Digital Health Science Research
Digital health is a broad term that encompasses use of digital devices and platforms, including electronic health records, patient-provider portals, mobile health (mHealth) applications and wearable biosensors to improve the process and outcomes of healthcare delivery.
At the Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), we explore how digital devices are being employed to drive clinical decisions and offer value to healthcare organizations, their patients and their staff. Our multidisciplinary team develops and tests wearable biosensors, creates mHealth smartphone applications (apps) and employs social media analytics to engage patients and drive outcomes of care.
There has been a revolution in remote patient monitoring made possible by ubiquitous broadband networks and wide penetration of smartphones across socioeconomic strata. More than 80 percent of the U.S. population now owns a smartphone. Of this group, 91 percent keep their phone within three feet of their body every moment of the day — a striking statistic that has produced novel data-collection strategies.
The ubiquity of smartphones offers a digital portal for patients to collect data about their symptoms and quality of life, also called patient-reported outcomes (PROs). In addition, it is now possible to supplement PROs with patient-reported informatics (PRIs), such as data from wearable biosensors transmitted through smartphones. Advances in micro-computing have enabled development of wearable biosensors for everyday use to measure a wide range of physiologic parameters. Off-the-shelf devices, such as Fitbit and the Apple Watch, enable convenient acquisition of free-range activity data among large patient populations, including step counts, stairs climbed, caloric expenditures from exercise, heart rate and sleep parameters. Specialized, medical-grade sensors are increasingly FDA-approved and useful to monitor a wide range of physiologic data, such as glucose levels, brain function and medication adherence.
CS-CORE digital health scientists are studying whether remote monitoring of PROs and PRIs can build a more complete and accurate picture of disease progression outside the walls of a hospital, clinic or research center. We are evaluating whether remote digital monitoring can identify subtle but meaningful changes in clinical function that predict clinical outcomes across a range of conditions, including rheumatoid arthritis, heart failure, cancer and gastrointestinal problems.
CS-CORE is developing and testing smartphone apps for patients across a range of conditions. For example, the center developed My GI Health, the first app that can outperform doctors at obtaining a meaningful patient history. The center is also developing apps for urology, rheumatology and nutrition sciences.
Expert Panel Research
There is often uncertainty about how best to diagnose or manage various medical conditions. One accepted approach to guide clinicians through circumstances of uncertainty is to elicit opinions from experts in the field.
CS-CORE has extensive experience in convening and conducting expert panels across a range of medical conditions, including gastrointestinal bleeding, gastroesophageal reflux disease, inflammatory bowel disease, irritable bowel syndrome and chronic viral hepatitis. In addition, members of CS-CORE are regularly called upon to act as experts on such panels.
Patient-Reported Outcomes Research
Patient-reported outcomes (PROs) are measures that capture the patient experience of health and illness. CS-CORE has extensive experience developing PROs across many fields of medicine, and was tapped by the National Institutes of Health to develop the Patient Reported Outcomes Measurement Information System (PROMIS).
The center provides expertise in designing, validating and applying both generic and disease-targeted PROs.
Social Media in Healthcare
The use of social media and electronic portals have enabled our team to scan Internet and social media sites to understand the experiences of patients outside the walls of a clinic, office or hospital, and outside the context of traditional research studies. This process offers new insights and patient perspectives, not previously available through more traditional methods.
The center’s work has included accessing social media sources to measure the impact of opioid use on gastrointestinal side effects (namely constipation), and to determine the quality of life for patients with Crohn's Disease. Forbes magazine recently covered this social media research.
Other Research Services
- Conjoint analysis
- Cost-effectiveness analyses
- Cost-utility analyses
- Cost-benefit analyses
- Cost-minimization analyses
- Digital health science
- Budget impact models
- Patient-reported outcome (PRO) instrument creation and validation
- Provider surveys
- Patient surveys
- Health-related quality-of-life instrument development and validation
- Minimal clinically important difference estimations
- Utility elicitations
- Systematic reviews
- Process intervention randomized trials
- Multivariable regression analyses
- Survival analyses
- Expert panels
- Guideline development
- Sample size calculations
- Statistical analysis of clinical trial data
- Biostatistical consultation