Switchboard

A connected health solution for navigating outpatient and inpatient patient encounters

Opportunity

When the COVID-19 pandemic hit, in-person visits were converted to virtual visits to reduce exposure risk for patients, providers, and families. The capacity of Penn Medicine's legacy video platform was quickly exceeded due to the increased demand, creating a need for a new enterprise solution.

During initial interviews, providers and other care team members described the manual and inefficient nature of conducting virtual visits and identified specific pain points such as fear that more than one patient could join a virtual “exam room” at a time and the high-occurrence of errors associated with meeting links.

As part of Penn Medicine’s rapid response to COVID-19, a multidisciplinary team explored solutions to these problems.

Intervention

A working prototype was created within days that leveraged existing custom data feeds from the electronic health record (EHR) and new vendor meeting software. Over the next few months, we released weekly iterations to continue to improve upon the solution.  

Switchboard, the final product, is a full-service digital platform that makes it easy for providers and patients to participate in secure virtual visits. The platform is desktop and mobile-friendly and negates the need for users to sign-in or download an app to ensure accessibility.

For patients, Switchboard automatically generates and sends unique visit links, appointment reminders through the Penn Medicine Visit Guide, and setup instructions, thereby removing the coordination burden from practice staff.  

For providers, Switchboard creates a dashboard view of daily appointments with encounter-specific links.  The platform integrates with Haiku, Canto, and Doximity Dialer. It also features live status indicators that show when patients have joined a virtual exam room and enables easy transitions between desktop and mobile devices using QR codes.

Finally, Switchboard streamlines communication for all parties with bi-directional texting functionality and embedded language translation.

Impact

Switchboard is currently in use at the Hospital of the University of Pennsylvania, Penn Presbyterian Medical Center, Pennsylvania Hospital, Radnor, Chester County, and Princeton locations. At its peak, it supported approximately 29,000 virtual appointments a week and more than 7,000 unique provider and staff users.  

Providers, staff, and patients report high satisfaction with the new platform.  

Most importantly, Switchboard enables patients to receive high-value virtual care from the comfort and safety of their own homes amid the COVID-19 pandemic.

Phase 3: How we work
Collaborators

Liz Deleener, MBA, BSN, RN
Bill Hanson, MD
Philynn Hepschmidt, MS.Ed
Neha Patel, MD, MS
Jake Moore, MBA
Timothy Jones
Greg Fil
Glenn Fala
Rich Urbani
Erik Lang, MS

Innovation leads

Srinath Adusumalli, MD, MSHP
Damien Leri, MS.Ed, MPH
Eugene Gitelman, MD
Katherine Choi, MD
Lauren Hahn, MBA
Christina O'Malley, MHA
Mohan Balachandran, MA, MS
Christianne Sevinc, MPH
Michael Kopinsky, BSE
Catherine Reale
David Asch, MD, MBA

Platforms

Innovation Methods

A day in the life

One of the best ways to learn more about a problem area is to experience it yourself. Immerse yourself in the physical environment of your user.

Do the things they are required to do to gain a firsthand experience of the challenges they face. Completing a day in the life exercise will enable you to uncover actionable insights and build empathy for the people you're hoping to help.

A day in the life
We immersed ourselves in the patient and clinician experience. We conducted virtual visits on Switchboard, attended visits as patients, and helped family members attend their appointments.
The concierge
A concierge provides hands-on, efficient, and proactive services for customers.
 
Similar to the concept of walking in someone's shoes, a concierge walks alongside someone and helps them get things done.
 
Acting as a concierge or high-touch helper for a small sample of people will enable you to get deep into the reality of their journey and learn about the barriers they face, because like a real concierge, you'll help them navigate those barriers. You can also test solutions in real time as you explore the problem space in context.
The concierge

We supported more than 300 patients to prepare for virtual visits over the phone. Observing where patients got stuck in the process helped us determine where enhancements needed to be made.

For example, in early pilots, we found that downloading an app to join visits caused frustration. This led us to develop a chatbot powered by Way to Health that, if triggered, got over 95 percent of patients to a successful set up on their own. Ultimately, we were able to launch an app-less meeting join feature, negating the chatbot's need, but it was key to early adoption rates.