The Penn Center for Cancer Care Innovation, or PC3I, is a nexus of research and practice that creates, tests, and scales solutions to transform cancer care delivery. Established in 2018, PC3I uses pragmatic research methods to address operational problems in cancer care while generating evidence that can extend effective practices beyond Penn Medicine.

PC3I Director Katharine A. Rendle, PhD, MPH shared her experience leading innovation in care delivery with students in Leading Change in Health Care, an MHCI core course taught by Dr. Ezekiel J. Emanuel, in Spring 2026. Focusing on the center’s ITALCS initiative, she illustrated how leadership skills can complement and extend the reach of research-driven innovation. The session offered a window into how evidence, operations, and leadership intersect.

ITALCS stands for Integrating Telehealth to Advance Lung Cancer Screening. Rendle explains that screening in its current configuration often fails to translate into population-level benefit. Because multiple sequential steps are required, and because payor requirements can be complex, implementation is difficult to execute at scale. Standard practice can favor patients with greater resources and greater familiarity with the health system. As a result, screening remains underused and inequitable, despite existing guidelines.

The ITALCS project tests how outreach, behavioral supports, and care delivery models can be structured to make lung cancer screening more accessible. The initiative embeds a pragmatic clinical trial into routine care, meaning that patients can be identified, contacted, and supported through existing workflows rather than parallel research infrastructure. And it tests different configurations of support—what happens, for example, when patients receive low-touch outreach versus more comprehensive digital care coordination?

Rendle emphasized that ITALCS evaluates not only screening uptake, but whether patients receive adequate information and support to make informed decisions. And it examines which approaches are most effective in determining screening eligibility without adding unnecessary burden. From an innovation standpoint, this focus reframes success: how might health systems reliably support decision making while keeping their resource usage sustainable?

The study uses a SMART design—in this case, short for “sequential multiple assignment randomized trial.” In other words, patients start with low-intensity contact, such as outreach messages. Those who do not engage are then randomized to receive more intensive support. By stepping up help only when needed, this lets investigators learn which patients benefit from which level of assistance.

This is a practical choice. Rendle explained to students that innovation requires allocating limited resources, using data to determine when additional support improves care and when it adds cost without meaningful benefit.

ITALCS also integrates behavioral science. Rather than relying solely on education, the initiative incorporates strategies that reduce friction and simplify engagement. For example, it assesses whether telehealth can lower logistical barriers to shared decision making, which may benefit patients facing transportation or scheduling challenges. It also tests whether systems can simplify smoking history assessment, reducing it to a small number of key questions to lower the implementation burden.

For students, ITALCS illustrates how applied research can drive health care innovation. Rendle describes how the initiative has supported the development of shared decision-making infrastructure at Penn Medicine, including workflows compatible with clinical and billing requirements.

ITALCS also demonstrates the power of aligning experts and stakeholders to solve complex problems. It brings together behavioral scientists, clinicians, operations leaders, and data analysts to address a challenge no single group can solve alone.

PC3I’s work models how students can use leadership to improve outcomes and implement change using the skills introduced in Leading Change in Health Care: identifying exigent challenges, using data to target interventions, and aligning stakeholders around feasible solutions. Rendle’s presentation underscores that translating research into practice depends not only on strong evidence, but on the ability to design workflows and incentives that make change possible.

Learn more about how clinical and nonclinical health care leaders approach complex challenges—and explore more cases like ITALCS. Discover the Master of Health Care Innovation.