pcciadmin, Author at PCCI

16 April 2021

Black Maternal Health Week: Doing Our Part to Help Prevent Premature Births




By Vikas Chowdhry, MBA

PCCI Chief Analytics and Information Officer

In observation of Black Maternal Health Week, Parkland Community Health Plan (PCHP), in partnership with Parkland Center for Clinical Innovation (PCCI) want to highlight our efforts in Dallas to prevent preterm births, which is especially impactful on women in under-served communities.

To better serve pregnant women in our community, PCCI and PCHP developed and implemented an innovative maternal health program that uses a machine learning algorithm, healthcare data and social determinants of health to identify pregnant women who are at a higher risk of pre-term birth. The program engages these women through text messages designed to help them be proactive in seeking care during pregnancy.

Proactive care is critical because American women are more likely to die from pregnancy-related causes than women in other high-income nations and their own mothers a generation before. National severe maternal morbidity (SMM) rates have nearly doubled over the past decade, and the occurrence of SMM was 166% higher for African American women than white women from 2012 to 2015. More broadly, African American and Latino women, as well as socioeconomically disadvantaged populations, are disproportionately affected by poor health outcomes due to pregnancy related causes.

“One of the major risk factors for pregnant mothers and newborn babies is pre-term birth,” said John Wendling, chief executive officer of Parkland Community Health Plan. “Apart from adding to the risk during delivery itself, there are so many other long-term health and well-being risks for the mother and the child when a baby is born prematurely.”

The rate of preterm birth in Texas is highest for Black infants (14%) followed by American Indian/Alaska Natives (11%), and Hispanics (10.6%). In 2019, in Texas, 1 in 9 babies was born preterm. While there are many efforts to address poor maternal health outcomes in the US, most focus on preventing deaths during labor and delivery. Not enough attention is paid to the larger environmental context and non-traditional risk factors such as educational achievement, body mass index, socioeconomic status and mental and behavioral factors.

“As a local community health plan, we need to protect our at-risk pregnant women and the program we partnered with PCCI on is a very effective way to help,” said Wendling. “This program is a great example of a health plan utilizing sophisticated AI, social determinants of health and digital technology to improve patient engagement and experience. The long-term result is that we’ve positively affected the overall health and wellness of families in our community.”

The program has been running successfully for over three years in seven counties in North Texas and has risk stratified 40,000 unique pregnancies. We’ve seen preterm births reduced by 20% during this period. In a survey of the program participants, 73% of respondents agreed this program made them better prepared to take care of themselves and their babies.

“Not enough funding in healthcare innovation goes towards serving the vulnerable populations and that has exacerbated the digital divide,” Steve Miff PhD, president and chief executive officer of PCCI. “This pre-natal program with PCHP is a powerful application of advanced data science and technology at the point of care that focuses on the whole person to improve lives for the most vulnerable.”

PCCI’s Vikas Chowdhry, MBA (chief analytics and information officer) and Dr. Yolande Pengetnze (senior medical director) have helped oversee the success of the program in collaboration with key stakeholders at PCHP including Dr. Mark Clanton (chief medical officer) and Paula Turicchi (chief strategy officer). PCCI has filed for several patents related to this platform.

“In addition to PCCI’s technology created to use data analytics for maternal and pediatric health, this cutting-edge platform has been key to impacting innovation for COVID-19 related work, Parkland Health and Hospital System and Dallas County,” Miff said. “This unparalleled use of machine learning algorithm, healthcare data and social determinants of health to create practical, usable solutions will continue to impact of this investment in Dallas county and beyond.”

About the author

Vikas Chowdhry, MS, MBA, is PCCI’s Chief Analytics and Information Officer with 15+ years of healthcare experience. He works closely with data science and clinical teams at PCCI to develop machine learning driven technologies and products that can empower clinical and social services providers and individuals to create communities that are healthier and more productive.

##

15 April 2021

PCCI Names Healthcare Technology Expert, Russell “Rusty” Lewis, as Chief Digital Technology Officer




Dallas, Texas – Parkland Center for Clinical Innovation (PCCI), which improves healthcare for vulnerable populations using advanced data science and clinical experts, has named Russell “Rusty” Lewis as Chief Digital Technology Officer, where he will accelerate the advancement of PCCI’s digital technology platform and data applications.

