Penn Health professionals pitch med-free treatment tweaks

Aromatherapy and guided-imagery therapy are useful tools in reducing patient anxiety and pain, says Susan Kristiniak, associate director of palliative care at the University of Pennsylvania Health System, who has been testing the Experience Delight care package.

High-tech, minute-by-minute tracking and care management clearly can improve patients’ medical treatment and recovery, project presenters testified this week at the University of Pennsylvania Health System’s annual Innovator Accelerator Pitch Day.

Better crunching of big data and small weans patients off feeding tubes and out of intensive-care units more quickly, and makes sure they’re getting enough nourishment. Smarter apps connect them when needed with the most appropriate doctors and test trials, and look for signs of excess consumption of meds. Sharper tracking tools also send patients home sooner, significantly lower readmissions rates, cut whopping bills, and save lives.

But sometimes, it’s the little things in life – zero or low-cost alternative solutions that work with mind-set therapy — that also spark salutary effects, suggested two of the presenting teams pitching before fellow professionals and project co-sponsors from United Healthcare.  

Nine HUP teams offered progress reports on transforming patient care, and there’s a good chance all will receive additional funding beyond the seed money rewarded in November, said Roy Rosin, chief innovation officer for the University of Pennsylvania Health System. The nine trials were authorized from a field of proposals 10 times as large.

A refined data-crunching platform that minutely tracks and makes decisions about patients in intensive care has already shown salutary effects after a six-month trial, said Barry Fuchs, medical director of ICU and respiratory-care services. Better monitoring is taking patients off ventilators and sedation a day sooner than before, on average,  and shortening their hospital stays by 1.4 days, he noted, potentially saving the ICU $3 million on an annualized basis.

“It’s a national problem," Fuchs said. "The 5 percent of patients in ICU are responsible for 20 percent of total hospital costs.”

Sharper remote supervision of patients who go home on IV antibiotics or who have cirrhotic liver conditions and liver transplants also has produced happier results in pilot studies. Team leaders talked of automated lab-test reporting and of cheery “chatbot” (robotic call) services that help patients connect with the right subspecialty consultants daily to describe how they’re feeling.

“We found patients are actually more comfortable communicating information — like their daily weight and issues of mental confusion — on their smartphone than on a dedicated tablet, “ said Vandana Khungar, lead physician on the Live Better Care Team.

Team leader Susan Kristiniak, the health system's associate director of palliative care, spoke positively of using aromatherapy and guided-imagery meditation to help patients suffering from postpartum blues, or from the rigors of chemotherapy or the reality that they are beyond surgical solutions. Promoted positively as “Experience Delight,” patients are presented small, attractive wooden boxes packed with long-lasting “pure essential oil” inhalers and hand lotions (with scents of lavender, orange, and ginger) that have properties said to reduce anxiety, pain, nausea, and inflammation, to alternately help in sleep or increase energy levels.

Akin to an amenity pack that first-class passengers get on long-distance flights, there’s even a pair of earphones included. But here, the earbuds are to connect wearers to guided-imagery meditation from healthjourneys.com “for a tranquil mind-body connection,” said Kristiniak. Given away free, the packs “bring both smiles and tears of joy” from patients and their families,  “who likewise benefit from the therapeutics.”

Penn-Presbyterian nurse managers Jennifer Nelson and Staci Pietrafesa talked about the success of “gamification” in rousing patients out of their beds and onto their feet after the “rest and recuperation” phase of post-op hospitalization, whether it's for  lower-extremity joint replacement or open-heart surgery.  To nudge them to walk the halls longer, the nurses’ mobility project offers patients a challenge: Find and retrieve bird and animal stickers — such as turtle doves, penguins, lions and giraffes — hidden in clear sight at spots along the patients'  path.

“Instead of the average 120 footsteps, our ‘Get Up and Go’ game inspires them to walk 170 per outing, and an average of 350 extra steps a day,” said Pietrafesa.  “Our open-heart-surgery patients are getting their discharge papers 33 percent faster than before.”