The Women's Health Center for Clinical Innovation (WHCCI) supports projects across a woman's lifespan in gynecology and obstetrics that improve care delivery and efficiency and offer novel solutions and implementation strategies to solve complex healthcare challenges. Our projects span the innovation lifecycle, including early-stage pilots and small patient populations and late stage scaled interventions impacting patients across Penn Medicine and beyond.
Obstetrics
Pre-Conception
Fast Track to Fertility (FTF) reimagines the fertility intake process to enable patients to start personalized treatment sooner. When patients call for an appointment, they are connected with a nurse practitioner (NP) for an intake appointment to obtain information about the couple’s medical history, provide education, answer questions, and explain the infertility workup process. Patients receive prompts and reminders via text message to complete their time-sensitive and cycle-dependent process in the shortest possible time to begin fertility treatment sooner.
Funding: Center for Health Care Innovation Accelerator Award
Project Team: Anuja Dokras, MD, MHCI, PhD, Suneeta Senapati, MD, MSCE, Emily Seltzer, MPH, Christina Mancheno, MPH, Mike Serpa, MS, Lisa Mills, MS, Roy Rosin, MBA, Raina Merchant, MD, MSHP, FAHA, David Asche, MD, MBA, Nick Bailey, Rebecca Brodie, RN, BSN, Roohi Kahn, CRNP, MSN, Marissa Weiss, MD, MSCE
Publications:
Barriers to access: findings from an implementation study of an artificial intelligence-augmented 2-way chatbot for fertility care
Fertility & Sterility | January 2023
The Fast Track to Fertility Program: Rapid Cycle Innovation to Redesign Fertility Care
NEJM Catalyst | October 2022
Q&A: Telemedicine Program Halves Time to Fertility Treatment
Healio | October 2022
Pregnancy of Unknown Location (PUL) is a diagnosis closely associated with life-threatening tubal ectopic pregnancies, which require close clinical oversite to prevent rupture. The PUL program provides reminders and follow-up for patients diagnosed with PUL at HUP. Patients receive serial quantitative human chorionic gonadotropin (HCG) blood tests every two days, weekly ultrasounds, and check-ins in order to monitor the pregnancy and prevent this dangerous outcome using the Way-to-Health platform.
Funding: Richard and Carolyn Sloane OB/GYN Innovation Award, Center for Health Care Innovation Accelerator Award
Project Team: Sarita Sonalkar, MD, MPH, Anne Flynn, MD, Emma Gilmore, MD, Natasha Seth-McCoy, DNP, MSN, FNP, WHNP-BC, Michael Josephs, Sarah Gutman, MD, MSPH, Emily Seltzer, MPH
Ante-Partum
THEA is a text-based program for home blood pressure monitoring and antenatal education available to patients across the POGA and Dickens clinics at Penn Medicine. The program provides patients with reliable, physician validated prenatal and pregnancy information weekly throughout pregnancy and generates automated feedback on normal and abnormal blood pressures during the 2nd and 3rd trimesters.
Funding: The Richard and Carolyn Sloane OB/GYN Innovation Award, Penn Medicine Women’s Health Leadership Council
Project Team: Anna Graseck, MD, MSCI, Christopher Klock, MBA, Michael Josephs, Abbie Lund, MA, Katy Mahraj, MSI
Tailored Interventions to Support Pregnant Patients Facing Challenges due to Social Determinants of Health (SDOH) is an early-stage pilot program aimed at improving the efficiency of the new OB appointment and patient satisfaction. The goal of the program is to pair systematic SDOH screening using a web platform with self-scheduling resources specifically identified to be of need for the individual patient. This will allow RN care coordinators to focus on complex case coordination, education, and clinical care and allow social work to focus on the most complex patient needs.
Funding: Optum Labs
Project Team: Elizabeth Clement, MD, Anna Graseck, MD, MSCI, Abike James, MD, MPH, Christopher Klock, MBA, Lisa Mills, MS, Nick Bailey
Post-Partum
Better follow up of Impaired Glucose Tolerance (BRIDGE) is a text-enabled intervention to improve primary care follow-up and repeat HbA1C screening for patients diagnosed with elevated HbA1C during pregnancy. The goal of BRIDGE is to prevent the progression diabetes during the post-partum patients. Patients receive text-based reminders and education in the weeks following delivery to remind them of their post-partum follow up appointment and provide education on the importance of having the HbA1C drawn prior to their appointment.
