NYU Langone Health innovators bring the rigor of research to digital health

Digital health is a growing sector of the healthcare landscape. At its heart, digital health is a simple concept — using technology to improve the health and wellness of individuals and communities.

In practice, however, digital health represents everything from sending an email to your doctor to uploading your entire biometric identity to a central server — the quantifiable self at its most extreme. While popular, many of these technologies lack evidence for their use; as a result, it is often difficult to evaluate the quality of digital health tools, or realistically assess their role in patient care, clinical practice, or the larger healthcare ecosystem. This can leave providers feeling underprepared and overwhelmed by the digitization of their patients and their practices.

Fortunately, there is a growing movement at NYU Langone and beyond to bring academic rigor to the production, implementation, and evaluation of these technologies. NYU Langone’s Healthcare Innovation Bridging Research, Informatics, and Design (HiBRID) Lab studies how digital health innovations can be used to improve healthcare delivery and patient care. Supported by the NYU Langone Health information technology department and in collaboration with NYU Langone partners across the digital health ecosystem — including the NYU Langone Virtual Health team, the Digital DesignLab, and others — the HiBRID team works to create better digital products for the healthcare system.

Building Research Foundations to Explore Digital Frontiers

The HiBRID Lab works with clinical partners from a diversity of specialties, as well as across institutions, to study in the role of digital technologies in health maintenance and disease prevention.

Their most recent initiative focuses on the role of providers in improving adherence to digital therapeutics for diabetes prevention. Apps and other tools that focus on comprehensive chronic-disease management (like diabetes, high blood pressure, or heart failure) offer unique opportunities for providers to partner with patients to maximize education, build self-management skills, and provide emotional support. However, there is little research in how those partnerships develop, or what role the provider should play in their patients’ journey with digital health apps.

“Apps are a new frontier for prescriptions,” says Lab founder and director Dr. Devin Mann. “Patients are using these tools every day, and for a lot of people those tools work. Our job is to figure out how to apply and adapt these technologies into provider workflows, to enhance the patient-provider relationship and really leverage those gains.”

The NIH-funded study will take place over the next five years, and will recruit providers and practices from the breadth of the NYU primary care network. The results of the study may have implications across a range of digital therapeutics, and will provide insight for providers and healthcare systems on how best to integrate the exploding world of health apps into their digital portfolios.

Bringing Diverse Perspectives

Studying digital health technology requires more than a traditional approach to research. Just as the larger tech world has pulled from the realms of engineering, marketing, design, and even the fine arts, the study of the digital health space requires broad and diverse perspectives.

The HiBRID Lab pulls expertise from the fields of medicine and public health, but also behavioral economics, sociology, engineering, architecture, informatics and machine learning, and design and user experience to do just that. The team itself is composed of clinicians, social science researchers, designers, programmers, and informaticists. Each member provides insight from their field to help produce thoughtful, well-crafted digital products for use in research.

“So much of medicine is lacking in thoughtful approaches to design,” says Dr. Katharine Lawrence, a physician and post-doctoral fellow in the Lab. “So many times as a clinician you’re working with a tool and thinking ‘who designed this?’And that’s why, when you have an opportunity to build in digital technology, it’s so important to use the knowledge that people in the fields of, say, product design, have been collecting for decades.”

The Lab also works closely with other groups transforming the digital experience at NYU Langone, particularly in the realm of hospital operations. As senior director of informatics innovation, Dr. Mann has partnered with Nader Mherabi, CIO, and Dr. Paul Testa, CMIO, to foster a collaborative environment that bridges gaps between digital health research and operations. The team has also partnered with the digital team within the NYU Langone Health IT department, led by Michael Maineiro, and Dr. Helen Egger, co-director of WonderLab, to help incubate practical, real-world digital development ideas from the larger NYU Langone community.

Adapting Novel Approaches

In the spirit of innovation, the HiBRID Lab adapts tools from other industries to optimize both their research interventions and their organizational processes.

As part of product development for digital research tools, the team offers user testing experiences like focus groups, A/B testing, rapid cycling and others, to allow for lean and iterative technology development. The team also conducts comprehensive evaluations of its target populations, using tools like clinical shadowing, workflow analysis, and in-depth interviews with clinicians, nurses, and other end-users, to fully understand their experiences and interactions with digital technology. These types of approaches also apply internally — recently, several members of the Lab underwent Agile training, and the team is in the process of restructuring their projects to incorporate Scrum methodologies.

Ultimately, each of these tools and collaborations allow the HiBRID group to develop robust digital interventions for use in both research and operations. This helps facilitate the rigorous study of digital health interventions in patient care, clinical practice, and the larger healthcare environment at NYU Langone and beyond.

• Katharine Lawrence, MD, MPH, Post-Doctoral Fellow, HiBRID Lab

For more information on the HiBRID Lab: https://med.nyu.edu/departments-institutes/population-health/divisions-sections-centers/healthcare-delivery-science/healthcare-innovation-bridging-research-informatics-design-lab

For more information on the Digital DesignLab: https://med.nyu.edu/research/digital-designlab/