Since the winners in “Your Big Idea: Penn Medicine’s Innovation Tournament” were announced in May, they have been partnering with the Penn Medicine Center for Innovation on the implementation and design of solutions. Below, they describe the work they have been doing to implement their winning ideas.
Innovation tournaments often end with the selection of proposed solutions as winners. In our case, those proposals were “kiosks” and “web scheduling.” Both are logical and valid, but it’s been fascinating to see the people who proposed them evolve their insights to realize these solutions may not be the best way to attack the underlying problems.
In the case of kiosks, we saw a similar shift from the initial focus on a solution (implementing kiosks) to a more nuanced understanding of the problem around the check-in experience. Following observations at various practices and discussions with both patients and providers, we learned this was anything but a homogeneous problem, with the patient experience varying significantly across practices. The one fairly consistent issue entailed patients’ failure to secure an insurance referral before arrival, delaying check-in and having an impact on staff time. So the problem definition in this case has become a combination of minimizing the incidence of patients arriving without this referral and minimizing the impact on other patients when it does happen (where kiosks can potentially play a role).
With the help of Roy Rosin, we are being challenged to look at and think about innovation and the use of kiosks differently. Thus far, we participated in a demo of EPIC Welcome kiosk technology and received training to conduct field research. In teams of three, we visited several practices and observed workflows at PCAM and PPMC practices, and interviewed staff and patients. The field work was most enjoyable because we were able to hear the patients’ and staff’s concerns and ideas regarding the existing workflow and process. This data gathering allowed the team to focus on both the precise needs of the patients and the practice and on how kiosk technology and innovation would -- or would not --impact the daily concerns of the practices. Going in, we all had our biases as to how kiosks would make workflows better. Yet there are pieces of the current check-in process that are problematic and that would still require intervention in order for the kiosk transaction to run smoothly, such as securing referrals. By looking at the front desk issues on a larger scale, we are working towards a successful solution.
I am working on changing the way we prep ourselves for patients prior to the day of service. We will do a scrub list two days in advance to flag all patients with missing referrals to contact them in advance.
We have been going to individual clinical sites to interview patients about their frustrations and feedback on their appointments. With this information we are deciding on the best and most effective way to roll out the kiosk concept with the most useful features first and which sites would most benefit from the kiosk technology.
I truly believe in what this idea has evolved into. It’s way bigger than just implementing kiosks in outpatient practices.
The Penn Scheduler project has evolved over time to address the issue of access to primary care across the Health System. I was struck that this issue has resonated with every person we have worked with, whether it is General Medicine, Clinical Care Associates, CPUP, the Call Center, or Family Medicine. We have spent a lot of time understanding the issues through interviews, contextual observations of the patient experience, and data analysis. We are now in the phase of quickly testing a variety of prototypes that range from facilitating communication between different clinic schedulers, enhancing primary care appointments for employees, and offering a dedicated call number for specialty practices at UPHS. Our entire cross-functional team across Penn Medicine is excited to move from thinking to doing!
Continue to follow their progress on www.pennmedicine.org/YourBigIdea/Blog.