Funding: The Richard and Carolyn Sloane OB/GYN Innovation Award
Project Team: Celeste Durnwald, MD, Natasha Kumar, MD, Michael Josephs, Joanne Bogdanovich, MSN, CRNP
Healing at Home's (H@H) mission is to support mothers and their babies through the transition from hospital to home in the immediate postpartum period. To better meet the needs of new parents and their babies, H@H redesigned the postpartum experience by expediting the discharge process and providing patient-centered support services through a texting platform called Penny. Penny uses augmented intelligence (AI) and a database of clinical content developed by Penn Obstetricians and Neonatologists to answer patient questions accurately and quickly.
Funding: Center for Health Care Innovation Accelerator Award, Johnson & Johnson Maternal Health Quick Fire Challenge, Penn Medicine Women’s Health Leadership Council, Independence Blue Cross Innovation Grant
Project Team: Kirstin Leitner, MD, Lori Christ, MD, Joana Parga-Belinkie, MD, Laura Scalise, MSN, RN, Jessica Gaulton, MD, MPH, Emily Seltzer, MPH, Davis Hermann, MD, Christina Mancheno, MPH, Ryan Schumacher, Lauren Hahn, MBA, Roy Rosin, MBA, Raina Merchant, MD, MSHP, FAHA
Publications:
Development of a Practical Training Method for a Healthcare Artificial Intelligence (AI) Chatbot
BMJ Innovations | December 2020
Healing at Home: Applying Innovation Principles to Redesign and Optimise Postpartum Care
BMJ Innovations | November 2021
Heart Safe Motherhood (HSM) is a novel approach to care delivery developed at Penn Medicine that leverages connected health technology to transform the quality, safety, experience, and cost of care during women’s transition from hospital admission after delivery to home. Powered by a bi-directional, text message-based platform called Way to Health, HSM involves sending automated twice daily reminders for patients to check their blood pressure using a hospital provided blood pressure monitor (instead of asking women to attend office visits). The goal of HSM is to drive better maternal outcomes and improve the care experience for women with pregnancy-related hypertension in the immediate postpartum period. HSM is the standard of care at The Hospital of the University of Pennsylvania, Pennsylvania Hospital, and Princeton Medical Center.
Funding: The U.S. Department of Health and Human Services on Women's Health, Center for Health Care Innovation Accelerator, Penn Presbyterian Harrison Fund Award, The Preeclampsia Foundation
Project Team: Sindhu Srinivas, MD, MSCE, Adi Hirshberg, MD, Katy Mahraj, MSI, Matt Van Der Tuyn, MA, Abbie Lund, MA, Emily Seltzer, MPH, Roy Rosin, MBA
Publications:
Rapid-Cycle Innovation Testing of Text-Based Monitoring for Management of Postpartum Hypertension, MDEdge | February 2017
Text Message Remote Monitoring Reduced Racial Disparities in Postpartum Blood Pressure Ascertainment
AJOG | May 2019
Heart Safe Motherhood: Applying Innovation Methodology for Improved Maternal Outcomes
NJEM Catalyst | May 2019
PEACE: Pregnancy Early Access Center provides access to comprehensive and compassionate care for individuals and families seeking family planning care and management of pregnancy complications. PEACE has special expertise in contraceptive care, abortion care and pregnancy loss care, and offers compassionate, expert support for women experiencing miscarriage, stillbirth or pregnancy complications. The program is offered at the Hospital of the University of Pennsylvania, Penn Medicine Washington Square, and Penn Medicine Cherry Hill.
Funding: Independence Blue Cross
Project team: Courtney Schreiber, MD, MPH, Jen Moore-Conrow, MFS, Katy Mahraj, MIS
Gynecology
Abnormal Uterine Bleeding (AUB) Pathway - A Hybrid Technology-Enabled Model of Care Delivery is a novel approach to achieving great patient access and timeliness of care for patients who call our practices with excessive bleeding. The goal of the AUB pathway is to reduce the time to diagnosis and initiate treatment within a single in-person visit with an appropriate provider. Using a refined decision tree and branching algorithm, the call center will identify the suitable AUB pathway for each patient, which will begin with a telehealth visit with an APP to assess bleeding partners, complete intake of medical history, and enable the ordering of diagnostic testing prior to an in-person appointment with a physician.
