Special to The Dallas Examiner
In health care, as with other industries, crisis often inspires innovation. On March 11, Parkland Health & Hospital System admitted its first patient with COVID-19. In an attempt to help contain the spread of the novel coronavirus in the community, Parkland quickly partnered with the Parkland Center for Clinical Innovation to develop an innovative technology-based solution to the challenge of identifying people most at risk of exposure to the virus, alert them of their risk and provide early diagnosis and treatment for those already infected.
The Proximity Risk Index generates a score for each patient using a sophisticated machine-learning algorithm, geo-mapping and hot-spotting technology to generate a dynamic personal risk score based on an individual’s proximity to other confirmed, active COVID-19 cases. Parkland created three initiatives utilizing the index to help triage which patients they should reach out to proactively to assess their needs.
“This project utilizes the key skillsets of Parkland and PCCI – innovation, public service, outreach and community engagement – in service of our patients and the residents of Dallas County. It is greatly extending our reach in combatting COVID-19 effectively, particularly for the most vulnerable in our community,” said Brett Moran, MD, senior vice president and chief medical information officer at Parkland.
The first initiative, dubbed Proximity Index 1.0, was developed and implemented in the spring to identify patients with appointments in the next 1 to 2 days who would be coming for an in-person visit at a Parkland facility. The goal is to find those at risk of having COVID-19 and triage them prior to the appointment to reduce risk of spreading the disease to others in the waiting room or clinic. For those who triage positive (i.e., suspected to be exposed), Parkland offers them a COVID-19 test and a virtual visit. To date, Parkland has screened more than 8,000 patients with this tool.
The second initiative, Proximity Index 2.0 rolled out the week of Sept. 8 to address the risks and needs of patients who are not coming into the health system in the next 30 days but have been seen in the past year. The goal is to connect directly with more Dallas County residents who are at higher risk of getting COVID-19 and at higher risk of poor outcomes if they should get it. Engaging people before they are sick or at early stages of illness can help aid recovery and prevent further spread of COVID-19 to family, friends and the community.
These patients receive a text from Parkland asking a few questions about their health and activities to help determine potential exposure to, or illness due to, COVID-19. If the patient screens that they are at risk for COVID-19 exposure, they are provided information about where to get tested and instructions about staying safe. Parkland also asks patients with COVID-related symptoms if they have medical needs and if so, arrange for a virtual visit for the patient, help obtain refills for medications or meet other health care needs.
Individuals are also assessed for their risk for food insecurity. Parkland has partnered with a local community-based organization that will deliver food to these potentially ill individuals who need good nutrition to keep them well or help recover from illness.
“The work PCCI does to connect providers with other community services to improve patients’ social determinants of health is more important now than ever,” said Steve Miff, PhD, PCCI president and CEO.
A 43-year-old Parkland patient developed symptoms of COVID-19 in July a short time after her husband was treated for the infection at Parkland Memorial Hospital. A Parkland community health worker followed up with the family to ask if they needed assistance with safely scheduling health care visits, obtaining groceries, financial aid for medical expenses or other needs. The patient later expressed that she was grateful for the outreach program during a difficult time.
The third initiative, Proximity Index 3.0, created geo-mapping of all COVID-19 cases across Dallas County. With the assistance of PCCI, Parkland identifies trends of where cases are growing, then mobilizes its staff of community health workers along with community leaders to disseminate information to those areas regarding staying safe, monitoring for symptoms and resources for where to get tested and obtain medical help.
To date, Parkland has text messaged more than 210,000 individuals and phone called more than 108,000 individuals with targeted messaging. Parkland Community Health Workers have had more than 2,800 encounters with at-risk patients, providing social/behavioral support, assistance with medications, COVID-19 education, appointment navigation and telehealth appointments.