Children’s Hospital of Philadelphia’s digital care transformation model is designed as
an enterprise strategic initiative — not simply an extension of ambulatory telehealth,
Jess Boyle, senior director of digital care transformation and digital health at the
health system, told Becker’s.
The model is built to follow patients across the continuum of care regardless of where they are on a given day.
CHOP currently organizes the strategy into four pillars: care at home, which includes
remote patient management and other home-based models; ambulatory digital care,
including video visits, e-consults, e-visits, virtual urgent care and virtual sick care;
virtual inpatient care, such as virtual nursing and consults; and affiliate network
digital services, which provide tele-diagnostics and remote specialist support to
partner hospitals.
“RPM for us today is much different than RPM in the adult space,” Mr. Boyle said.
“This is meant to transcend where children are in their care on any given day, as well
as try to then bring care where it previously hasn’t been.”
By the end of its current fiscal year, CHOP expects to have about 25 live remote
patient management use cases across the enterprise, reaching roughly 50,000
eligible patients annually.
Many of the programs fall under what the organization calls CATCH — Connected Applications to Transition to Care at Home — a post-discharge model designed to monitor high-risk pediatric patients after they leave the hospital.
“The idea is to catch these babies before they fall,” Mr. Boyle said.
In one program focused on infants with single-ventricle heart disease, remote monitoring has enabled clinicians to identify early signs of deterioration and intervene before patients require emergency care. Mr. Boyle said the program has identified early signs of critical illness and allowed clinicians to bring children back for urgent intervention.
Beyond post-discharge care, CHOP has expanded remote monitoring into pre and
postsurgical programs, chronic disease management and primary care.
For children with epilepsy on a ketogenic diet, for example, patients may remain enrolled in a monitoring program indefinitely. Mr. Boyle said once a child is enrolled, “it isn’t turned off” until the patient transitions to an adult provider.
In primary care, CHOP launched a Newborn Navigator program focused on
anticipatory guidance. Using historical data, the hospital delivers education to
families during a child’s first year of life. Mr. Boyle described the effort as designing something similar to “a digital manual for the first year of life,” anticipating common
questions before families seek help through messages or phone calls.
For CHOP, the digital model is as much about operational sustainability as it is about patient convenience.
“There are less physicians graduating from certain pediatric fellowships and they
need to fill the need of the medical complexity that we’re seeing,” Mr. Boyle said. “If
we can shift those clinicians to doing other things as opposed to low-level tasks,
that’s so much more substantial.”
Digital care allows clinicians to monitor larger patient panels while reserving inpatient and ambulatory capacity for the highest-acuity patients.
Measuring ROI beyond reimbursement
CHOP evaluates return on investment for remote patient management across four
primary areas: engagement, clinical outcomes, operational impact, and financial
value.
Clinically, the hospital measures avoided readmissions, prevented emergency department visits and early detection of deterioration. In high-risk cardiac populations, Mr. Boyle said the infant single-ventricle program is “up to nine or 10 lives saved.”
Operationally, the organization examines how digital workflows replace what Mr. Boyle described as “analog care models,” such as phone calls and manual follow-ups.
While reimbursement remains complex — particularly for stand-alone children’s hospitals that do not fall neatly into adult-designed payment models — Mr. Boyle said, “You have to have that holistic view of all this.”
“Where are the cost efficiencies, where are the labor efficiencies, where are the clinical efficiencies in all of this?” he said.
One of the biggest challenges in scaling pediatric remote monitoring is the limited availability of child-specific connected devices.
Mr. Boyle said some manufacturers have told CHOP, “You can’t use this in children who have abnormal cardiac or pulmonary physiology,” limiting device applicability in complex pediatric populations.
To address those gaps, CHOP has worked with EHR vendor Epic and collaborates with other leading children’s hospitals through a national pediatric digital health collaborative.
Beyond remote patient management, CHOP has also rapidly scaled virtual inpatient
nursing across its medical-surgical units. Mr. Boyle said the program has grown
“exponentially” over roughly 18 months.
The hospital has also launched and expanded virtual urgent care, which he said has
scaled “so significantly” with strong utilization.
As CHOP continues to expand digital care, Mr. Boyle emphasized its broader purpose.
“Digital care isn’t just about isolated reimbursement,” he said. “It’s about preserving
capacity, extending our expertise beyond our walls and making sure children receive
the right level of care at the right time.”
Editor’s note: This article was edited Feb. 23.
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