“We are so pleased to welcome Rusty to our team of clinical and data science experts who are leading the industry in solving some of the most challenging issues facing vulnerable populations,” said Steve Miff, PCCI’s CEO and President. “Rusty is joining an existing dynamic team of top industry experts and his experience and vision will make PCCI’s groundbreaking AI/ML platform even more robust and impactful. Our partners and collaborators will find his humble, yet fun and outgoing personality a pleasure to work with.”

As a member of PCCI’s advisory team since 2017, Lewis is uniquely familiar with PCCI’s programs and leading-edge technology, enabling him to make a rapid impact. He will assume duties immediately, reporting to PCCI’s CEO in Dallas.

Lewis’ professional career spans a wide range of health care firms and technology roles, and most recently served as President of AppianRX, a manufacturer of healthcare-oriented artificial intelligence products. Previous to that, he was Group SVP of Data, Analytics, and Product Delivery for Vizient and Provista. Lewis also served as SVP and Chief Technology Officer for McKesson and later served as President of the Automation and Technology division of AmerisourceBergen.

Lewis has also served as a senior executive in a number of venture-backed health information technology (HIT) start-ups including Ameritech Health Connections, Bridge Medical Systems, and Skylight Healthcare Systems. Lewis began his career at Texas Instruments and holds more than 15 international and U.S. patents spanning handwriting recognition, virtual reality, clinical software and medication management systems. He is author of two books – “Impact of Information Technology on Patient Safety” and “Barcode and Auto-ID Implementation Guide” – both of which are published by the Healthcare Information and Management Systems Society (HIMSS).

Lewis holds degrees in computer science and applied mathematics from Southern Methodist University. He is a past board member of the National Alliance for Healthcare Information Technology (NAHIT) and Microsoft’s Healthcare User’s Group (MSHUG).

About Parkland Center for Clinical Innovation
Parkland Center for Clinical Innovation (PCCI) is an independent, not-for-profit, healthcare intelligence organization affiliated with Parkland Health & Hospital System. PCCI leverages clinical expertise, data science and social determinants of health to address the needs of vulnerable populations.

###

14 April 2021

PCCI’s Vulnerability Index Shows Lowest COVID-19 Infection Risk Level for Dallas County




DALLAS – Towards the end of March, Parkland Center for Clinical Innovation’s COVID-19 Vulnerability Index has recorded the lowest infection risk since the Vulnerability Index launched in June of last year.

“After the holidays, we had vulnerability index ratings at nearly 200, which meant the COVID-19 virus was running rampant through our community,” said George “Holt” Oliver, MD, Vice President of Clinical Informatics at PCCI. “It is a great relief to see that the highest vulnerability index rating now is only 16.91. This is a triumph for our county’s public health leaders, providers and residents who have made the sacrifices and efforts needed to bend the curve.”

One of the hardest hit ZIP Codes during the past year, 75211, which includes the areas around Cockrell Hill and Oak Cliff, saw its vulnerability risk hit the high of 196.9 in January. This was the highest level any ZIP code in Dallas County reached. By mid-March, its vulnerability rating was 8.74, a dramatic improvement for an area facing some of the most sever socioeconomic issues.

“This is very good news for the residents of the 75211 ZIP code; however, we advise caution going forward,” said Dr. Oliver. “I believe that our new normal will be continued vigilance. To keep COVID-19 from resurging, everyone who can be vaccinated should seek it, and adhere to local health official guidance that includes direction on social distancing and face covering.”

Launched in June 2020, PCCI’s Vulnerability Index identifies communities at risk by examining comorbidity rates, including chronic illnesses such as hypertension, cancer, diabetes and heart disease; areas with a high density of populations over the age of 65; and increased social deprivation such as lack of access to food, medicine, employment and transportation. These factors are combined with dynamic mobility rates and confirmed COVID-19 cases where a vulnerability index value is scaled relative to July 2020’s COVID-19 peak value. The PCCI COVID-19 Vulnerability Index can be found on its COVID-19 Hub for Dallas County at: https://covid-analytics-pccinnovation.hub.arcgis.com/.

