pre-term birth Archives – 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.

##

14 August 2019

D CEO Healthcare: Avoiding Pre-Term Birth with Text Messages




D CEO Healthcare features PCCI’s work with the Parkland Community Health Plan and Parkland Hospital on pre-term birth prevention. The results of this work show how PCCI and Parkland are working together to develop innovative ways to improve healthcare for the under-served in our community.

##

Avoiding Pre-Term Birth with Text Messages in Dallas

At the Parkland Center for Clinical Innovation, data analytics and technology are improving outcomes for underserved pregnant women in Dallas. One significant way to reduce maternal and infant mortality is to avoid pre-term birth, and in 2017, Texas had a 10.4 percent pre-term birth rate – earning a D in the annual ranking from March of Dimes.

PCCI is a nonprofit that marries data science and social determinants of health to improve outcomes for  underserved populations in Dallas. In one of its initiatives, the group targeted 700 women at risk of pre-term birth, and engaged them with a series of text reminders about everything from general wellness and prescriptions to what to expect and pre-natal appointments. Avoiding pre-term birth is beneficial for the women and children, but for a hospital like Parkland where the majority of the care they provide is uncompensated, keeping mothers healthy and babies out of the NICU can significantly reduce costs.

The women were enrolled in the Parkland health plan, which reached out to them to get the women signed up for the texting system. Pre-term birth can be a difficult thing to predict, says Dr. Joseph Chang, Associate Chief Medical Officer for Outpatient and Ambulatory Services at Parkland. Traditionally, the only way to know if a women was going to have a pre-term birth was if she had a past pre-term birth. But he says that a couple of interventions, including progesterone shots, can make a huge difference.

“Adherence to medicine is the biggest factor,” Chang says. “If we really were able to identify the right people, use a platform for today’s young parents, maybe that would really work.”

Because Parkland is both the health plan and the healthcare provider, PCCI was able to access both sides of the payer relationship in a way that can be difficult to access in traditional healthcare systems. Their system brought the electronic health record together with behavioral health information to identify the women, and yielded impressive results.

Appointments were closely monitored, with PCCI measuring data along the way to adjust the text messaging and tailor it to the patients’ needs. After just one year, women in the program increased prenatal visit attendance by 24 percent, reduced pre-term birth by 27 percent. The program also reduced post-delivery cost by 54 percent in the first year.  The 679 women who enrolled saved the system $1 million in the first year.

Fighting healthcare battles before the patient arrives at the doctor is important for PCCI CEO Steve Miff. “Health begins where we work, live, learn, play, and pray,” he says. “We are moving upstream, because if they are not addressed it will have a negative impact on health.”

Politico covered PCCI’s efforts to reduce frequent flyers by targeting patients who lacked many of the supports needed after they left the hospital. Their software connected social service agencies to the healthcare system to refer patients to get those services outside of the hospital, which would be cheaper and more efficient than seeing patients return again and again because they lacked food or housing. The impact was significant. The pre-term birth program is another way to head off medical costs before they happen.

Looking ahead, PCCI hopes to continue to fight social isolation to provide access to services, improving many of the behavioral and environmental factors that negatively impact health. “How do we use digital tech and bring women together, create clusters of similar individuals, customize behavioral therapy?” Miff says. “We can do that via a digitally provided environment, we can do it from home, and bridge the gap via telemedicine.”

Chang sees this technology being applied to any number of ailments, but sees a massive opportunity in addressing diabetes treatment. There are apps for measuring and taking glucose, but the texting might be more effective because it doesn’t require another application. “The biggest problem is taking their medicine – taking it and taking it correctly.”

https://healthcare.dmagazine.com/2019/08/13/avoiding-pre-term-birth-with-text-messages-in-dallas/
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