CEPHR: Advancing Patient Care Through Environmental Health Research

In late 2024, Cleveland Clinic’s Department of Pulmonary and Critical Care Medicine was awarded a Mandel Accelerator Grant to create a new center that would address gaps in environmental health resources. Today, the Center for Environment, Place and Health Research (CEPHR) serves as a research hub for clinicians interested in how environmental and community factors affect health.

“CEPHR is here because of our patients,” says Wayne Tsuang, MD, PhD, a pulmonologist at Cleveland Clinic and Director of CEPHR. “We started the center because patients ask really good questions about how the environment impacts their health. We realized that there was a gap here at Cleveland Clinic, both in terms of our ability to answer patients' questions and answer research questions from other caregivers.”

Laying the foundation

The center leverages faculty expertise to help emerging researchers interested in studying how neighborhoods affect health and quickly apply their findings to patient care. This includes resources, like mapping services, statistical support and guidance for both research and clinical applications.

“It’s only been a little over a year since we were awarded funding, but I think we’ve done a lot since then,” says Maeve MacMurdo, MD, MBChB, MPH, Director of the Occupational Lung Disease Clinic at Cleveland Clinic and co-Director of CEPHR. “Much of it is still setting the foundation and getting that groundwork laid since, historically, Cleveland Clinic hasn't had these resources. So, we've really been building this all from the ground up.”

But Dr. MacMurdo notes that CEPHR aims to go beyond answering research questions and providing research help. The center also takes a translational approach and looks at how the findings and data can be applied towards recognizing where the right patient resources are.

“We want CEPHR to function as both a research center and to help patients and providers with real clinical questions,” she says. “So, for example, making interactive maps that help providers find the pulmonary rehabilitation location closest to their patients. We want to help people both understand what the challenges are in the communities where their patients live and also identify the strengths and resources”.

Resources for every specialty

Dr. Macmurdo and Dr. Tsuang are both pulmonologists, but they reiterate that CEPHR is not just for lung health.

“The goal with CEPHR is to think about the health impacts of exposure beyond the lungs- we know that environmental and place-based exposures impact every organ,” says Dr. MacMurdo. “We have pilot awardees who are working on answering questions about vascular surgery access, culture and healthcare utilization, and trauma, as well as conditions like asthma. Admittedly, we have a pretty heavy pulmonary focus because that's what Dr. Tsuang and I do, but the goal with CEPHR is to move beyond that”.

Dr. Tsuang adds, “We are building collaborations with researchers across Cleveland Clinic, including our first class of awardees. These are caregivers at Cleveland Clinic who submitted ideas for a one-year collaboration project where we support and mentor them.”

Looking at geographical impact

CEPHR will be rolling out user-friendly mapping software that could be used across Cleveland Clinic’s entire enterprise. The mapping software can be used in a variety of ways and tailored to a researcher's needs.

“The sky is the limit when it comes to mapping,” says Dr. MacMurdo. “We could map out, for example, where the factories or the bus stops are around Cleveland Clinic. We can help a provider think about how to map out their own patient location data, where patients are coming from and how they're getting to them. We can look at travel time for patients and where there might be potential barriers to care. If you can think it, there’s a good chance we can map it.”

While the mapping services do not have any geographical limitations, bigger map areas mean bigger data sets, which could make things potentially more complicated to sift through what’s relevant. But CEPHR’s mapping is not just limited to Cleveland Clinic locations, and it can make environmental maps for any location across the globe

“One of the nice things about environmental exposure is that there is a lot we can do to make a difference,” says Dr. Macmurdo. “Even if we can’t change guidelines or fix policy, we can work with our patients on what they’re exposed to and where they spend time, to try and reduce their exposure”.

Collaborating with CEPHR

For clinicians who are interested in working with CEPHR, Dr. Tsuang and Dr. MacMurdo both reiterate that requesting help from CEPHR is fairly straightforward.

“Our level of involvement can really vary, ranging from mapping software, direct mentorship, statistical support, or just a helping hand throughout the research process,” says Dr. MacMurdo. “But the first step is the consultation form, so we can determine what you need.”

Maggie Urban-Waala, MPH, CEPHR’s project manager, reviews the form, determines the best point-of-contact and sets up meetings based on the researcher’s needs.

“From there, we figure out how we can help, whether that’s just making a map, collaborating on the project, finding another researcher to connect you with, or really helping you however you need,” says Dr. Tsuang. “We were able to provide help at a level that caregivers need. We don't take a one-size-fits-all approach to collaborations. We really tailor it to what a caregiver's questions are and what their needs are.”