The 2024 Nudges in Health Care Symposium will take place September 26–27 in Philadelphia. Learn more and register

Covid SAFE

Covid SAFE

A saliva-based screening program for COVID-19 detection

Project status



Jon Epstein, MD

Arupa Ganguly, PhD

Frederic Bushman, PhD

Ned Haubein, PhD

Andrew Parambath, BA, MEd

Rapid Assay Task Force

Innovation leads


Perelman School of Medicine, University of Pennsylvania


Before the release of COVID-19 vaccines, the University of Pennsylvania and Penn Medicine recognized the need to implement a surveillance testing program for faculty, staff, and students returning to campus. 

A successful program would rapidly identify cases and manage spread without requiring significant staff time.


In partnership with colleagues from both institutions, we developed and implemented a bi-weekly asymptomatic screening program called Covid SAFE (Screening Assessment for Exposure) in the fall of 2020. 

The program used a saliva-based test developed by Penn Medicine scientists that produced results rapidly and utilized internally developed reagents to avoid potential supply chain shortages. 

Employees and students were enrolled in the program remotely via Way to Health, and two-way texting was leveraged to conduct daily symptom tracking and securely distribute test results. If a participant screened positive for COVID-19, they were automatically referred to a centralized call center to schedule a confirmatory test and receive guidance about how to quarantine and when they would be eligible to return to work. 

During the rollout, we leveraged insights from behavioral economics to test different recruitment strategies and ways to improve program effectiveness and scalability.  


By January 2021, approximately 4,000 faculty, staff, and students had enrolled in Covid SAFE, and over 24,000 tests had been conducted. 

The program provided confidence that mitigation measures were working, enabling community members to feel safe on campus. Participants in the program reported high satisfaction, with more than 90 percent stating that the saliva test was easy, not painful, and felt safe to complete. And retention rates were impressive, with fewer than 50 people unenrolling from the program during its tenure.  

Insights gathered during the design and implementation of this program – such as the fact that opt-out framed recruitment messaging increased enrollment into the program and the overall test completion rate – can inform future health promotion efforts needed to address pandemics.

Due to an increase in the vaccinated population and a decline in COVID-19 cases in Philadelphia, the Covid SAFE surveillance testing program was retired in June 2021.

Way to Health Specs

Learn more about the platform
Activity monitoring
Arms and randomization
Criteria-based rules
Dashboard view
Device integration
EHR integration
Multiple languages
Patient portal messaging
Patient-reported outcomes capture
Photo messaging
Remote patient monitoring
Schedule-based rules
Survey administration
Two-way texting
Vitals monitoring