Currently, the 75150 ZIP code, at the intersection of Interstate Highway 30 and 635 has the highest COVID-19 risk at 16.91, down from a high of 107.30 in January. The ZIP code 75204, in east downtown Dallas, has the second highest vulnerability level at 15.81, down from a high of 126.5 in January.

PCCI’s forecast of Dallas County reaching COVID-19 herd immunity is still on-track but reaching that threshold is highly dependent residents receiving their vaccinations.

“With vaccinations available to all adults, we need to get in line and get immunized,” said Dr. Steve Miff, PCCI President and CEO. “We don’t want another year to go by where grandparents can’t hug their grandchildren. We have seen how safe and effective the current vaccines are, so it is the responsible thing to do for our friends, families and co-workers to get immunized.”

While always concerning when adverse reactions emerge, the action by the FDA to pause the J&J vaccine is out of “abundance of caution” and it’s a strong signal of how responsive they are to any potential safety concerns. Cerebral venous sinus thrombosis (CVST) with J&J vaccine has been reported in 6 young women (ages 18-48) among 6.8 million doses in the US. To date, Dallas County has administered 61% Pfizer, 35% Moderna, and 4% J&J. The syndrome has been dubbed vaccine-induced immune thrombotic thrombocytopenia.(VITT), based on a similar syndrome after the commonly-used medication heparin abbreviated HITT. The reported rates are much lower than IV Heparin which is used frequently in the hospital. While the risk benefit ratio of continuing to use J& J vaccine in the US COVID-19 vaccination plan may still make sense given the observed case fatality rate of 1.8% of COVID-19, prudence to understand the situation given the FDA emergency use authorization for use is warranted..

The FDA pause for the J&J vaccine will not significantly impact the PCCI initial estimate for Dallas County’s path to herd immunity by June. We were progressing towards herd immunity at a rate of approximately 3% per week, which was ahead of initial predictions. While the allocations for J&J were scheduled to increase and the latest developments will pause those vaccinations likely for days, up to several weeks, we forecast that Dallas county will continue to make progress at 2-2.5% per  week, which maintains the pace for mid-June.

A year in retrospective
With the COVID-19 pandemic ongoing for over a year, PCCI identified the zip codes with the highest average vulnerability from July 2020 through March 2021. These represent areas which have faced the highest risk during the COVID-19 pandemic to date.

Data Sources:
To build Vulnerability Index, PCCI relied on data from Parkland Health & Hospital System, Dallas County Health and Human Services Department, the Dallas-Fort Worth Hospital Council, U.S. Census, and SafeGraph.

About Parkland Center for Clinical Innovation
Parkland Center for Clinical Innovation (PCCI) is an independent, not-for-profit, healthcare intelligence organization affiliated with Parkland Health & Hospital System. PCCI leverages clinical expertise, data science and social determinants of health to address the needs of vulnerable populations. We believe that data, done right, has the power to galvanize communities, inform leaders, and empower people.

###

Authors

Steve Miff, PhD., President & CEO of PCCI, George “Holt” Oliver, MD, Vice President of Clinical Informatics at PCCI and  Thomas Roderick, PhD, Senior Director of Data and Applied Sciences at PCCI.

7 April 2021

“BUILDING CONNECTED COMMUNITIES OF CARE” BOOK EXCERPT Case Study – Engaging Patients—Location and Relationships Matter




Following is an excerpt from PCCI’s book, “Building Connected Communities of Care: The Playbook For Streamlining Effective Coordination Between Medical And Community-Based Organizations.” This is a practical how-to guide for clinical, community, and government, population health leaders interested in building connected clinical-community (CCC) services.

This section is from Chapter 6, “Clinical Providers Track.” The purpose of the Clinical Providers Track is to set out the stakeholders and processes required to integrate clinical entities, insights, programs, interventions, strategies, and measurement for the CCC.

PCCI and its partner Healthbox, offers readiness assessments as a service. If you and your organization are interested, go here for more information: https://pccinnovation.org/connected-communities-of-care/.

