Michigan Medicine: Positioned to lead in technology-driven research
COVID-19 has disrupted everyone’s lives, especially those working within health care. But this disruption has also accelerated technology-driven research — with much of that work being performed at Michigan Medicine.
Digital data gathering, artificial intelligence, precision health, real-time feedback monitoring and virtual clinical trial validation will become positive by-products of what many industry experts call “health care’s Amazon moment.”
Seizing on that moment, Michigan Medicine researchers turned to technology to fight the virus.
For example, teams have employed artificial intelligence to sift through thousands of treatment options, used the new national HERO registry for a multi-website clinical trial and leveraged American Heart Association grants to establish a wearable health technology research center and track cardiovascular consequences of COVID-19.
Considering U-M’s reputation for cutting-edge research, it’s not surprising how quickly researchers plunged into this important work in the battle against COVID-19. What some may not realize, however, is how many Michigan Medicine research initiatives were already challenging the status quo prior to the outbreak.
Virtual becomes reality for U-M clinical trials
Just as the state was shutting down due to COVID-19, the Office of Research, with the help of its Fast Forward Medical Innovation (FFMI) unit and the Clinical Trials Support Office’s Heart, Vessel, Blood Unit, engaged in an innovative virtual clinical trial design at the request of a large pharmaceutical company. With the project signed and sealed this April, U-M is now one of only a handful of U.S. research institutions participating in a large-scale, 100-percent virtual clinical trial.
“Modernizing the clinical trial method requires a new approach and U-M will work side-by-side with industry partners to shape this new and exciting landscape,” said Mike Ranella, director of business development at FFMI. “We are in a unique position with our expertise in virtual design and recruitment for clinical trial studies.”
The study will use video conferences, emails, phone calls and even wearable devices to enroll and check milestones of human subjects. This virtual design accelerates FDA approval timelines and enables researchers to include unique or isolated population segments difficult to reach in the past.
“Virtual clinical trial design is a huge paradigm shift involving human subject research,” Ranella added. “This concept is now being embraced as an approach to enrolling subjects as compared to a year ago. Since so much research took a back seat to COVID work, there is pent-up demand, so we have the inside track when things return to normal.”
Bringing precision to mental health care
Hundreds of other U-M research projects are merging high-tech data with digital patient information, such as biomarkers, to determine variables like genes, environment and lifestyle, to provide an individualized “precision medicine” treatment plan for patients as opposed to a one-size-fits-all method.
PROMPT (PROviding Mental health Precision Treatment) assesses mobile technology interventions among patients on the waitlist for traditional psychiatric care, which is increasingly relevant today since traditional face-to-face psychotherapy is difficult during a pandemic.
“The pandemic has made it clear that remote care in mental health is possible and necessary,” said Srijan Sen, associate vice president for research — health sciences, and co-lead of the project. “The mobile technology and electronic health record tools we develop through PROMPT should improve the quality of care and substantially expand our capacity to provide care to a larger proportion of those who need help. We hope that the scale of study, along with the use of cutting-edge tools, will advance the field in a way that has not been possible before and establish U-M as the leader in this critically important domain.”
Video and phone-based visits have allowed the study to progress during the pandemic, according to Amy S.B. Bohnert, a health services researcher and co-lead of the project with Sen.
“Having this ability is really important to us, because the need for mental health care will continue to increase during the pandemic,” she said. “People who recover from a critical illness are more likely to experience mental health symptoms, such as depression and anxiety, during their recovery. Furthermore, we can hypothesize that the social isolation and economic downturn will have a negative impact on mental health, even among those not directly impacted by COVID.”
Wearable data enhances patient health records
The Prospective Study of Perioperative Experience and Recovery (PROSPER) project is another technology-based study which collects and evaluates data from Electronic Health Records (EHR), survey results, national outcome data, and integrates it with activity, fitness, and clinical information on wearable devices such as the Apple Watch and FitBit (https://mpog.org/research/prosper/).
These devices can collect step count, heart rate and other activity data that is often missing from electronic health records. When this information is combined with other health data, researchers may see a more complete picture of a patient’s health. They will gain insight into a patient’s daily experiences instead of the episodic visits to a medical facility.
According to Ranella, all this research gives Michigan Medicine “a great presence in the virtual space — a space which was already growing but will be pushed way out in front due to the pandemic challenges we are learning to conquer.”