How constraints and urgency promote innovation

The development of PennOpen Pass (symptom tracker and exposure alert system) provides courses on how to focus on challenging factors so that new tools can be developed to meet the needs of the community.

The COVID-19 pandemic has brought major population health challenges to communities around the world. In our corner of the world, as a university and academic medical center, this is a special challenge that university leadership poses to us.

Although our basic health care facilities have never ceased operations, most campus university activities have been suspended. Students are sent home to take classes remotely, and many university departments and administrative functions have also been converted to remote work.

Although at first we were asked to find a way to ensure the safe return of students, the scope of the problem quickly expanded to include all community members in all campus facilities. This expanded community includes students, faculty, staff, external contractors, patients, and visitors to our university campus and medical institutions.

As a health care information service team, we realize that we cannot solve this problem alone. However, we do know that our ability to conceive and provide effective digital technology solutions is critical to the successful realization of this goal.

Since safety is an important need for our community during a pandemic, we considered a wide range of potential solutions.

We brainstormed and explored various technical methods to detect close interpersonal relationships and collect information to support contact tracking that we can establish by ourselves or in collaboration with others. We met with other organizations around the world facing similar challenges to understand their solutions to the problem.

Since we have considered technical feasibility (for example, automatic detection of close connections between people through the Bluetooth signal of a smartphone or triangulation of data from wireless networks), the solution we face is affected by the “population” aspect of the population The limits of health – our community members and organizational stakeholders.

The message we hear over and over is: reach out to everyone. Privacy comes first.

The need to reach everyone in our community means that our digital solutions cannot rely on everyone with the latest technology. Some members of our community do not have regular access to smartphones and computers, so we need to design manual alternatives as part of the solution.

Privacy is usually the biggest factor in determining what we do or don’t do. Solutions that collect location data or record acceptable human contact in certain parts of the world are considered too intrusive for our employees and students.

In order to resolve these issues, our privacy and legal team has developed a “Privacy Statement” which clearly states our goals and the actions we will take and the actions we will not take. This helps to make our work transparent to our community and provides a framework for approving future technical changes and data usage.

These considerations drive us to focus on what to build. We have developed PennOpen Pass, a daily symptom and exposure survey tool, provided through SMS text messages and web form surveys, which can provide next-step advice for people experiencing COVID-19 symptoms or exposure experience.

We have also developed tools to help employees manage the in-depth follow-up required for positive cases. Through real-time API, our tracking and management solution can interoperate with our EHR and COVID-19 test results system.

Every day, we are able to understand how many people are experiencing COVID-19 symptoms, how many people may be contact-related, and are required to be isolated to limit the number of faculty and staff who will be contacted in the future. These efforts have helped us achieve our goal of ensuring the safety of the community while restoring education, research, and healthcare activities on campus.

As technicians, we often view the limitations of the solution as an obstacle to success. However, by providing the focus we need, and focusing more quickly on solutions that truly meet the needs of our community, these limitations are very helpful to us.

Glenn Fala is the Deputy Chief Information Officer of Penn Medicine.