Funding: Optum Labs
Project Team: Florencia Polite, MD, Anuja Dokras, MD, MHCI, PhD, Kirsten Leitner, MD, Anna Graseck, MD, MSCI, Abike James, MD, MPH, Lisa Mills, MS, Christopher Klock, MBA, Nick Bailey
ERICA: Educational, remote Interstitial Cystitis Aide is a patient-centered, smartphone-based education program for the self-management of interstitial cystitis/bladder pain syndrome (IC/BPS). ERICA leverages a texting platform to deliver six-week educational video modules to enable patients newly diagnosed with IC/BPS to proactively manage their bladder pain. Educational modules are self-selected by patients and include mindfulness, physical therapy, and cognitive behavioral therapy.
Funding: The American Urogynecology Association
Project Team: Edward Kim, MD, Lily Arya, MD, MS, Emily Seltzer, MPH
Publications:
Development of a Conceptual Framework and Digital Platform for the Self-Management of Interstitial Cystitis: ERICA (Remote Engagement with Interstitial Cystitis Aide)
International Continence Society | September 2022
Development of a Patient-Centered Text-Messaged Based Platform for the Self-Management of Interstitial Cystitis/Bladder Pain Syndrome Symptoms
Journal of Neurourology and Urodynamics | December 2022
Gyn-Onc Accelerator is a pilot program that aims to improve new patient access and reduce time to treatment by using advanced branching logic and an automated texting platform to aid patients in providing existing diagnostic testing and imaging of their cancer in advance of their new patient appointment.
Funding: Optum Labs
Project Team: Emily Ko, MD, MSCR, Robert Giuntoli, MD, Lisa Mills, MS, Jenna Moyer, RN, MSN, Meredith Brady, MBA, Siri Oliver, CRNP, DNP, Emily Gleason
HPV Vaccination is a quality improvement and innovation project aimed at improving the rates of HPV vaccinations among patients across Penn Medicine’s gynecology practices. Despite the demonstrated efficacy of the prophylactic HPV vaccines, vaccine uptake has been suboptimal with a recent survey demonstrating that only 48.6% of US adolescents were up-to-date with the vaccine. Previous investigations at Penn Medicine demonstrated three main barriers to uptake; access, deficit of provider and patient level education and provider burden for accurately identifying patients who need vaccination and adequate counseling. The HPV Vaccination project utilizes a Best Practice Advisory within the health record and ongoing data analysis on uptake to continuously improve rates of vaccination.
Project Team: Lori Cory, MD, MSCE, Danielle Burkland, MD, Anuja Dokras, MD, MHCI, PhD, Cara Curley, DNP, CRNP, Lisa Mills, MS, Nick Bailey, Elizabeth Clement, MD
Together Care is a personalized patient pathway that integrates a bi-directional texting program and home health care services for patients undergoing surgery, as well as chemotherapy. The goal of this high-touch, patient-centered program is to prevent unnecessary emergency department utilization and readmissions. Together Care provides text message-based peri-operative education, chemotherapy and postoperative symptom management recommendations, and streamlined triage support for patients using the Way-to-Health platform.
Funding: Center for Health Care Innovation Award
Project Team: Nawar Latif, MD, MPH, Leslie Andriani, MD, Ashley Haggerty, MD, Siri Oliver, CRNP, DNP, Emily Seltzer, MPH, Lisa Mills, MS, January Chaffee-Pasquantonio, CRNP, Wendy Watson, BSN, RN, PernaLyn McAlexander, RN, Danielle Flynn, RN, MSN, Nicole Y. Brown, LPN, Mary D’Agostino Kelly, MD, MPH, David Asch, MD, MBA, Nick Bailey, Alexandra Caulfield, MS, PA-C, Marsha Fitzgerald, BSN, RN, Ashna Agarwal
Publications:
TOGETHER Care: PatienT-tailOred GynEcologic Oncology posT discHargE caRe
Gynecologic Oncology | August 2022
UroTrust is a patient-centered texting program that guides patients towards self-management of recurrent urinary tract infections (UTI). UroTrust gives patients immediate access to evidence-based 'next steps' when they are experiencing symptoms of UTI. UroTrust also provides patient-friendly, brief educational videos about recurrent UTIs and how to prevent them. The goal is to empower patients to manage their recurrent UTIs safely, efficiently, and reliably at home.
Funding: Women's Health Center for Clinical Innovation Award
Project Team: Surbhi Agrawal, MD, Lily Arya, MD, MS, Nick Bailey, Lisa Mills, MS, Ngozi Ikpeama