nearly five times as many diagnosis codes as ICD-9. In addition, its classification codes contain five to seven alphanumeric categories as compared to ICD-9’s three to five numeric digits. All these changes needed to be incorporated in screen views, reports, and interface messages in each of the Health System’s 40 clinical and financial systems that were impacted by the conversion to ICD-10. To make things even more complicated, each system required specific changes.

While one vendor had the ability to run software programs to identify and convert codes, most systems required our IS analysts and vendors to manually make the changes. Changes ranged from simply clicking on a setting to manually updating 100 configuration settings or table rows.

The six-week integrated testing phase required many hours of effort and expertise from both IS and Operations. “Operational participation and collaboration was critical in identifying appropriate real-life clinical and billing workflows,” Trenton said.

While the primary goal of the project was to ensure all systems could accommodate ICD-10 codes after October 1, it was also a requirement for systems to identify and differentiate between ICD-9 vs. ICD-10 codes.

“Services provided prior to October 1st require an ICD-9 code; however it may be sent to another system for coding/billing after October 1st,” said Kevin Pollock, senior Software Development manager in IS. “This added another layer of complexity to testing the communication between 40 systems” The entire process took 18 months to complete. Because ICD codes are used throughout the organization, making the changes “was a joint effort. We had representation from every area,” Hanson said. “It was a big unknown — like Y2K — but we were very well prepared.”

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“Intrapreneurship”

Alive & Well

Making An IMPaCT

at

UPHS

IMPaCT (Individualized Management for Patient-Centered Targets) trains neighborhood residents as community health workers who then help patients set and reach health goals. The workers do everything from exercising with their clients at the local YMCA to helping coordinate doctor's appointments. IMPaCT has been adopted throughout the Health System as part of routine care for over 3,000 patients.

IMPaCT’s developer, Shreya Kangovi, MD, MS, assistant professor of General Internal Medicine, and Rosin, Damien Leri, and Kate Clayton of the Center designed a business plan that includes guidelines for hiring, training, and supporting the workers, a website, and a consultation service through which Kangovi’s team helps other organizations adapt the model. More than 400 institutions across the country — including Massachusetts General Hospital and the Pennsylvania Department of Health — have accessed IMPaCT’s online toolkit.

“There is a clear path for bringing new medications into focus,” Kangovi said. “But until I discovered the Center, I was not aware of anything comparable for converting approaches such as IMPaCT from an idea into action.”

TIPS-Connect

`` Roy Rosin (second from left) meets with members of a team that is reimagining the preoperative evaluation processes.

Innovation Accelerator Program Kick Starts Eight Projects

Penn Medicine’s Innovation Accelerator Program, now in its third year, announced funding for eight new projects aimed at improving health care delivery and patient outcomes The newly funded teams were selected from a record pool of more than 85 proposals: »» Automated lab monitoring for patients on

»» Reimagining preoperative evaluation high risk medications. processes to reduce cancellations and improve outcomes »» I ncreasing completion of and compliance »» Redesigning follow-up scheduling to with advance directives. reduce cancellations and improve patient »» Implementing a teleretinal imaging experience. program to increase screening of diabetic » » patients.

P EACE - optimizing care models for women with signs of miscarriage »» Increasing compliance with perioperative »» Managing superutilizers. instructions to decrease complications and improve outcomes.

Hypertension is the leading cause of readmissions for postpartum mothers in the first week after discharge. And up to a quarter of pregnancies are affected by symptoms of maternal depression, which can increase women’s risk behaviors during pregnancy, such as poor nutrition and substance and alcohol use, leading to premature birth, low birth weight, and development problems.

Staff at HUP’s Helen O. Dickens Center for Women's Health often had difficulty reaching patients on the phone to ensure timely screening. Noticing that patients were avid texters, they turned to the Center for Health Care Innovation staff to develop text-based interventions for both conditions.

The first, a mobile screening application for prenatal depression, uses text-based mood monitoring. Participants are asked questions that assess their frame of mind; caregivers are then alerted to potential red flags. Following several adaptations to the prototype, the rate of standardized screening for prenatal depression increased from virtually 0 to more than 85 percent of Dickens Center patients.

In the second initiative, patients were discharged with electronic blood pressure monitors and sent daily text reminders to check their pressure. Patients texted their readings in, which physicians reviewed and assessed. The percentage of patients reporting at least one blood pressure reading in the first week post-discharge increased from 15 percent pre-intervention to 84 percent post-intervention.

Designer Matt Van Der Tuyn, who helped devise and implement TIPS-Connect, enjoys working at the Center because it emphasizes partnering with users, rather than imposing solutions. “We learned a lot by listening to the Dickens Center staff and their patients.

While we offered some technical insights, ultimately TIPS-Connect is about meeting their needs. It’s been a privilege to be part of such a meaningful project.”

Learn more about the Center’s efforts at healthcareinnovation.upenn.edu and @PM Innovation on Twitter.

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AWARDS and ACCOLADES Hennessy and Jensen Elected to National Academy of Medicine Sean Hennessy, PharmD, PhD, of Biostatistics and Epidemiology, and Frances E. Jensen, MD, chair of Neurology and co-director of the Penn Medicine Translational Neuroscience Center, were elected members to the National Academy of Medicine (NAM), one of the nation's highest honors in biomedicine. The new NAM members bring Penn Medicine’s total membership in the prestigious group to 66.