###

Case Study: Engaging Patients—Location and Relationships Matter

As part of our CCC history, PCCI has developed and tested a number of approaches to identifying individuals within the population of vulnerable and under-served Parkland patients who could benefit from screening for health related social determinants, engaging them in the completion of a brief risk assessment and subsequent linkage to available community resources. As with many of the elements of the CCC, this proved to be a learning experience in which initial, more conventional approaches gave way to new and more innovative approaches of engaging this population to optimize goal
attainment.

RECRUITMENT
Much of the initial work began with screening in the outpatient setting. Parkland has 12 Community-Oriented Primary Care (COPC) clinics located throughout Dallas County to serve local residents. Because the COPCs see a large number of patients on a daily basis, many of whom are considered vulnerable and underserved, these COPCs were determined to be a great
location to conduct the social determinant risk assessments. When a patient checked in for a visit, the office staff would provide the patient with a paper-based screening tool to self-administer. Trained community health workers were available in the waiting area to help, if required. Initially we felt like this approach made sense since the large number of COPC patients translated into large numbers of completed screening surveys. However, while there were a large number of initial screenings, the number was very low of patients that agreed to engage with a PCCI community health worker to connect with local community services. Many stated they were not interested or needed to leave the facility for another commitment. Other patients completed the needs assessment but left the COPC before staff members were able to connect with them. Of these, very few responded to follow-up phone outreach and the ones that did were hesitant about referral to community-based services. The team attributed this gap to the lack of personal engagement at the point of initial screening.

As a result of this initial experience, the team made some changes to the screening protocols. Three concurrent workflows focusing on different points of patient encounters were designed and tested. The three new points included: (1) engagement while the individual was in the ED, (2) engagement of individuals that had already left the ED, and (3) engagement of hospitalized patients on the medical/surgical floors of the hospital.

For the direct engagement while the individual was in the ED, licensed social workers conducted initial face-to-face screenings with patients awaiting care. The social workers were provided a list of eligible patients (those with multiple ED visits in the past year) and went room to room to conduct the screenings and determine if the patients were interested in connecting with community resources. Because many of these patient interactions took place while the individual was in the middle of an ED care visit, the PCCI team member was mindful of this and stepped aside, as needed, to ensure they didn’t interrupt the patient’s care. For those individuals that left the ED before screening, the PCCI team placed these individuals’ names and contact numbers on a sheet and later reached out to them by phone to explain the program and ask if they were interested in receiving information on community resources.

Finally, for those individuals undergoing an inpatient stay in the hospital, PCCI personnel obtained census data reports with information about eligible patients and then staff visited these patients in their rooms to conduct one-on-one conversations to implement the screening tool and to determine if the patients were interested in receiving more information about navigation services to community resources.


As shown in Table 6.1, a key learning from this undertaking was that the site matters in conducting the screenings and successfully connecting people to local programs for support. We learned that engaging patients during their inpatient stay was the optimal care setting in which to conduct screenings and then connect those patients to the appropriate community resources.

Establishing trust with patients early in the process was essential, both for completing the initial screening tool and for facilitating connection to community services. During our initial approach, we relied on self-administered screenings that provided little in the way of opportunity to establish a relationship with patients. Our modified workflow allowed our social workers and community health workers to verbally administer the screening tool and provide additional explanations as part of that exchange. This process also made the transition to navigation services virtually seamless and much more
effective. Feedback from patients has also been positive; most indicated that the information received was useful and many said they would share this information with other family members and close friends.

THE SCREENING PROCESS
The PCCI community engagement team consisted of six community health workers and two master’s-level, licensed social workers. Initially, the team consisted entirely of social workers, but our experience taught us that a blended staff model was more cost-effective. PCCI physician leaders coached all team members on how to be flexible and professional when working in the ED, where care moves at a rapid pace. The team needed to take cues from medical staff on where and when to step in to conduct the screenings. Similar trainings were delivered to those staff visiting patients in the hospital.

Over the course of the 6-month pilot, we were also able to identify a number of key elements that increased both the effectiveness and efficiency of the screening process. For example, we learned that it took on average 15 minutes to complete the assessment tool when it was facilitated by a team member but only 10 minutes when self-administered. While the self-administered survey took less time to complete, we found a much higher percentage of incomplete and inaccurate responses, making many of the screens useless. As would be expected, we also found that older patients—those 65 or older—took on average 20 minutes to complete the facilitated screening survey while younger individuals completed it in half the time. The difference was attributable to the amount of questions asked and attendant conversations, which were much more prevalent with older patients. Finally, once we began to work more closely with the patients and they developed a better sense of the purpose of the work, we encountered very few issues with obtaining consent from the patients to share their information with others.

