Building a longitudinal engagement system for adolescent patients at Children’s Hospital Los Angeles

Case Study: Automating & Scaling Research Operations at CHLA

Project Overview

This case study details my role in establishing, automating, and scaling a nascent research program at the Center for Healthy Adolescent Transition (CHAT) within Children’s Hospital Los Angeles (CHLA). Facing undefined objectives, limited resources, and complex operational needs, I spearheaded the design and implementation of an automated, long-term research infrastructure that significantly enhanced efficiency, expanded patient engagement, and delivered substantial cost savings.

My Role

Research Program Manager & Automation Lead

• Duration: 2020 – 2024
• Key Responsibilities: Program Strategy & Design, Automated System Development, Stakeholder Management, Team Leadership & Training, Patient Engagement Strategy, Data Management, Operational Optimization, Cross-Functional Collaboration.

The Challenge

The CHAT program aimed to build a research repository for adolescent Quality of Life (QOL) data, but the initiative was in its infancy, characterized by:

• Ambiguous Direction: No clear roadmap for research beyond a broad goal of QOL data collection on REDCap (an unfamiliar platform).
• Operational Inefficiencies: Reliance on manual processes for a planned 10-year, 1000+ participant longitudinal study, despite severe staff limitations (only two part-time research associates).
• Low Engagement Potential: Lack of a structured strategy for sustained patient participation over a decade.
• Interdepartmental Silos: Need to integrate research efforts within a large hospital system with diverse departmental needs and policies.

My Approach & Process

My approach was systematic and multi-faceted, focusing on strategic planning, system design, and stakeholder collaboration:

1. Strategic Research & Needs Assessment:
   • Initiated by thoroughly reviewing existing documents (grant letters, internal agreements) to align the research with CHAT’s core mission.
   • Independently conducted comprehensive research on relevant QOL and transition-of-care surveys, presenting a curated list with pros and cons to leadership for informed decision-making.
2. System Automation & Design (Product/Process Design):
   • Designed and built a fully automated, logic-driven survey flow on RedCap. This involved significant coding and complex logic construction to handle customized survey timing, language preferences, and cognitive status for individual participants over a 10-year period. This directly addressed the staff limitation and scalability challenge.
   • Focused on a “hands-off” system design where staff primarily input participant contact information, automating all subsequent survey distribution and follow-ups.
3. Cross-Functional Stakeholder Engagement (Project Management):
   • Proactively established and maintained relationships with critical hospital departments, including IRB, research support, legal, and IT teams, to understand and navigate policy landscapes.
   • Expanded recruitment efforts to 8 distinct hospital departments, tailoring recruitment strategies (remote, in-person, direct/indirect contact) for each clinic to minimize disruption and maximize buy-in.
   • Collaborated routinely with a USC team, providing data updates and ensuring seamless external research collaboration.
4. Operational Standardization & Team Enablement:
   • Developed comprehensive Standard Operating Procedures (SOPs) and training materials, empowering a lean team (initially 2 part-time RAs) to manage complex operations effectively.
   • Mentored and supervised junior staff and MPH students, fostering a self-sustaining team.
5. Continuous Improvement & Innovation (AI-Adjacent Thinking):
   • Investigated and implemented cost-effective patient incentive programs (leveraging existing hospital resources) to improve engagement.
   • Initiated discussions with IT and data teams to develop an automated patient tracking data dashboard, moving beyond manual Excel reports to provide real-time response and dropout rates. This anticipated need for scalable data visualization and predictive analytics.

Key Contributions & Solutions

• Automated Research Infrastructure: Architected and implemented a scalable, automated REDCap survey system capable of managing a 10-year, 1000+ participant longitudinal study with minimal manual intervention.
• Stakeholder & Partnership Development: Successfully built bridges across 8 hospital departments and with external university partners, ensuring collaborative and compliant research execution.
• Operational Efficiency & Cost Optimization: Developed and implemented processes that not only increased productivity but also led to significant financial savings.
• Team Training & Empowerment: Created clear documentation and training protocols that drastically reduced onboarding time and fostered team autonomy.
• Data-Driven Engagement Strategies: Designed and implemented multi-pronged strategies informed by data to enhance participant retention.

Impact & Results

My efforts led to quantifiable and impactful outcomes:

• Exceeded Enrollment Goals: Surpassed leadership’s initial projection by 300%, enrolling 160 patients in the first 6 months (vs. 40 projected).
• Enhanced Operational Efficiency: Reduced new staff training time by 75% (from over 2 months to 2 weeks) through standardized SOPs and training.
• Significant Cost Savings: Pioneered an optimized operational model leading to a potential annual savings of approximately $100K by restructuring team roles and automating processes.
• Increased Patient Engagement: Boosted patient engagement rates from 24% to 43% through strategic incentive programs and perfected engagement strategies.
• Streamlined Processes: The digital form and automated survey flow reduced manual effort and staff time, paving the way for scalable research operations.
• Foundation for AI/Data Analytics: Laid groundwork for a robust data dashboard, moving towards real-time insights on engagement and attrition.

Learnings & Takeaways for Tech Roles

This experience provided invaluable lessons directly applicable to UX Research, Product/Project Management, and AI-adjacent roles:

• User/Patient-Centric Design: Deep understanding of user needs (patients, staff, other departments) to design systems that are intuitive, culturally sensitive, and efficient.
• Product/System Thinking: Ability to conceptualize, design, and implement complex automated systems from the ground up, considering scalability, user experience, and resource constraints.
• Data-Driven Decision Making: Leveraging quantitative and qualitative data to identify problems, measure impact, and iterate on solutions (e.g., patient engagement metrics, dropout rates, cost analysis).
• Cross-Functional Leadership: Proven ability to build consensus and manage diverse stakeholders (clinical teams, legal, IT, external partners) in a complex organizational environment.
• Adaptability & Problem-Solving: Navigating ambiguous initial conditions, adapting to unforeseen challenges, and independently researching and building solutions (e.g., mastering RedCap, customizing recruitment).
• Process Optimization & Automation: A strong track record in identifying manual bottlenecks and implementing automated solutions that drive significant efficiency gains.

This project solidified my capacity to lead complex initiatives, manage data-driven programs, and design user-friendly systems – all critical skills for thriving in the dynamic tech and AI landscape.

Publications

Mirinjian, A., Porter, C., Cuevas, R., Baird, J., Iverson, E. (2022, July). The CHAT Research Cohort; A Longitudinal Study. Presented at Clinical Services Research and Education Research Day, Los Angeles, CA.