How constraints and a sense of urgency can drive innovation
The development of the PennOpen Pass, a symptom tracking and exposure alert system, offers a lesson on how challenging factors can focus the mind, enabling the development of new tools that meet communities’ needs.
The COVID-19 pandemic has posed significant population health challenges for societies around the world. In our corner of the world, as a university and an academic medical center, this was the special challenge that the university leadership presented to us.
While our primary healthcare facilities have never stopped functioning, most university activities on campus have been suspended. Students were sent home, classes were held remotely, and many university departments and administrative jobs were moved to remote work.
Although we were initially asked to find a way to ensure the safe return of our students, the scope of the problem quickly expanded to include all members of our community, across all campus facilities. This expanded community included students, faculty, staff, outside contractors, patients, campus visitors and healthcare facilities.
As a team of Healthcare Information Services, we realized that we cannot solve this problem on our own. However, we knew that our ability to conceptualize and deliver effective digital technology solutions would be critical to successfully achieving the goal.
Since safety was an important need for our community during the pandemic, we studied a wide range of potential solutions.
We brainstormed different technical approaches to discover close personal connections and gather information to support contact tracing that we can build ourselves or partner with others to build. We met with other organizations around the world that were facing similar challenges, to learn about their approaches to this problem.
Because we considered technical feasibility, for example, automatically detecting close interpersonal communications via the Bluetooth signals of their smartphones or by triangulating data from wireless networks, we encountered limitations on our potential solutions imposed by the ‘population’ aspect of health – our community members and stakeholders Regulators.
The message we heard over and over again was: Reach out to everyone. Privacy is crucial.
The need to reach everyone in our community meant that our digital solutions could not be dependent on everyone possessing the latest technology. Some members of our community lack regular access to smartphones and computers, so we needed to design manual alternatives as part of the solution.
Privacy has often been the biggest factor in determining what we did and what we did not build. Solutions that collected location data or those documented human communications that were acceptable in some parts of the world have been identified as very intrusive for our staff and students.
To address these concerns, our Privacy and Law team has developed a “privacy statement” that explicitly states our goals, and what we will do – and will not do – with the data we have collected. This helped make our efforts transparent to our community, and provided a framework for approval of future technology changes and data uses.
These considerations prompted our efforts and focused on what needs to be built. We’ve developed PennOpen Pass, a daily symptom and exposure survey tool, delivered via SMS text messages and web form surveys, that advises on next steps for those who have symptoms of COVID-19 or have been exposed to it.
We also developed tools to help employees manage the extensive follow-up required for positive cases. Through real-time APIs, our tracking and management solutions work with our EHR and COVID-19 test results systems.
On a daily basis, we were able to understand how many people have symptoms of COVID-19, how many people have potential exposures, and how many staff and students have been required to quarantine to limit future exposure. These efforts helped us achieve our goal of keeping our community safe as they restarted their educational, research, and healthcare activities on campus.
As technologists, we often view solution limitations as barriers to success. But these limitations can be very beneficial to us, by providing the focus we need to focus more quickly on solutions that truly meet our community’s needs.
Glenn Falla is the Assistant Chief Information Officer at Penn Medicine.