Liz Deleener, MBA, RN
Christina O’Malley, MHA
Charles Bae, MD, MHCI
Neha Patel, MD, MS
Kert Emperado, RN
Christopher Erickson, MSW
C. William Hanson, MD
Andrew Ahn, MD
Glenn Fala, MS
Michael Lurakis, MBA
Jake Moore, MBA
The COVID-19 pandemic required health systems to scale telemedicine rapidly to ensure patient access while reducing infection risk. Unfortunately, the capacity of Penn Medicine's legacy video platform was quickly exceeded due to the increased demand, creating a need for a new enterprise solution.
During initial interviews, providers and other care team members described the manual and inefficient nature of conducting virtual visits and identified specific pain points, such as fear that more than one patient could join a virtual "exam room" at a time and the high occurrence of errors associated with meeting links.
As part of Penn Medicine's rapid response to COVID-19, we collaborated with colleagues from across the health system to explore solutions to these problems.
Switchboard is a feature-rich, user-friendly, sustainable, and adaptable platform that makes it easy for providers and patients to participate in secure virtual visits. It leverages a commercial, cloud-based video meeting platform and facilitates an end-to-end virtual care encounter workflow.
The desktop- and mobile-friendly platform integrates with Haiku, Canto, Doximity Dialer, and interpreter services for over 50 languages. To ensure accessibility, patients do not need to sign in or download an app to use the service.
Switchboard automatically generates and sends patients unique visit links, appointment reminders, and setup instructions to reduce the administrative burden on clinical staff. Providers and staff can access dashboard views of daily appointments with encounter-specific links and live status indicators show when patients have joined a virtual exam room. QR codes are also available to ensure an easy transition between desktop and mobile devices.
Switchboard enabled patients to receive high-value virtual care from the comfort and safety of their homes amid the COVID-19 pandemic. The platform supported approximately 30,000 virtual appointments a week at its peak.
Within weeks of launching, Switchboard converted an average of 75 percent of telehealth phone encounters to video visits and eliminated incidences of multiple patients inadvertently joining the same session.
Switchboard remains an integral part of our operations today, with an average of 30,000 telehealth visits happening each month. Providers, staff, and patients all report high satisfaction with the platform, and the team continues to iterate on and add features as opportunities arise.
Switchboard technology has also been leveraged to launch new homegrown solutions. Examples include 1) Switchboard Campaigns, which deliver appointment reminders, communicate logistical changes, and encourage adherence to pre-procedural instructions to improve care coordination and operational workflow, and 2) PMX Feedback, which optimizes patient surveying to enable real-time service recovery.
A day in the life
A day in the life
We immersed ourselves in the patient and clinician experience. We conducted virtual visits on Switchboard, attended visits as patients, and helped family members attend their appointments. This allowed us to gain deep insight into the user experience.
A day in the life
One of the best ways to learn more about a problem area is to experience it yourself. Immerse yourself in the physical environment of your user.
Do the things they are required to do to gain a firsthand experience of the challenges they face. Completing a day in the life exercise will enable you to uncover actionable insights and build empathy for the people you're hoping to help.
During early concierge pilots, patients told us they were frustrated that they had to download an app to participate in virtual visits. We leveraged deletion to brainstorm how the process might work if downloading an app was impossible.
In partnership with BlueJeans, we launched an app-less meeting join feature that negated the need for patients to download the native app. Eliminating that step enabled a more seamless process for patients and reduced dropoffs.
We supported more than 300 patients to prepare for virtual visits over the phone. Acting as a concierge for users enabled us to learn where patients were getting stuck and determine where enhancements needed to be made.
For example, in early pilots, we found that downloading an app to join visits was a significant barrier for patients. This led us to develop a chatbot powered by Way to Health that, if triggered, got over 95 percent of patients to a successful setup on their own.
Down the line, we were able to launch an app-less meeting join feature, negating the need for the chatbot, but it was crucial for early adoption rates.