Several things were coming to a crossroads in 2016 when Data Cubed (D3) was founded, said Dr. Paul Glimcher, CEO and founder of the NY-based company. Among these, structured big data, mobile technologies, patient-centric care, and social networks.
To understand better the implications of these advancements, Glimcher and co-founder Dr. Alex Pentland, ventured to define the challenges and opportunities of digital health.
From this, Data Cubed was formed – emerging as a commercial offshoot of The Human Data Project at New York University. The project, led by Glimcher, is a 20-year study of 10,000 New Yorkers designed to collect hundreds of types of real-time data.
The company currently is working with various pharmaceutical companies and contract research organizations (CROs) to apply its digital health tools to increase patient engagement.
Gamification of the clinical trial app
While assessing the state of the digital health market, the team landed on a set of requirements including the need for gamification. The tools also needed to be configurable and cost-effective – all with “an eye towards academia and clinical research,” added Glimcher.
“This creative approach to understanding human action and interaction remains at the heart of Data Cubed,” he said, “the notion that future medical and research interventions will encompass both genetics and environment – genomic and phenomic information – requiring huge, artfully structured data sets to advance an interdisciplinary approach to health.”
Data Cubed designers studied Candy Crush, World of Warcraft, and League of Legends, among other games to apply “the lures of bestselling gaming technology to the needs of health care research,” Glimcher said. The resulting tools aim to improve patient retention, compliance, and adherence across clinical trials.
Glimcher noted, “To keep a diverse sample of people engaged over time, interactions must be fun and frictionless, attractive and ‘sticky.’” As part of this, the company has made a substantial investment in hiring designers, not just engineers, with 25% of its employees focusing specifically on product design.
“We invest in beautiful and functional design to bring patients and sponsors the best possible user experience at a fraction of the cost of other technology providers,” said Glimcher.
The company’s five core products include customizable apps, eDiaries, games to encourage patient reported outcomes (PRO), and a cross-platform app to gather social, behavioral, and environmental data.
“With colorful apps, engaging games, illuminating surveys, and keen wearable and in-home sensors, Data Cubed collects accurate real-world data that is relevant and actionable, taking study participants on a journey, with reinforcements to drive task completion through incentives and rewards,” Glimcher explained.
According to the company, across the clinical lifecycle, the devices can clock social media interactions, stress, financial transactions, and air quality, among other data points. Clients can select scales and tasks to measure cognitive control, memory, abstract reasoning, spending behavior, nutrition, and more, Glimcher explained.
“Our digital tools exponentially increase touch-points with participants to nearly 4,000 hours of data – a 75-fold increase in real-world site-collected data,” he said.
Data Cubed partners with companies to provide devices such as the Nokia Smart Scale, Garmin Activity Tracker, Emifit and Nokia Advanced Sleep Trackers, inhalers, smart pill bottles, and smart location beacons, in addition to its own advanced air quality monitor.
Beyond EHRs for RWE
The US Food and Drug Administration (FDA) recently released a draft guidance supporting the use of real world evidence (RWE) in clinical research. While Glimcher was excited to see this, he thinks there is a lot of momentum to build on, beyond electronic health records (EHRs).
“Phenomic data is imperative to advance an interdisciplinary healthcare approach and we see promise in expanding how we collect and analyze this data using everything from air quality measures to social media interaction to geotracking,” he said.
“With the increasing sensitivity and variety of technologies we have today, the possibilities are just about limitless and we are at a pivotal moment to use technology to better understand the human condition to create positive health changes.”
The company also conducted research within elderly populations and various focus groups to make sure the platform would appeal to a range of users. “Though the design borrows heavily from the gaming world, the product incorporates various reward mechanisms – including opportunities for charitable giving – as incentives that might be of particular interest to older populations,” said Glimcher.
As for privacy, participants expressed that “extraordinary security measures improved the likelihood of consenting to join a study,” he added. “Our platform has surpassed HIPAA standards and we looked to additional standards such as FERPA and NIS and employ double encryption keys that key data encrypted both at rest and in transit.”
Research studies and partnerships
As of August 2018, D3 is working on several projects, including a pilot with ERT for asthmas/COPD.
As part of the project with ERT, Data Cubed has partnered with ERT’s Innovation Lab and ERT’s Trial Oversight product team. The project uses Data Cubed’s tools to collect in-home movement via Bluetooth beacons, sleep quality via an under-the-mattress monitor, and environmental data from an in-home monitor.
A project also is underway to evaluate glycemic control and patient-reported outcomes in patients with type 1 diabetes in collaboration with LMC. For the 12-week, open-label, randomized clinical trial, the Data Cubed app is configured to allow participants to electronically record daily doses of insulin degludec, as well as exercise.
“Our early clients and tell us that they want solutions that improve the consistency of collected data, that offer patients flexibility to use their own devices, that reduce burden on study participants, and that offer engaging and rewarding patient experiences,” said Glimcher.