###

 

24 March 2021

COVID-19 fatalities become the leading cause of death in Dallas County one year into the pandemic 




Dallas – With the anniversary of Dallas County’s first COVID-19 death having recently passed, mortalities due to the pandemic has become the leading cause of death among county residents, surpassing heart disease, cancer and strokes in the past year.

According to the Centers for Disease Control and Prevention (CDC), the first death in Dallas County was recorded on March 19, 2020. By March 21, 2021, deaths in Dallas County from COVID-19 stood at 3,763. This surpassed estimated deaths due to heart disease (3,668), cancer (3,356) and strokes (1,015) during that same period.

COVID-19 deaths in Dallas County saw their steepest increases starting in December. On Dec. 21, 2020, deaths due to COVID-19 stood at 1,841, but in the following three months deaths more than doubled, adding 1,922 more casualties.

“This is a sad milestone for Dallas County,” said Vikas Chowdhry, MBA, Chief Analytics and Information Officer at PCCI. “We can see that COVID-19 claimed the most lives following social gatherings and holiday travel beginning with Thanksgiving through Christmas and New Year’s. Starting in December we saw a startling spike of deaths due to COVID-19 that represented more than all of the deaths in the previous months we had experienced during the pandemic. This offers a valuable lesson going forward, that we must remain vigilant to protect ourselves, our families and friends.”

PCCI recently forecast that Dallas County may reach COVID-19 herd immunity by mid-June. However, in order to reach this threshold residents of Dallas County need to continue their efforts to protect themselves from infection. “We are remaining optimistic that we can reach herd immunity by the early summer, but the key is ongoing vigilance, including continued adhering to local health official guidance, social distancing, face covering, and registering for vaccinations as soon as possible,” said Chowdhry.

An animated graphic showing the evolution of the COVID-19 mortality rate in Dallas County can be viewed at https://covid-analytics-pccinnovation.hub.arcgis.com/, PCCI’s COVID-19 Hub for the region. This shows total COVID-19 deaths by day, based on data provided by the New York Times COVID-19 data tracking project. The mortality data includes both confirmed cases, based on laboratory testing and probable cases, based on specific criteria for symptom and exposure. This is per guidance form the Council of State and Territorial Epidemiologists.*

To help protect Dallas County residents, PCCI recently launched the MyPCI App, a web-based program to help inform the residents of Dallas County to their individual risks. The MyPCI App, free to register and use, is a secure, cloud-based tool that doesn’t require personal health information and doesn’t track an individual’s mobile phone data. Instead, it is a sophisticated machine learning algorithm, geomapping and hot-spotting technology that uses daily updated data from the Dallas County Health and Human Services (DCHHS) on confirmed positive COVID-19 cases and the population density in a given neighborhood. Based on density and distances to those nearby who are infected, the MyPCI App generates a dynamic personal risk score.

To use the MyPCI App, go to, https://pccinnovation.org/mypci/, click on the link and register (Using code: GP-7xI6QT). Registration includes a request for individual location information that will be used only for generating a risk assessment, never shared. Once registered, simply login daily and a COVID-19 personal risk level score will be provided along with information to help individuals make informed decisions about how to manage their risk.

About Parkland Center for Clinical Innovation

Parkland Center for Clinical Innovation (PCCI) is an independent, not-for-profit, healthcare intelligence organization affiliated with Parkland Health & Hospital System. PCCI leverages clinical expertise, data science and social determinants of health to address the needs of vulnerable populations. We believe that data, done right, has the power to galvanize communities, inform leaders, and empower people.

 

###

 

*The tallies reported here include probable and confirmed cases and deaths. Confirmed cases and deaths, which are widely considered to be an undercount of the true toll, are counts of individuals whose coronavirus infections were confirmed by a molecular laboratory test. Probable cases and deaths count individuals who meet criteria for other types of testing, symptoms and exposure, as developed by national and local governments.

