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 offers 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.
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 messages 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
Current Project Team:
- Anuja Dokras, MD, MHCI, PhD
- Rebecca Brodie, RN, BSN
- Benjamin Peipert, MD
- Zoe Sivak, JD, MPH
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
Current Project Team:
- Sarita Sonalkar, MD, MPH
- Jessica Wu, MD
- Faridat Folarin-Amode, MD
- Ryan Carr
- Zoe Sivak, MPH, JD
Preparing for Pregnancy (P4P) is randomized controlled trial comparing group pre-pregnancy care to usual care among patients seeking fertility care at Penn. The benefits of group prenatal care are well established, but this model of care has not yet been used in this patient population. The main focus of the group sessions is pre-pregnancy optimization of health conditions including high blood pressure, diabetes, and mental health disorders, as this is an important part of preparing for a healthy pregnancy and improving maternal and neonatal outcomes. The study is being conducted in collaboration with Pomelo Care, a virtual women’s health practice.
Funding: Independence Blue Cross
Project Team:
- Anuja Dokras, MD, MHCI, PhD
- Iris Lee, MD
- Caitlin Martinez, MBA-HCM
Ante-Partum
Conversational Artificial Intelligence to Improve Early Pregnancy Access (CIRCA): Pregnancy is a life changing diagnosis, frequently made at home. CIRCA helps pregnant individuals connect to care suited to their needs in a specialized clinical setting, reducing stress, confusion, and delays in accessing evidence-based management options for time-sensitive symptoms. Patients receive educational text messages, answers to their questions, and connection to clinical experts.
Funding: National Institutes of Health, NICHD
Current Project Team:
- Alice Abernathy, MD MSHP
- Courtney Schreiber MD MPH
- Arden McAllister MPH
- Cecelia Tannous-Taylor
- Elizabeth Critchlow, MD
- Laura King, MHA
NUVO Remote Fetal Monitoring is a private industry collaboration with Invu aimed at improving access and adherence with high risk fetal monitoring. High risk pregnancies require increased fetal surveillance in the third trimester, often via non-stress tests (NSTs) performed in a medical office, to reduce the risk of stillbirth. Public health emergencies, such as the current COVID-19 pandemic, highlight the already significant challenges that pregnant women, especially Black women, face in trying to adhere to these frequent visits. This project will optimize a workflow to extend the capabilities of an FDA-approved digital platform and wearable device, Invu, and demonstrate how it can enable women to perform their prescribed NSTs remotely, from the comfort of their own home, thus alleviating many of the burdens associated with fetal monitoring and improving access and adherence to care.
Funding: National Institutes of Health, Invu
Project Team:
- Nadav Schwartz, MD
- Rebecca Hamm, MD
- Megan McCabe
- Janelle Purnell
- Emily Seltzer, MPH
- Ruanna Small; Roy Rosin, MBA
Publications:
- Utilization of a wireless monitoring device to perform non-stress tests from home: the patient perspective
AJOG MFM | April 2024 - Utilization of a wireless monitoring device to perform nonstress tests in high-risk pregnancies from home
AJOG | October 2023 - Novel uterine contraction monitoring to enable remote, self-administered nonstress testing
AJOG | April 2022 - Experience with home-based, remote non-stress tests, including automatic decision support for interpretation of reactivity
AJOG | January 2022
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
Current Project Team:
- Kirstin E. Leitner, MD
- Alice Abernathy, MD
- Caitlyn Martinez, MBA-HCM
- Michael Josephs
- Abbie Lund, MA
- Katy Mahraj, MSI
Publications:
- Prenatal Education and Remote Blood Pressure Monitoring
NEJM Catalyst | February 2024
Tailored Interventions for Pregnant Patients Facing Social Determinants of Health (SDOH) pilot program is designed to enhance the efficiency of initial OB appointments, deliver targeted resources to patients, and improve overall patient satisfaction. This program utilizes systematic SDOH screening through PennChart, enabling patients who screen positively to receive support from a social worker and access necessary resources. By implementing this approach, RN care coordinators can focus on complex case management, patient education, and clinical care, while social workers can concentrate on addressing the most intricate patient needs and providing tailored resource assistance.
Funding: Optum Labs
Current Project Team:
- Elizabeth Clement, MD
- Abike James, MD, MPH
- Caitlin Martinez, MBA-HCM
Post-Partum
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
Current 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 an innovative care model developed at Penn Medicine, designed to enhance the quality, safety, experience, and cost of maternal care during the transition from hospital to home. Utilizing advanced connected health technology, Way to Health, a bi-directional text message platform, HSM sends automated reminders twice daily, prompting patients to monitor their blood pressure with a provided device. This approach eliminates the need for frequent office visits, aiming to improve maternal outcomes and the care experience for women managing pregnancy-related hypertension in the immediate postpartum period. HSM has become the standard of care at The Hospital of the University of Pennsylvania, Pennsylvania Hospital, Lancaster General Hospital, and Princeton Medical Center. We have extended our reach to include prestigious institutions such as Jefferson Einstein Philadelphia Hospital, Woman’s Hospital in Louisiana, and the University of South Florida, among others.
