I am the director and founder of the Clinical Decision Technology Laboratory (CDTL) of the Massachusetts General Hospital (MGH), which has been financially supported by over $7M in competitive grant awards from government, foundation, industry, and institutional sources. The CTDL develops and deploys automated software systems providing real-time clinical decision-support. I also serve as an attending physician in the MGH Emergency Department, which treats over 120,000 patients per year including specialty care for trauma, neurological and cardiac emergencies. Currently, approximately 50% of my effort is dedicated to research and 50% to clinical service.
The work of the CDTL is focused on one central question: how can new computational capabilities enable care that is safer, more efficient, and more effective? Our bedside technology is focused on management decisions for unstable, critically-ill patients. For example, the VIGORIS system is designed to optimize neuro-protection, especially optimal blood pressure management, for undifferentiated circulatory shock, acute spinal cord injury, or other neuro-critical care. The APPRAISE system is designed to optimize assessment and early management of trauma patients. In addition to bedside decision-support, our “META” computing infrastructure provides clinical decision-support for complex protocols that run multiple hours, enhancing quality and safety for general task tracking, resuscitation, and sepsis management.
Underlying these software systems are our core competencies: data analytics; software system engineering; and end-user (clinician) design factors. Our scope of work has spanned computational techniques – how to accommodate data fluctuations through time; removal of measurement artifact & bias; multi-parameter analysis; and machine learning – operational issues – how to build, curate, and effectively analyze large electronic databases; how to implement software and user interfaces that allow for effective real-time clinician interactions – and clinical investigations – regulatory requirements; assessment of the performance of novel technologies during clinical operation; and whether investigational technology offers additional benefit over routine care.
CDTL research has led to over 100 peer-reviewed conference abstracts and journal reports; invited presentations to technology development teams of the world’s leading technology companies, including: General Electric (also serving on their customer advisory board), Masimo, Philips, Zoll, Sharp, Nihon Kohden, Google, Amazon Web Services, FitBit, and IBM; and multiple US patents.