Computational Neuroscience Outcomes Center at Harvard (CNOC)

CNOC seeks to understand, predict, and improve clinical outcomes for neurosurgical patients by combining the use of epidemiological data, advanced statistical analysis, and emerging biological/information system technologies. This data science center strives to collect and maintain prospective active and passive data on all neurosurgical patients, as well as implement process and outcome improvement through comparison with national data. The center also provides statistical and design expertise to the faculty and their academic teams. Examples include the use of large national data sets for analysis of neurosurgical complications and identification of their related predictors, patient reported outcomes, machine learning and artificial intelligence clinical applications, as well as investigations into the use of smart phone sensors for the collection of patient behavioral data.

Technology is at the core of our mission to help and learn from our patients. We are expanding our horizons to include advanced technologies to track patients’ health and behavioral metrics more efficiently including wearable tech, personal digital devices, and large data analytics, which is all intended to improve patient care with real-time monitoring and responsiveness.

The use of digital data from devices including wearable technology - which allows for real time physiologic data, combined with data acquired from patient smart phones, helps us to accurately track outcomes in the patients’ natural environment outside of the clinical setting. Specifically designed technology for patients to wear helps to track parameters that can be individualized to patients’ needs.

Large data obtained from electronic medical records, combined with administrative and national data sources will allow for more powerful analysis and generalizability.

Patient Reported Outcomes Measures (PROMS) platform, we are able to do the following:

• Assess the benefits and harms of preventive, diagnostic, therapeutic, palliative, or health delivery system interventions to inform decision making, highlighting comparisons and outcomes that matter to people.
• Develop a complete understanding of an individual's preferences, autonomy, and needs, focusing on outcomes that people notice and care about such as survival, function, symptoms, and health-related quality of life.
• Incorporate a wide variety of settings and diversity of participants to address individual differences and barriers to implementation and dissemination.
• Investigate optimizing outcomes while addressing burdens to individuals, availability of services, technology, and personnel, and other stakeholder perspectives.

We have designed a value-based approach around our patients’ needs. Our medical care teams zero in on individual needs, whether preventive, chronic or acute. You benefit from a team that coordinates your care, and technology that connects you and your providers with information to help you get the right care across the health care system.

Implementing a discharge program that frames the episode of care, helps both families and providers to efficiently coordinate resources and the timely and safe transition from hospital, to rehab, to home. This orchestrated effort will reduce costs while improving satisfaction with the delivery of care.

By building and developing smartphone apps that bring care recommendations and education to patients directly, risk bundle creation, and wearable technology, we seek to serve our patients needs at their convenience. Our smartphone apps help to track our patient’s recovery by collecting their movement, engagement with others and rate of recovery, to identify adequate progression back to health.

We are continuously growing our team which consists of students, residents, physician assistants, data analysts and public health experts, and faculty members. The goal is to have this be a base for the advancement of great projects and ideas, and the education of individuals at many different levels in their career. We have developed collaborations with national and international partners including, the University Medical Center of Utrecht, Netherlands, the Harvard School of Public Health, the Harvard Medical School, the Brigham and Women’s Center for Surgery and Public Health and the Massachusetts College of Pharmacy and Health Sciences. Our team has been able to publish widely, present at national and international meetings, and has received multiple awards on the work that has been done through CNOC.