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.
PCCI’s COVID-19 Efforts To Bend the Curve In Dallas
PCCI became involved with Dallas County Health and Human Services (DCHHS), Parkland, and other civic, hospital, and public health leaders at the outset of the COVID-19 pandemic to address the multiple challenges the pandemic presented to care providers and the community. In order for DCHHS to launch public health initiatives to reduce the spread of COVID-19, it needed access to real-time, hyper-localized data to track infection rates, monitor effectiveness of local efforts, identify emerging “hot spots” and high-risk areas for proactive education and testing, and forecast community needs.
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.
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.