Powerful predictive analytics and mobile technology
improve the lives of children with asthma in Dallas
Donna Persaud, MD, MBA | Vice president of Clinical Leadership, Parkland Center for Clinical Innovation
An innovative program driven
by predictive analytics
and mobile technology
engagement has improved the
lives of thousands of children
with asthma in Dallas. The population
health framework integrated with powerful
predictive analytics in its third consecutive
year of intervention was developed for
children covered under Parkland Community
Health Plan (PCHP) by Parkland Center for
Clinical Innovation (PCCI).
Asthma is one of the most common
chronic diseases for children under the age
of 18, with 6.2 million affected individuals.
More than 8% of children have asthma,
most with symptoms occurring before five
years of age. Asthma disproportionately
affects low-income, minority and innercity
populations, with African-American
children at highest risk. In this scenario,
variations in care can significantly
compound the negative effects of the
disease. Asthma is a significant driver of
school absenteeism, with an estimated 12 to
15 million school days lost per year.
Asthma impacts both families and the
healthcare system financially and socially.
Childhood asthma is the cause of nearly
5 million physician visits and more than
200,000 hospitalizations each year. Medical
expenses for a child with asthma are almost
double those for a child without the disease.
Given these statistics, there’s a compelling
need for early identification and effective
intervention to control this disease.
Approximately 30,000 children are risk
stratified monthly for risk of an emergency
department visit or hospitalization. The
resulting risk stratification is used to embed
algorithms into updated workflows and to
align and connect services while engaging
the children and their caregivers. The
updated intelligent system of care gets
everyone on the same page and allows the
best use of resources at each setting and
encounter.
Goals of the program are to reduce
asthma emergency department visits and
hospitalizations, increase patient adherence
to medication and clinic visits, and increase
evidence-based leading practices at the
provider level.
16 Dallas Medical Journal November 2018
PCCI Pediatric Asthma Framework
Processes and workflows
Through tailored clinical workflows, monthly provider reports, point-of-care EHR
integration, and patient-centric mobile messaging applications, the framework engages
providers, communities, patients, and their families to optimize care, drive engagement and
reduce unnecessary utilization.
Within three years, deployment of the program in the Dallas metro area by a large health
plan resulted in:
• 32% – 50% increase in the appropriate prescription of controller medications
• 31% reduction in ED visits
• 42% reduction in asthma-related inpatient admissions
This framework has resulted in a more than 40% drop in the cost of asthma care, with the
health plan saving over $18 million for both patients and healthcare providers.
Streamlining the care system and community
The key to this pediatric asthma framework is that the clinicians, patients, payers of chronic
disease programs, case managers, and health systems are all engaged, which generates value
for all parties involved. With a foundation in literature-based evidence, the framework aligns
with national and international guidelines. It is modular and patient-friendly, offering levels
of interventions based on patient risk score, needs and available resources.
This risk stratification-driven comprehensive population health framework consistently:
• Increases patient adherence to medication and clinic visits
• Educates patients in care and self-management
• Optimizes health plan to care manager outreach and workflow
• Engages physicians via direct EHR alerts
• Reduces preventable asthma ED visits and hospitalizations