PHILADELPHIA – Forty-nine percent of hospice patients have a diagnosis of cancer, whereas only 11 percent have a primary diagnosis of heart failure. Despite the fact that heart failure affects nearly six million people in the U.S., these patients rarely receive hospice care compared to patients with other conditions.
Penn Medicine's Innovation Accelerator Program, now in its fifth year, has announced funding for four new projects aimed at addressing this and other disparities to improve health care delivery and patient outcomes. The program, operated by the Penn Medicine Center for Health Care Innovation, supports proposals from University of Pennsylvania Health System faculty and staff, based on their insights into opportunities to achieve high value care. This is the second year the Accelerator has been co-sponsored by UnitedHealthcare. A record 104 applications were received for this year's program.
"The Accelerator Program embodies the Penn Medicine culture of a continuously learning health system," said David A. Asch, MD, MBA, executive director of the Center for Health Care Innovation. "The emphasis is on turning insights into action by finding out what works in the winning projects, fine-tuning when necessary, and testing for effectiveness. We want every contact with every patient to be an opportunity to learn how to treat the next patient even better. At all times, we strive to ensure that the entrepreneurial frame-of-mind remains at the forefront."
The four newly funded projects are:
– Moving assessment of post-discharge needs to the home setting for older adult patients: Older, medically-stable hospitalized adults are usually discharged only after post-discharge care has been organized. But this often causes patients to remain in the hospital longer than medically necessary while waiting for services to be arranged. This delay can compromise patient safety (infection, falls) and overall health status (impaired cognition and function), leading to increased hospital cost (longer length of stay, cost of caring for adverse events, and readmissions). This project will test a transitional care model with strong prior evidence of improved outcomes that moves patients home sooner, with appropriate care and support for ensuring safety upon earlier discharge. Team lead: Rebecca Trotta, PhD, RN, director of Nursing Research and Science
– Reimagining primary care doctor 'visits' and payment models with telemedicine: Studies have shown that telemedicine video visits can increase care-provider capacity, improve patient satisfaction, and reduce costs. This project will test algorithms assessing appropriateness for remote care, tools and infrastructure required for efficient care and payment models promoting increased access. The goal is to determine how patient-evaluation and management services can best be completed through video visits – for the benefit of patients, clinicians and payers – while establishing a sustainable business model. Team lead: Janice Hillman, MD, adolescent and young adult medicine, Penn Medicine at Radnor
– Enhancing symptom management for heart failure patients on hospice: While as serious an illness as advanced cancer, cancer patients benefit from more fully developed hospice programs. Late-stage heart failure care is often suboptimal, with inadequate and untimely symptom management and fatigue and breathlessness resulting in preventable emergency department visits and hospital readmissions. This project will develop a novel hospice heart failure program to improve symptom management for patients, increase teamwork between hospice and cardiology personnel, and provide for timely referrals to hospice. Team lead: Esther Pak, MD, fellow in Cardiovascular Medicine
– Multidisciplinary cost-effective transitional care program for COPD patients: Chronic obstructive pulmonary disease is the third leading cause of death in the US. One of five patients admitted to the hospital with COPD is readmitted within 30 days, and up to half of these readmissions may be preventable. This project will develop a multi-team transitional care program for COPD patients that will include evidence-based interventions for high-risk hospitalized patients who are discharged to home. Team lead: Vivek Ahya, MD, vice chief, clinical affairs, Pulmonary, Allergy & Critical Care Division; associate professor of Medicine
Winning teams receive seed funding to develop and test new ideas using rapid experimentation methods, mentoring from advisors, support from partners across the institution aiming to enable new ideas and recognition from health system leaders at forums designed to celebrate and learn from early progress. The teams also have the opportunity to secure additional funding based on evidence and promise revealed by initial deployments of interventions.
"This year's winning proposals represent an impressive range of innovative thinking about practices and services that can be transformed to make a meaningful impact for patients. These projects offer real potential for improving patient health, enhancing care experiences, and advancing high value care delivery," said Roy Rosin, MBA, chief innovation officer at Penn Medicine. "We've seen over the past few years that the seed money, mentoring, and support from internal partners such as Penn Medicine's information services team result in faster experimentation, more efficient evolution of new ideas and higher impact implementation."
Including this year's projects, the Innovation Accelerator Program has provided more than $2.5 million in funding for inventive projects over the past five years and about twice that in staff support. Past winners range from PEACE, a novel care model allowing women with signs of miscarriage to avoid unnecessary ER visits to new strategies reducing readmissions and the total cost of care for a range of complex, vulnerable patient populations. Several past projects have achieved recognition as best practices beyond Penn, including a connected health care model reducing readmissions and morbidity for women at risk for preeclampsia and personalized, automated antibiograms for improved antibiotic stewardship.
Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $6.7 billion enterprise.
The Perelman School of Medicine has been ranked among the top five medical schools in the United States for the past 20 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $392 million awarded in the 2016 fiscal year.
The University of Pennsylvania Health System's patient care facilities include: The Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center — which are recognized as one of the nation's top "Honor Roll" hospitals by U.S. News & World Report — Chester County Hospital; Lancaster General Health; Penn Wissahickon Hospice; and Pennsylvania Hospital — the nation's first hospital, founded in 1751. Additional affiliated inpatient care facilities and services throughout the Philadelphia region include Good Shepherd Penn Partners, a partnership between Good Shepherd Rehabilitation Network and Penn Medicine.
Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2016, Penn Medicine provided $393 million to benefit our community.