23 March 2021

Governance: The Glue That Holds Connected Communities of Care Together




By Keith C. Kosel, PhD, MHSA, MBA

Aligning groups that have very different backgrounds and agendas, for the good of the community, is no easy matter. Whether at the city, state, or federal level, governmental or civic entities are tasked with trying to build consensus among various stakeholder groups to affect an outcome that works for the constituents they represent. It is no different for those tasked with leading a Connected Community of Care (CCC).

The Role of Governance
The premise behind the CCC is that by bringing together healthcare providers, community-based social service organizations (CBOs), faith-based organizations, and various civic entities, a community can establish a network of care providers focused on addressing residents’ social and/or clinical needs. While the premise is straightforward, establishing the governance group and governance structure to set up and manage a CCC is anything but straightforward. Before we look at how we might bring entities with different missions and agendas to the table, let’s understand what we mean by a governance group and a governance structure, and why these are essential to form a successful CCC.

The nucleus of a CCC is its governance group― those organizations that have come together to establish the CCC and to form the rules by which it will operate (the governance structure). As most CCCs form from scratch, the governance group is typically made up of one or two organizations we refer to as Anchor Organizations. These are typically large, well-established, and highly respected organizations within the community. They could include national social service organizations such as the United Way or Salvation Army, or they could be philanthropic funders, faith-based organizations or healthcare systems. What all these organizations have in common is a mission to improve the health and well-being of their community’s residents. As such they lie at the heart of the governance group (Figure 1).

Figure 1. Connected Communities of Care Including Governance Structure

In addition to the Anchor Organizations, the governance group typically consists of four to six additional Partner Organizations. These may be somewhat smaller CBOs (in scale and scope), but they all play a foundational community role in addressing resident’s social and/or clinical needs. Partner Organizations are well-known within the community and historically work closely with the Anchor Organizations. Partners could be regional food banks, housing assistance providers, crisis centers, mental health providers, local school districts, etc.― all defined by the fact they deliver essential social or clinical services within the community.

The role of the governance group is to provide structure and guidance for the CCC. By structure we mean things like: (1) how network participants will be identified and approved, and what will be expected of each; (2) what the CCC’s mission and charter will include; (3) how the CCC will be funded; and what type of data must be collected and shared, consistent with HIPAA regulations. While the governance structure deals with establishing the rules and policies that guide the day-to-day workings of the CCC, the governance guidance function focuses on issues like: (1) support for a Readiness Assessment (See previous blog) to determine if the community needs― and is even ready for ―a CCC; (2) how and at what rate the CCC should grow; (3) strategic partnerships; and (4) CCC sustainability. A governance group is essential to establishing and growing the CCC. Moreover, without a strong, representative and resilient governance group, most CCCs will eventually fail.

Act 1 -Forming the Governance Group

While we might think that forming the Governance Group would be a fairly easy task, given that many Anchors and Partners already know one other, in reality the process is far more complicated. While many of the Anchor and Partner Organizations work in parallel, they often have a narrow topical focus, such as providing food, housing, healthcare or after-school programs. These topical focus areas may conflict either with regard to the purpose of the work or the process by which the work takes place. As an outsider looking in, we might think these are minor, easily solved issues when in fact they are anything but. Layer on top of this funding mechanisms that often are not uniform or are based on an organization’s own performance to support its mission within the broader CCC, and simple differences compound quickly. As the number of Anchor and Partner Organizations increases, the complexity of achieving alignment among these entities also increases dramatically. This is the point where the presence of a powerful and commanding Anchor Organization(s) become critical in driving alignment.

Because there are usually only one or two Anchor Organizations, the likelihood of disagreement is minimized, compared to the next governance level down (i.e., Partners). Typically, the Anchor Organizations individually have been contemplating a Connected Community of Care for some time and all it takes is the right “spark” at the right moment to bring them together. Further, Anchor Organizations by their nature are well versed in coalition building and working across multiple sectors, which is a skill set that may be less well-developed in the Partners, especially in smaller or rural communities.

A key function of an Anchor Organization is to bring a handful of Partner Organizations into the governance group. Here the Anchor’s skill in selecting collegial partners or ones that can easily be won over to align with the CCC’s mission and goals is extremely important. Including a Partner that will be disruptive or non-cooperative is a fatal error, regardless of what resources that Partner might control. Even if it means working harder to secure the necessary resources, it is better to include only cooperative and committed partners than to access resources at the cost of major disruption.

