Developing a Large-Scale Covid-19 Surveillance System to Reopen Campuses

To open campuses safely, the University of Pennsylvania (Penn) and its health system (UPHS), with six hospitals and hundreds of outpatient practices, needed to develop an early warning system to identify the infected and exposed among Penn and UPHS campus members — 70,000 faculty, staff, and students who were at risk of transmitting severe acute respiratory syndrome coronavirus 2, or Covid-19. This warning system would help to minimize future spread by preventing individuals with concerning symptoms or recent exposures from coming into contact with others and, when necessary, streamline access to testing, self-isolation guidance, contact tracing, and medical care. The authors describe the challenges in designing, implementing, and continuously improving PennOpen Pass and the Red Pass Management System, a part-digital, part-human screening system. The lessons learned while developing and implementing PennOpen Pass provide key insights for the future of innovations in health care as we move toward improving the health of communities long after the pandemic.