Taking the Fight to COVID-19

PCCI’s data-driven approach has helped Dallas leaders make pandemic-management activities more transparent and precise through an enhanced approach to disease prevention and mitigation.

BMJ Journals: 5 Methods and tools for situational awareness and equitable decision-making during COVID-19

Read a presentation abstract, co-authored by PCCI’s Steve Miff, that highlights the evolution of PCCI’s COVID-19 vulnerability index
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New COVID-19 Analytics Dashboards Unveiled by Consortium of Healthcare and Data Experts Tracks Levels of Protection Against the Virus at the County Level

Data on COVID-19’s ever changing behavior and its potential impact at the county level is now available with
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Children’s COVID-19 Vaccine: A Key to Protecting Pediatric Asthma Patients

By Yolande Pengetnze, MD, MS, FAAP, PCCI’s Vice President of Clinical Leadership What Has Everyone Excited about COVID-19
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Dallas Morning News: Big data, big impact: How Dallas researchers and providers are targeting vaccines to fight COVID

Dallas Morning News: Big data, big impact: How Dallas researchers and providers are targeting vaccines to fight COVID
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DCEO Healthcare: Info Envy: Dallas County’s Public Health Data Is Among the Best in the Country

One of Dallas’ top media outlets, D CEO Healthcare, ran a story on the reaction to PCCI, IHI
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MSN News: DFW hospital beds filling up with COVID-19 patients; Delta making it harder to reach herd immunity

MSN News: Across the state, more than 23,000 new positive COVID-19 cases were reported. And the Delta variant,
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PCCI’S COVID-19 EFFORTS TO BEND THE CURVE IN DALLAS

PCCI, Parkland, and Dallas County Health and Human Services (DCHHS) have collaborated from the outset of the pandemic to address the multiple challenges COVID-19 has presented to care providers and the community. Our collaborative efforts centered on the following developments:

These programs and solutions included:

  1. Geo Mapping and Hotspotting. Uses hotspotting trends and block level information to guide testing strategies and increase awareness, messaging, and stay-safe initiatives in the community and in high-density facilities, like nursing homes.
  2. Capacity Forecasting Model. Leverages deployed frameworks for geocoded information and forecasts for tracking the course of the disease, with scenario mapping for Parkland hospital beds, ICU, and ventilator census; assists in planning bed capacity, staffing needs, and development of workflows.
  3. Proximity Index (PI). AI predictive model that empowers frontline clinical and population health teams to proactively manage high-risk patients and reduce potential spread from asymptomatic patients in hospital and community settings. Including MyPCI application for individual level engagement.
  4. We created the Vulnerability Index (VI) tool by geomapping data from disparate sources to identify―for proactive interventions― sub-populations who are at high risk for complications and mortality from COVID-19 and/or who harbor other SDOH factors that place them at greater risk of infection.
  5. Virtual Learning Index (VLI) + School COVID Risk (SCR). AI predictive model that incorporates SDOH to evaluate COVID risk at school. VLI is derived from a set of sub-indices incorporating SDOH and is evaluated in the context of SCR, which reflects COVID risk, including census tract rates, mobility patterns, and outside individuals entering the school area.
  6. Vaccine Distribution Protocol. As a prioritization protocol, assists Parkland and Dallas County in distributing the COVID vaccine to vulnerable communities. PCCI derived the protocol using our understanding of the Dallas healthcare provider landscape and Centers for Disease Control and Prevention (CDC) recommendations.
  7. Herd Immunity Methodology and Prediction. Dashboard creation, including metrics and indicators, and analytics to facilitate and drive effective decision-making for county leadership regarding Dallas County COVID-19 risk and incidence.

PCCI’s advanced analytics worked to guide the local COVID-19 response that has been recognized nationally with several publications in the New England Journal of Medicine and many local and national media outlets.

To address this Public Health Challenge PCCI leveraged our CCC network to mitigate mortality and morbidity tied to COVID-19.

Our CCC network aligning and connecting healthcare providers and community-based organizations (CBOs) across Dallas allowed us to quickly assemble data to provide geospatial analysis to help identify hotspot neighborhoods where the virus was having a disproportional impact on residents, and then turn that information into targeted communications and tactical containment efforts through community-wide awareness and education messaging and guided testing strategies. We also created a Vulnerability Index (VI) tool by geomapping data from disparate sources to identify―for proactive interventions― sub-populations who are at high risk for complications and mortality from COVID-19 and/or who harbor other SDOH factors that place them at greater risk of infection. DCHHS, Parkland, and PCCI have also collaborated to facilitate the contact tracing process, with positive results.

With Isthmus, the geospatial analysis for Parkland and Dallas County was hosted for regular updates, via COVID Hub website, in a record 4 weeks’ timeframe amidst the critical first COVID-19 surge in early Spring 2020.

CRITICAL RESOURCE MANAGEMENT

Given the large and diverse patient population that Parkland serves as the area’s largest safety-net hospital, it functioned as a focal point for the Dallas COVID-19 response. But it faced a Care Delivery Capacity Challenge, given the disproportionate number of complex patients served, which can quickly exhaust its critical care bed capacity and intensive care resources. To solve this challenge, in collaboration with Parkland, PCCI created a capacity forecasting model that can evolve with disease surges. The model maximizes the available information to provide clarity for public health leadership by use of deployed frameworks for geocoded information and forecasts that hospitals and communities can use to track the course of the disease.

FRONTLINE SUPPORT

Finally, we knew that initial criteria used at the pandemic’s outset, such as travel history, were not specific enough since the infection rates (and disease progression) became highly localized. Frontline staff needed additional real-time information about patient exposure to ensure effective testing, triage, prioritization, and follow-up. To address this Frontline Care Management Challenge, PCCI created an Index to Manage Proximity through early identification of high-risk individuals. This index provided geocoded, confirmed COVID-19 cases at the block level and density details of the population living in that proximity. Index scores were incorporated into existing Parkland workflows and COVID dashboards to better manage scheduled outpatient visits and inform care management for unscheduled ED visits. The goal is to identify high-risk patients with upcoming appointments in the next 48 hours and then triage those identified as high risk for proactive outreach and to reduce spread through virtual visits and testing.
PCCI created an additional version of this index (Proximity Index 2.0) to screen a broader list of Parkland patients, including those with at least 1 appointment in the past 18 months. Since July 22, Proximity Index 2.0 has identified 17,206 High Risk patients. PCCI’s data-driven approach has helped Dallas leaders make pandemic-management activities more transparent and precise through an enhanced approach to disease prevention and mitigation.

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