Act 2 – Moving the Governance Group Forward
Establishing a highly cohesive and well-functioning governance group is only the first step in an ongoing process to grow a successful CCC. The governance group must continue to evolve along with the CCC network. As the network expands, there may be a need to increase representation within the governance group. While warranted, this process must be handled carefully to avoid the disruption just mentioned. At the same time, the governance group may need to remove some participants from the network for failing to follow the CCC’s charter or for sub-standard performance. Although these are difficult decisions, neglecting to make them can irreparably damage the entire CCC over time.

In wrestling with these decisions, the governance group must always be focused on sustainability – sustainability of the CCC and of the governance group itself. Sustainability of the CCC takes different forms from operational sustainability to financial sustainability, each of which are indispensable to a CCC’s long-term growth and viability. Operational sustainability focuses on the challenges of keeping the CCC network up-to-date with regard to technology, strategic partnerships, growth through additional participants, and ongoing social and health needs assessments (i.e., is the prevalence of obesity increasing silently in the community? Are more people accessing utility assistance in the face of declining employment as businesses relocate to more favorable locations?). It also includes provisions for turnover at both the CCC administrative level and at the level of the CBOs, which historically have high turnover levels due to numbers of volunteer staff, etc.

Achieving financial sustainability is the ultimate challenge facing CCC governance groups. Without sustained funding, whether through internal or external means, a CCC cannot survive long term as an effective functioning network. The real challenge is not only securing funding but doing so in a way that benefits all network participants in some fashion based on need and contribution. When network participants must seek funding on their own, inequities are prone to develop, as participants begin to follow their own interests rather than the collective interest of the CCC. Though a difficult challenge, especially in today’s pandemic environment of scarce funding, CCC governance groups must confront it head-on.

CCC governance is not an easy or straight road. Rather it is strewn with potholes, stop signs and detours- but one that must be followed none the less if a CCC is to achieve its goal of improving the health and well-being of the community and its residents. The time and thought that goes into establishing a cohesive and highly effective governance group and structure will pay dividends to the CCC and those it serves many times over as the CCC grows and matures to become a key fixture within the community.

About the author
Dr. Keith Kosel is a Vice President at Parkland Center for Clinical Innovation (PCCI) and is author of “Building Connected Communities of Care: The Playbook for Streamlining Effective Coordination Between Medical and Community-Based Organizations,” a guide that brings together communities to support our most vulnerable. At PCCI, Keith is leveraging his passion for – and extensive experience in – patient safety, quality, and population health by focusing on understanding social determinants of health and the impact of community-based interventions in improving the health of vulnerable and under-served populations.

17 March 2021

New England Journal of Medicine – Catalyst featured PCCI in article about using data to manage COVID-19




New England Journal of Medicine – Catalyst: The Imperative for Integrating Public Health and Health Care Delivery Systems

NEJM-Catalyst published a column by leaders at Parkland Hospital and Dallas County’s health department about how they used PCCI’s capabilities leveraging data to educate and care for the county’s high-risk population. Click on the link below to read the whole article:

https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0580

10 March 2021

PCCI CEO Steve Miff’s Statement on Changing Texas COVID-19 Mask Policies




5 March 2021

PCCI’s Vulnerability Index Records 66 Percent Reduction in COVID-19 Risk for Dallas County




DALLAS – Dallas County saw a massive 66 percent reduction in risk values recorded by PCCI’s COVID-19 Vulnerability Index in February, with some of the most vulnerable ZIP codes showing significant reductions.

One of the hardest hit ZIP Codes, 75211, which includes the areas around Cockrell Hill and Oak Hill, saw its vulnerability risk value drop by 151.9 points, going from 196.9 vulnerability rating in January to 44.9 in February. The 75211 ZIP code remains the second most at risk area in Dallas County, however its overall improvement is a positive sign for the hard-hit area.

