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VA Palo Alto Health Care System

 

VA Makes Smart Move with Big Data

Photos of the Hacking for Defense team members

VAPAHCS staff partnered with a team from Stanford University to find a way to use data to better identify changes in behavior of patients with traumatic brain injuries over time.

By Michael Hill-Jackson
Thursday, August 17, 2017

Data is one of the underlying factors that support many ideas in Silicon Valley, helping people to create new technology and innovate what already exists. Yet healthcare data is so complex that many organizations are still scrambling to find a way to leverage it successfully.

VA Palo Alto Health Care System (VAPAHCS) staff partnered with a team from the Stanford University course, Hacking for Defense: Solving National Security Issues with the Lean Launchpad (H4D) - consisting of Monica Chan, Buvana Dayanandan, Kian Katanforoosh and Sarah Van Sickle - to find a way to use data to better identify clinically relevant changes in behavior of patients with traumatic brain injuries over time.

Traumatic brain injuries, or TBI, are caused by a violent blow or jolt to the head or body resulting in cognitive and behavioral changes that can be hard to manage.

“While the rehabilitation services at VAPAHCS are among the finest in the country, we are always looking to enhance our current model of care to better meet our Veterans’ needs," said Jonathan Sills, PhD., a clinical psychologist and the Program Director for Assisted Technology at VAPAHCS, who was one of the key mentors and VA sponsor for the project. "Given the VA mission to provide lifelong care, understanding how technological advancements may help to ensure that our Veterans continue to thrive and maximize their quality of life as they age is of critical importance.”

Although expanding the use of technology is everyday work in Silicon Valley, the challenges for the engineering team were absorbing the complexity of TBI care, getting to know the population, and understanding the needs of clinicians.

“I didn’t even know what a TBI was before I came here,” said Dayanandan, a graduate student in Stanford’s MSx Program at the Graduate School of Business.

After interviewing more than 100 Veterans and working side-by-side with clinicians in Polytrauma to understand the data needed, the team worked through various concepts. Initial ideas included developing a smart phone app for behavior logging and tracking, but the team soon realized this approach wasn’t very efficient in collecting consistent information.

“We needed to track data passively without the Veteran having to click on a button,” said Katanforoosh, a master’s degree candidate in Stanford’s Management Science and Engineering department.

Investigating how they could use various wearable and mobile devices already available in the market, the team expanded their approach and created VA Companion – a system that receives Veteran data from various devices to populate an interactive electronic computer dashboard of clinical information available to the clinician.

Keeping true to the patient-centered care that VA provides, the dashboard design allows the clinician to work collaboratively with the Veteran to identify and set thresholds that are unique to the Veteran’s functional levels and what data points should trigger intervention or follow-up.

For example, the clinician might be monitoring sleep levels and can see if a patient has not been sleeping well over the past few days, triggering them to request a visit to work through the issue before it becomes a larger problem. Future development includes possibly detecting changes in a broader array of mental health and behavioral symptoms which would provide an alert to intervene and potentially save Veterans’ lives.

Based on the Lean LaunchPad developed by eight-time serial entrepreneur Steve Blank, the Hacking for Defense course was developed to give students an opportunity to solve real problems while working with members of the Department of Defense and Intelligence Communities. This platform hits home as some of the teaching team is made up of several military Veterans, including Retired Col. Joe Felter who was recently appointed Deputy Assistant Secretary of Defense for South Asia, investigating how technology can enhance the long-term management of TBI patients was the first VA sponsored problem ever selected to be worked on in the class.

With a commitment from Dr. Odette Harris, Associate Chief of Staff for Rehabilitation and VAPAHCS executive leadership to provide ongoing support, the work started by the VA Companion team will continue with a long-term plan to further develop the technology so that it may be brought to full-scale implementation.

To learn more, view the team's presentation on VA Companion.

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