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Video:
In this episode of the SeamlessMD Podcast, Dr. Joshua Liu, Co-founder & CEO at SeamlessMD, and marketing colleague, Alan Sardana, discuss conducting research on Digital Patient Engagement – the challenges and how to design a good study for Digital Patient Engagement. See the full show notes below for details.
Guest(s): Dr. Joshua Liu (@joshuapliu), Co-founder & CEO at SeamlessMD
Episode 11 – Show notes:
[00:41] How Dr. Liu came to appreciate the marriage of the clinical world and technology vendor world; how he learned the importance of proper research to evaluate new interventions and why patient safety comes first for any new solutions;
[02:04] How Healthcare has a higher bar for safety than other industries (rightfully so);
[03:06] How researchers today often use the same approach for designing studies for software interventions (e.g. mobile applications) as they do for drugs and medical devices - and how this approach does not properly recognize software iteration methodology;
[04:36] Why Dr. Liu believes it is important for studies on software interventions to be designed to account for rapid software iteration;
[06:16] How research on software requires the software version to be "frozen" to eliminate confounders, and how that approach leads to mixed study results;
[07:13] How Dr. Liu recommends designing research for software - starting as a Quality Improvement initiative following a PDSA (Plan, Do, Study, Act) process to refine the implementation, features, content, algorithms, etc. until you reach a steady-state, before freezing the version to evaluate the solution formally;
[09:01] How studying an unpolished version of the software inhibits progress in the industry by resulting in the literature showing a wide-variation in efficacy without recognizing its potential;
[10:11] Why software efficacy depends on execution and how the "devil is in the details" with many papers on the same ”intervention” showing variation in efficacy today (for example, mixed results on the implementation of mobile health or telehealth solutions that are described the same on paper);
[10:31] Why software is not a magic pill and how research on SeamlessMD and other software shows varying levels of success due to different workflows, quality of implementation processes and staff engagement;
[11:21] Plug to SeamlessMD Podcast Episode 9 on Best Practices For Implementing Digital Patient Engagement (LINK);
[12:06] How research studies on software oversimplifies the intervention because no two software and implementations are the same and how even though results in research mentioning the same product 5 years apart can have very different results;
[13:36] How lag-time between data collection and research publication presents a challenge for software due to the nature of its iterative process;
[14:36] How SeamlessMD's product has changed entirely since its first versions, for e.g. how V1 was only on smartphones and tablet, not the web and how the workflows, algorithms and even playbooks for implementation and scripts for patient activation has changed overtime;
[16:23] How outcomes variation in Enhanced Recovery After Surgery (ERAS) research also stems from variation in execution and provider compliance;
[18:01] How the iterative process for software and digital patient engagement relies on large sets of data and how a research-first focus sometimes has small sample sizes that are not meaningful for software iteration;
[20:51] How digital patient engagement is often a relatively safer intervention than many others in healthcare;
[22:33] How there is a competing interest between research and outcomes, wherein a research-first approach is indifferent to the outcome vs. an outcomes-first approach helps design & iterate software interventions to improve quality and patient care;
[24:13] Why researching digital patient engagement feasibility is less important (and exciting) than research using the data collected on the platform and how the patient-reported outcomes (PROs) data leads to more meaningful research;
[24:28] How SeamlessMD partners are using the data to study new topics such as:
- Using the Opioid PROs to understand opioid consumption and patient opioid use
- Measuring health literacy scores as it correlates to patient engagement
- Measuring the frequency of certain symptoms after surgery
[26:16] How Digital Patient Engagement enables researchers to collect Patient-Reported Outcomes at scale, and with more granularity (for e.g. daily data collection vs. the traditional collection of PRO surveys at only a few times points in a clinical episode); and
[27:41] How the future is now regarding Digital Patient Engagement and how providers can use Digital Patient Engagement today to build thought leadership by answering more compelling questions previously unexplored in research;