NEJM Catalyst – Pediatric Asthma Surveillance System (PASS): Community-Facing Disease Monitoring for Health Equity
In 2024, the highly respected medical journals, The New England Journal of Medicine Catalyst, published a peer-reviewed paper authored by experts from PCCI, Parkland Health and the Dallas County Health & Human Services department about the innovative Pediatric Asthma Surveillance System (PASS) that allow Dallas County residents suffering from asthma understand their risks.
The PASS dashboard, hosted on the DCHHS website, has served the county for two years leveraging innovative data management that gives asthma risks down to the block level.
PCCI Publishing: Virtual Health Care Encounters for Lung Cancer Screening in a Safety-Net Population
Recently published in the Journal of Clinical Oncology, is a publication co-authored by George “Holt” Oliver, PhD, MBA, VP Clinical Informatics at PCCI, that examines how lung cancer screening was conducted during the COVID-19 pandemic to help determine the difference between virtual and in-person encounters in an urban, safety-net health care system.
PCCI Publishing: Supporting Access to HIV Pre-Exposure Prophylaxis in a Shifting Financial and Insurance Landscape
In a peer reviewed paper published in AJPM Focus, Jacqueline Naeem, VP of Clinical and Social Health at PCCI joined other experts to share information on efforts to expand the use of HIV pre-exposure prophylaxis with the support of community based organizations in Dallas, Texas.
Using Machine Learning to Identify Patients at Risk of Acquiring HIV in an Urban Health System
In the peer reviewed Journal of Acquired Immune Deficiency Syndrome (JAIDS), the identification of patients who are at risk for contracting HIV and are candidates for preventative measures is discussed as a machine learning model to predict risk for HIV may enhance patient selection for proactive outreach. This important paper’s authors include PCCI’s Arun Kumar Nethi, MS, Data & Applied Scientist, and Albert Karam, VP, Data Strategy Analytics.
Dallas County celebrates the second anniversary of PASS, a celebrated tool helping asthma sufferers understand their vulnerability
In March of 2023, Dallas County Health & Human Services (DCHHS) announced the unveiling of the Pediatric Asthma Surveillance System* (PASS) that is helping asthma sufferers better understand the harmfulness of their environment to their condition. In the two years since its deployment on the DCHHS website, PASS has positively impacted the residents of Dallas County and has supported the efforts of Parkland Health (Parkland) and DCHHS in reducing poor health outcomes related to pediatric asthma.
“Dallas County is one of the few, if not only, communities in the country that offer this kind of support to residents suffering from asthma,” said Steve Miff, PhD, CEO and President of Parkland Center for Clinical Innovation (PCCI). “We are very proud of the success of this model program showing how properly applied artificial intelligence systems can be used to directly inform and affect those in need in our community.”
PASS is a community-wide effort between Dallas County Health and Human Services, PCCI, and Parkland. Publicly available at the DCHHS website, it has been visited by more than 6,000 Dallas County residents, was honored by the Dallas County Commissioners for its service to asthma sufferers, and described by the Dallas Morning News as “a win for Dallas County.” PASS has also been featured in the highly respected New England Journal of Medicine Catalyst.
“PASS is the direct result of the joint Parkland-DCHHS Community Health Needs Assessment, which identified the need for an actionable dashboard to help stakeholders collaborate using a single source of truth,” said Teresita Oaks, Director of Community Health Programs at Parkland Health.“By integrating health and social data, PASS enables our community to take a proactive approach in addressing pediatric asthma and reducing disparities in care.”
PASS includes a novel, validated Pediatric Asthma Vulnerability Index that integrates health and social data insights to identify communities where children have higher vulnerability to poor asthma outcomes and highlight areas of health disparities. It can also predict the probability of a community-level asthma-related emergency department (ED) visit or hospitalization within three months, by incorporating the effect of 10 community indicators, such as socioeconomic conditions, demographic characteristics, medication use patterns, health services utilization, and environmental conditions, on community-level asthma risk.
“One of the most impactful outcomes of PASS has been the identification of neighborhoods with the highest burden of pediatric asthma,” Philip Huang, MD, MPH, Director/Health Authority, DCHHS. “By leveraging real-time data, PASS has enabled us to pinpoint geographic areas where asthma prevalence and hospitalizations are disproportionately high, so we can more effectively target our resources and interventions to the communities that need them the most.”
The Pediatric Asthma Vulnerability Index and all indicators are categorized as Very High, High, Moderate, Low, or Very Low Risk based on their impact on pediatric asthma vulnerability in the community. On the website dashboard, users can drill down from the Vulnerability Index view to specific indicator views by clicking on specific indicators of interest or navigating to the “Other Indicators” tab. The user can also navigate the map from a ZIP Code view to a census tract view and can select a specific geography of interest for further analysis.
At every geographic level, a risk-driven, color-coded map is displayed in the center with demographic data included below the map. The top indicators contributing to the Vulnerability Index are displayed to the right of the map. To the right of each gauge, an impact score shows the degree to which the indicator contributes to the Vulnerability Index within a selected geographic area. Each gauge has a central black line indicating the vulnerability quintile of the indicator within Dallas County.