Hennessy’s primary field of interest is pharmacoepidemiology, the study of the health effects of drugs and other medical products in populations. He is a past scientific chair and past president of the International Society for Pharmacoepidemiology and has served on the FDA’s Drug Safety and Risk Management. Hennessy has received several awards, including the 2007 Leon I. Goldberg Young Investigator Award from the American Society for Clinical Pharmacology and Therapeutics, and the 2013 Samuel Martin Health Evaluation Sciences Research Award from the Perelman School of Medicine.

Jensen’s research has focused on investigating mechanisms of epilepsy as well as their age-dependent differences, with special attention to the interactions between brain development, brain injury, epilepsy, and cognition. She received the NIH Director's Pioneer Award and the American Epilepsy Research Recognition Award. She serves on a number of patient and research advocacy boards and is a Fellow of the American College of Physicians, a member of the editorial board of Annals of Neurology, and a reviewing editor for the Journal of Neuroscience. Jensen is the author of more than 150 manuscripts and the author of the widely acclaimed book, The Teenage Brain.

Joseph Berger, MD, chief of Multiple Sclerosis in Neurology, received the Distinguished Neurology Teacher Award form the American Neurological Association for his outstanding accomplishments in teaching neurology to residents and medical students.

Paul Casale, MD, chief of Cardiology at LG Health, was appointed to a committee that will advise the U.S. Secretary of Health and Human Serivces on physician payment methods.

Baligh Yehia, MD, of Infectious Diseases, received the 2015-2016 Walter J. McDonald Award for Early Career Physicians, which recognizes outstanding achievement by a physican member under 40.

CEO’s corner

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Pennsylvania Hospital are earmarked for the Safe Sleep Sack program to reduce sudden infant death syndrome in Philadelphia. Once Safe Sleep Sack is fully funded at both hospitals, remaining funds will go to their respective pharmacy discharge-medication programs.

As I write, this year’s Penn’s Way is coming to a close.

If you haven’t done so, I urge you to participate in this worthwhile and important venture. Giving to Penn’s Way is easy, with your choice of an online donation or paper pledge form, which you can obtain from your Penn’s Way captain or coordinator or download from the Penn’s way website: http://www.upenn.edu/pennsway.

In addition to generously donating to Penn’s Way, Penn Medicine faculty, staff, and students volunteer in many community-based projects and programs. To help with these efforts, Penn Medicine CAREs provides grants to the programs to purchase supplies and other (non-salary) resources.

CAREs grants are distributed up to four times per year.

Since the program began in January 2012, $209,184 has been given to 174 projects. In all of these cases, members of the Penn Medicine community directly volunteer their services. Two newly funded examples are Woodland Writers and the Dina Project.

Aivi Nguyen, MD, from HUP’s Department of Pathology and Laboratory Medicine, brought Woodland Writers to our attention. Having attended and volunteered at Vietnamese Mennonite Church for many years, Dr. Nguyen and other youth group leaders saw a need for SAT prep and writing tutoring for the church’s young members. Thus Woodland Writers was formed. The project is beginning with 10 young people aged 13-16 from the church and surrounding disadvantaged area.

Funding is going toward workbooks and other resources for producing the educational sessions.

Jawanza Bundy, a certified registered nurse practitioner at Pennsylvania Hospital, works with the Dina Project, a mentoring program linking Penn nurses with students from Mathematics Civics and Science Charter School who are considering nursing careers. CAREs’ funding supports transportation, meals, and related expenses for students for overnight visits to area schools of nursing.

As health care providers, you recognize that service to those in need is among the highest of callings.

Intensifying those efforts by participating in Penn’s Way and volunteering in the community puts us in even closer touch with those we serve.

There is a wonderful Latin phrase: multum in parvo — much in little. No matter the size of your gift or the amount of time you can offer, your thoughtfulness will put a smile on someone’s face. This is the perfect time of the year to do so!

Systemnews Editorial Staff: Sally Sapega, MA Editor Trissy Laurito Graphic Design

Administration:

Record Turnout for the 5K for the IOA On September 20, a record 435 Penn faculty, staff and friends and families ran or walked to raise money and awareness for the work of the Institute on Aging. The 3.1-mile run started at Franklin Field and took participants through Penn Park. The Memory Mile Walk brought participants down Locust Walk and through the scenic Penn campus. This year, leashed dogs were permitted to tag along for the Memory Mile walk.

Over the past four years, the event has raised more than $170,000 in support of basic and clinical research into normal aging processes and age-related diseases. This includes disorders such as Alzheimer’s, Parkinson’s and neurodegenerative diseases, as well as osteoporosis and frailty, and more.

“It is truly a race against time in aging research,” said P.J. Brennan, MD, chief medical officer for Penn Medicine and IOA External Advisory Board member. “With the population aging, we need the research dollars so that we can increase the treatment options for the growing number of patients with Alzheimer’s and aging-related disorders.”

For more on this year’s 5K for the IOA & Memory Mile Walk, including photos and the full list of race results, visit: www.PennInstituteOnAging.wordpress.com.

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Susan E. Phillips Senior Vice President, Public Affairs Holly Auer Director of Communications

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3535 Market Street, Mezzanine Philadelphia, PA 19104 phone: 215.662.4488 fax: 215.349.8312 Please feel free to share your thoughts and ideas for improving System News! E-mail the editor at sally.sapega@uphs.upenn.edu.