“The dramatic drop in the county’s vulnerability is positive and offers a hopeful path going forward,” Thomas Roderick, PhD, Senior Director of Data and Applied Sciences at PCCI. “We are remaining cautious as we saw vulnerability rates come down

last summer only to see increase significantly later. The key to continued reduction of vulnerability is ongoing vigilance, including continued adhering to local health official guidance, social distancing, face covering, and registering for vaccinations as soon as you’re able.”

Launched in June of 2020, PCCI’s Vulnerability Index identifies communities at risk by examining comorbidity rates, including chronic illnesses such as hypertension, cancer, diabetes and heart disease; areas with a high density of populations over the age of 65; and increased social deprivation such as lack of access to food, medicine, employment and transportation. These factors are combined with dynamic mobility rates and confirmed COVID-19 cases where a vulnerability index value is scaled relative to July 2020’s COVID-19 peak value. The PCCI COVID-19 Vulnerability Index

can be found on its COVID-19 Hub for Dallas County at: https://covid-analytics-pccinnovation.hub.arcgis.com/.

In addition to the drop in 75211, the ZIP code 75204, in east downtown Dallas, saw a 104.4 drop in its vulnerability ratings. ZIP code 75224, in southern Dallas, saw a drop of 64.9 in its vulnerability ratings, but now is ranked as the most vulnerable area in Dallas County with a vulnerability value of 45.87. Also, the ZIP code 75227, in east Dallas County intersected by State Highway 12, is the third most vulnerable area in Dallas with a 42.45 value, though it dropped 70.5 in its vulnerability ratings since January.

“Holidays and events are potential super-spreader events,” said Dr. Roderick. “We are in a time of year where these tend to

be limited, which impacts ongoing COVID-19 cases. However, Spring Break and occasional holidays on the calendar represent potential trouble times. PCCI will continue monitoring for things that can push Dallas County into higher levels of vulnerability.”

PCCI recently forecast that Dallas County may reach COVID-19 herd immunity by mid-June. This, Dr. Roderick points out, is only possible though vaccinations.

“We each need to be patient as well as register and receive our COVID-19 vaccination,” said Dr. Roderick. “The only way we will reach herd immunity is by maintaining our vigilance and getting vaccinated. Reaching herd immunity is a community effort and should be a priority for each of us.”

PCCI recently launched the MyPCI App, another program to help inform the residents of Dallas County to their individual risks. The MyPCI App, free to register and use, is a secure, cloud-based tool that doesn’t require personal health information and doesn’t track an individual’s mobile phone data. Instead, it is a sophisticated machine learning algorithm, geomapping and hot-spotting technology that uses daily updated data from the Dallas County Health and Human Services (DCHHS) on confirmed positive COVID-19 cases and the population density in a given neighborhood. Based on density and distances to those nearby who are infected, the MyPCI App generates a dynamic personal risk score.

To use the MyPCI App, go to, https://pccinnovation.org/mypci/, click on the link and register (Using code: GP-7xI6QT). Registration includes a request for individual location information that will be used only for generating a risk assessment, never shared. Once registered, simply login daily and a COVID-19 personal risk level score will be provided along with information to help individuals make informed decisions about how to manage their risk.

Data Sources:
To build Vulnerability Index, PCCI relied on data from Parkland Health & Hospital System, Dallas County Health and Human Services Department, the Dallas-Fort Worth Hospital Council, U.S. Census, and SafeGraph.

About Parkland Center for Clinical Innovation
Parkland Center for Clinical Innovation (PCCI) is an independent, not-for-profit, healthcare intelligence organization affiliated with Parkland Health & Hospital System. PCCI leverages clinical expertise, data science and social determinants of health to address the needs of vulnerable populations. We believe that data, done right, has the power to galvanize communities, inform leaders, and empower people.

###

2 March 2021

In the News: TIME Magazine – This County Tried to Ensure Racial Equity in COVID-19 Vaccinations.




 Magazine has posted a story about #Dallas County’s efforts to distribute #covid vaccines fairly, and it features PCCI’s work with its Vulnerability Index and other COVID data as a way to help support the under-served in our community.

 

 

Register your team to receive a complimentary set of “Building Connected Communities of Care” and kick off your Executive Book Club with a consultation from one of our experts.

Sign up to receive email updates on PCCI announcements, advancements in the industry, and more!
Loading