Ex­ec­u­tive Ses­sion

Health Data Management - - INSIDE DEPARTMENTS - In­ter­view by Fred Baz­zoli

Bren­nan Spiegel, Cedars-Si­nai direc­tor of health ser­vices re­search, sees be­yond the gee-whiz gad­getry of dig­i­tal health.

Bren­nan Spiegel, MD, moved seam­lessly from his role as a gas­troen­terol­o­gist to dig­i­tal health maven by in­vent­ing a wear­able de­vice that helps clin­i­cians an­swer a sim­ple ques­tion—when can a pa­tient start eat­ing af­ter surgery? us was born the AbS­tats mon­i­tor, a small de­vice that lis­tens to the gur­gles of the in­testines to de­ter­mine if they’ve re­cov­ered enough af­ter surgery to al­low the pa­tient to eat. at suc­cess has in­spired Spiegel to look at other dig­i­tal de­vice ap­proaches, most no­tably vir­tual re­al­ity and aug­mented re­al­ity, which he be­lieves can help pa­tients cope with pain with­out the ad­dic­tive risk of opi­oids.

Spiegel doesn’t just see gee-whiz gad­getry in dig­i­tal health. “It’s a plat­form to serve our pa­tients,” he says. “Health IT is less of a com­puter sci­ence or en­gi­neer­ing sci­ence—it’s more of a so­cial sci­ence and a be­hav­ioral sci­ence. Tech­nol­ogy de­vel­op­ment has be­come rather triv­ial—the hard part now is, how do we im­ple­ment these tech­nolo­gies on the front lines of care?”

On dig­i­tal health’s value

Dig­i­tal tech­nol­ogy al­lows us to go be­yond the four walls of the hos­pi­tal. Pa­tients spend most of their lives far away from the hos­pi­tal—if we’re re­ally go­ing to en­gage them, we have to reach out to where they are.

On in­no­va­tion

In my role, I re­port to the se­nior vice pres­i­dent of clin­i­cal trans­for­ma­tion and also the dean of our fac­ulty. That rec­og­nizes that my role spans both re­search and op­er­a­tions. Our re­search needs to sup­port the learn­ing health sys­tem cy­cle—re­search is great but what we dis­cover should not just stop there; it should be in­serted back into the health sys­tem to move the nee­dle.

On value-based care

e in­cen­tives of pay­ment re­form are be­ing aligned so we get paid for do­ing high-qual­ity care, and dig­i­tal health and in­for­mat­ics are right at the heart of that.

On hype sur­round­ing AR/VR

Much de­pends on the use case; on the Gart­ner hype cy­cle it’s mov­ing back up the plateau of pro­duc­tiv­ity—it seems like it’s ready to be im­ple­mented. Our re­cent re­search sug­gests VR may be more e ec­tive at re­duc­ing pa­tient pain than opi­oids, with low risk of ad­dic­tive side e ects. e ques­tion is, how do we get it into the hands of pa­tients and into the clinic?

We’ve also re­cently pub­lished re­search that there’s not yet su cient ev­i­dence that wear­able biosen­sors im­prove the value of health­care—that doesn’t mean it won’t hap­pen in the fu­ture.

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