“The two years PASS has been running have been a huge benefit to Dallas County as community residents and stakeholders have had single source of precise, timely, and actionable data insights at a highly localized level to identify areas at high-risk for poor asthma outcomes,” said Yolande Pengetnze, MD, Senior Vice President, Clinical Leadership at PCCI. “More importantly, PASS strengthens public health leaders’ ability to plan, design, deploy, and evaluate pediatric asthma programs because they now have a single source of truth as a robust data source.”
Additional indicators are presented under “Other Indicators.” While these indicators were not retained in the Vulnerability Index prediction model, they provide the user with additional, actionable insights into drivers of asthma vulnerability in the community, such as the proportion of the population reporting tobacco smoking in the neighborhood.
“In this example,” said Dr. Pengetnze, “If a child with poorly controlled asthma lives in a census tract with a high prevalence of smokers and low controller medication use, the clinical provider might initiate caregiver education about secondhand smoking and medication adherence. Additionally, public health entities might address access to medication and smoking cessation programming at the community level.”
The PASS supports Parkland’s and DCHHS’ communitywide pediatric asthma programming and has been has also been used to engage parents or caregivers to participate in Parkland’s educational, interactive, pediatric asthma text-messaging program designed to help parents manage their child’s asthma.
*This work is funded in part by Lyda Hill Philanthropies. Lyda Hill Philanthropies encompasses the charitable giving for founder Lyda Hill and includes her foundation and personal philanthropy. Our organization is committed to funding transformational advances in science and nature, empowering nonprofit organizations and improving the Texas and Colorado communities. Because Miss Hill has a fervent belief that “science is the answer” to many of life’s most challenging issues, she has chosen to donate the entirety of her estate to philanthropy and scientific research. For more details visit lydahillphilanthropies.org.
PCCI Sets Friday, Aug. 8 for Sachs Summer Scholars Innovation Showcase
PCCI’s Sachs Summer Scholars Innovation Showcase has been set for Friday, August 8, 2025 from 9 a.m. to Noon in room 101 at Pegasus Park. PCCI’s Sachs Summer Scholars is an internship program that advances women in STEM and data science. This end-of-term showcase spotlights the work of PCCI’s elite group of interns who worked side-by-side with our clinical, technical and data science experts on real projects of substantial impact. The intern showcase will also provide an inside view into the diverse and innovative work PCCI does every day in support of underserved communities.
The Sachs Summer Scholars intern showcase demonstrates PCCI’s ongoing commitment to supporting women in the data science and technology industry. This program has become one of the premier internships in North Texas that immerses students in meaningful, real word projects with measurable impact. This includes providing each intern direct experience with innovative healthcare case studies, groundbreaking and responsible artificial intelligence applications and social determinants of health projects. The aim is to support and promote practical applications of analytics, computing, and data science all while advancing the spirit of mentorship and advancement of female students.
At the research showcase, the interns will highlight their work on core projects that include core, innovative projects PCCI created that include advanced AI and non-medical determinants of health analytics.
To learn more about PCCI’s programs and the impact on the community, take a look at last year’s program video.
Please, mark this exciting program on your calendar now!
In The News: Health IT Analytics Takes a Deep Dive into PCCI’s Suicide Prevention Program
Recently, Health IT Analytics interviewed PCCI’s Jacqueline Naeem, MD, Senior Medical Director, and Kimberly Roaten, PhD, ABPP, professor in the Department of Psychiatry at University of Texas Southwestern Medical Center and associate chief quality and safety officer for Behavioral Health – Parkland Health about the suicide screening and prevention program that is being used in all of Parkland’s facilities.
Parkland Health & Hospital System (PHHS) and Parkland Center for Clinical Innovation (PCCI) in Dallas, Texas have successfully achieved this with their Universal Suicide Screening Program. Two experts from the initiative sat down to discuss the program’s hurdles, successes, and future plans in a recent episode of Healthcare Strategies.
In this video from the recent Invest Dallas-Fort Worth Launch Conference, PCCI’s CEO Steve Miff, PhD, moderated a panel, “Closing the Gap: How educators and healthcare professionals collaborate to improve healthcare outcomes, the talent gap, and workforce wellbeing.” This important panel discussed providing more access to care, the importance of unbiased data, and strategies to improve healthcare outcomes.
PCCI Receives “Achievement in Innovation” Award at D CEO Excellence in Healthcare Awards
PCCI is proud to receive the “Achievement in Innovation” award from DCEO and we congratulate the other award finalists award for their service to the community. The program recognizes industry leaders and organizations for their industry achievements and impact on the North Texas economy. The award was received by PCCI’s CEO Steve Miff, PhD.
This past year, PCCI’s mission of innovation to help the most vulnerable in our communities led to the development of:
-The Community Vulnerability Index that enables its users to visualize and more fully understand the context and complexities of the social barriers to health, access, and well-being of a community’s most vulnerable populations. https://lnkd.in/gMatRiSc
-The Pediatric Asthma Surveillance System: A collaboration between PCCI, Parkland Health and Dallas County Health and Human Services (DCHHS) that created a public dashboard that describes community-level information regarding pediatric asthma risk factors in Dallas County. https://lnkd.in/gJYNvThp
-Preterm Birth Prevention: This ongoing program helps to keep at-risk mothers on track for full-term births. https://lnkd.in/gQHpsGgE