Funding:
- 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
Current 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
- Caitlin Martinez, MBA-HCM
Publications:
- Association of a Remote Blood Pressure Monitoring Program with Postpartum Adverse Outcomes
Obstetrics and Gynecology | June 2023 - Implementation of a text-based postpartum blood pressure monitoring program at three different academic sites
AJOG MFM | November 2021 - Successful implementation of text-based blood pressure monitoring for postpartum hypertension
Pregnancy Hypertension | October 2020 - 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 - Rapid-Cycle Innovation Testing of Text-Based Monitoring for Management of Postpartum Hypertension
MDEdge | February 2017
Gynecology
Abnormal Uterine Bleeding (AUB) Pathway - A Hybrid Technology-Enabled Model of Care Delivery represents an innovative approach to enhancing patient access and timeliness of care for individuals experiencing excessive bleeding. The primary goal of the AUB Pathway is to streamline the diagnostic and treatment process, aiming to achieve both within a single in-person visit with a qualified provider. By employing a refined decision tree and scheduling algorithm, the pathway facilitates telehealth options with advanced practice providers or physicians when appropriate. Each visit is structured around a standardized template that includes targeted laboratory tests, imaging evaluations, and counseling based on national care standards.
In addition, we have recently expanded our services to include patient education through a series of informative videos. These videos will address the anatomical and medical causes of AUB and will be designed using innovative techniques to maximize their effectiveness.
Funding: Optum Labs
Current 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
- Caitlin Martinez, MBA-HCM
Centralized Cervical Cancer Prevention Pathway at Penn (C3P3) utilizes a novel electronic health record automation tool to streamline the interpretation of pathology results for cervical cancer, aiming to save providers valuable time in managing patient care. By automating results analysis and routing, providers can quickly identify and follow up with patients who have abnormal Pap smear results. Additionally, we've hired an advanced practice provider dedicated to managing Pap results and colposcopies, ensuring timely interventions. This integrated approach enhances efficiency and supports our overarching goal of cervical cancer prevention through improved follow-up and patient management.
Funding:
- Department of Obstetrics and Gynecology
- Penn Center for Health Care Innovation Accelerator
Current Project Team:
- Danielle Burkland, MD
- Anuja Dokras, MD, MHCI, PhD
- Care Curley, DNP, CRNP
- Lisa Mills, MS
- Andrea Bizzaro, PMP, MPH
- Steve Honeywell Jr, MBA
- Martina Plag, MHCI
HPV Administration and Reconciliation Program (HARP) 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:
- Danielle Burkland, MD
- Anuja Dokras, MD, MHCI, PhD
- Cara Curley, DNP, CRNP
- Joanna Wishnoff, CRNP
- Zoe Sivak, JD, MPH
Intrauterine Device Guard for Reduced Expulsion and Displacement (IUD-GUARD) is a novel, biodegradable device aimed to improve immediate post-placental IUD performance during the postpartum period. In combination with a patient’s IUD of choice, this device seeks to temporarily secure the IUD to the uterine fundus immediately after delivery and minimize post-placental IUD complications such as IUD expulsion and displacement. This innovation has the potential to improve maternal health outcomes and contraceptive disparities, reduce healthcare costs, and foster uninterrupted postpartum bonding and healing.
Funding:
- Penn Health-Tech Accelerator Program
- Philadelphia Regional Integrated Medicine Alliance (PRIMA) grant
Current Project Team:
- Gabriel Arenas, MD
- Jessica Chen, MD
- Eileen Wang, 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
Current 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
- Independence Blue Cross
Current Project Team:
- Surbhi Agrawal, MD
- Lily Arya, MD, MS
- Nick Bailey
- Lisa Mills, MS
- Ngozi Ikpeama
Past projects
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
Educational Remote Interstitial Cystitis Aide (ERICA) 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
Pregnancy Early Access Center (PEACE) 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
Gyn-Onc Accelerator is a pilot program designed to improve new patient access and accelerate treatment by integrating an automated decision-tree algorithm, an Intake SmartForm, and the support of a nurse navigator. This initiative streamlines the submission of existing diagnostic tests and imaging before the initial patient appointment, allowing for scheduling based on the urgency and nature of the diagnosis. By optimizing these processes, the program ensures that patients with urgent diagnoses receive timely care, thereby enhancing overall efficiency. The nurse navigator plays a crucial role in facilitating smoother workflows and reducing the burden on other staff members.
Funding: Optum Labs
Project Team:
- Emily Ko, MD, MSCR
- Sarah Kim, MD, MSCE
- Robert L. Giuntoli II, MD
- Amy Lodise, NP
- Lisa Mills, MS
- Amber Bayliche, MHA
- Caitlin Martinez, MBA-HCM
- Melissa Koepke, BA
- Katie Boyk, BS, MHA
- Angela DiDato, BS
- Jessica Tindall, MBE, ASQ CSSYB
- Steve Honeywell, MBA
- Jenna Moyer, RN, MSN
- Meredith Brady, MBA
- Emily Gleason
- Sandra Mancao, RN