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Using AI and Design Thinking To Help Kids With Asthma

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Parkland Center for Clinical Innovation (PCCI) uses AI to risk stratify individuals and embed actionable insights at the point of care. We do this using design thinking so that our AI based solutions solve real healthcare problems. In this presentation, we talk about how we used this framework to generate a solution that helps kids with pediatric asthma in North Texas.

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Using AI and Design Thinking To Help Kids With Asthma

  1. 1. COPYRIGHT 2019 PCCI. All Rights Reserved.
  2. 2. Show Me The Value! Vikas Chowdhry Chief Analytics & Information Officer, Parkland Center for Clinical Innovations Using Design Thinking to Make Machine Learning Actionable in Healthcare COPYRIGHT 2019 PCCI. All Rights Reserved.
  3. 3. I don’t care about c-stat or PPV or Sensitivity! Show me the value. COPYRIGHT 2019 PCCI. All Rights Reserved.
  4. 4. Goals for The Next 30 Minutes •Introduce design thinking framework •Overview of machine learning framework used by PCCI •How we apply design thinking to our projects •Keep you awake! COPYRIGHT 2019 PCCI. All Rights Reserved.
  5. 5. Design Thinking Framework Iterative & Non-Linear COPYRIGHT 2019 PCCI. All Rights Reserved.
  6. 6. CREATING A WORLD OF CONNECTED COMMUNITIES WHERE EVERY HEALTH OUTCOME IS POSITIVE Clinical Insights Data Science Expertise Innovation Framework Innovation process and discipline, building breakthroughs and leading change Prescriptive analytics and artificial intelligence driving personalized and precision medicine Leading clinical expertise applying practical insights across the continuum of care COPYRIGHT 2019 PCCI. All Rights Reserved.
  7. 7. 7 PCCI ECOSYSTEM Non-profit, Innovation, Early Stage Advanced Analytics R&D Organization For-profit, Technology and Advanced Analytics Company One of the largest and most technologically advanced public health systems in the world serving a very diverse and vulnerable population. COPYRIGHT 2019 PCCI. All Rights Reserved.
  8. 8. 8 PERSON-FOCUSED TECHNOLOGY Data Healthcare SDOH Genomics Analytics Predictive Prescriptive AI PCCIPORTAL - AZURE CLOUD BASED ANALYTICS PLATFORM Data Ingestion and Normalization Batch and Streaming (IoT) Data ML Library NLP Deep Learning Models Application Programming WORKFLOW INTEGRATIONS FOR ACTIONABILITY Mobile App & Texting Platform for Patient Engagement Integration with CBO Workflows Integration with IoTs (Alexa, Wearables) Integration with EHRs COPYRIGHT 2019 PCCI. All Rights Reserved.
  9. 9. MULTI-TENANT ARCHITECTURE WITH CLOUD SCALABILITY COPYRIGHT 2019 PCCI. All Rights Reserved.
  10. 10. Personalized Medicine at Scale SCALABLE MACHINE LEARNING COPYRIGHT 2019 PCCI. All Rights Reserved.
  11. 11. CREATING A WORLD OF CONNECTED COMMUNITIES WHERE EVERY HEALTH OUTCOME IS POSITIVE Clinical Insights Data Science Expertise Innovation Framework Translation: 1. Enable individuals and families to live a healthy, productive life in their communities • Aka – Population Health 2. If admitted to a healthcare facility, enable individuals to recover safely and most efficiently so that they can go back to #1 COPYRIGHT 2019 PCCI. All Rights Reserved.
  12. 12. Keep Them Healthy Recover Safely and Efficiently Preventing Pediatric Asthma Early Warning System to prevent ICU admissions Maternal Care: Eliminating Pre- and Post- Birth Complications Avoiding Sepsis Self-Administered Outpatient Parenteral Antimicrobial Therapy Optimizing Palliative Care In-home Patient Engagement– Mobile; Digital Personal Assistant; IoT Enabled monitoring Prevention of Adverse Drug Events (PARADE) Reducing Oncology Admissions Optimizing Length of Stay and Transitions of Care Connected Communities of Care (Social Determinants of Health) OUR PROGRAMS COPYRIGHT 2019 PCCI. All Rights Reserved.
  13. 13. Case Study: Pediatric Asthma
  14. 14. PEDIATRIC ASTHMA PROGRAM • All pediatric asthma patients screened: AI/ML algorithm generates risk- stratification profiles and identifies high risk patients for follow up • Coordinated intervention (physician alerts, case management prioritization, and patient engagement) • Saves costs through decreased ED visits and admissions • 3 years of documented success Parkland Community Health Plan
  15. 15. Clinical Improvement • 32% - 50% improvement in asthma controller medication prescription • 15% improvement in the asthma medication ratio (HEDIS metric) • Patient engagement - 70% high satisfaction and Utilization Improvement • 31% drop in annual rates of asthma ED visits • 42% drop in annual rates of asthma inpatient admissions • 40% drop in total annual costs • $18M savings Financial Improvement Results: $18,000,000 in Savings over 3 Years COPYRIGHT 2019 PCCI. All Rights Reserved.
  16. 16. Sustained cost savings over 3 years • ~$18M saved in 3 years • 5X ROI PROGRAM IMPACT - COST COPYRIGHT 2019 PCCI. All Rights Reserved.
  17. 17. • Control#1: DFWHC dataset Medicaid <18 yo o 5% drop in asthma ED visits • Control#2: All PCHP members <18 yo o 10% drop in asthma ED visits • PCCI Asthma Program o 31% drop in asthma ED visits • Intervention-specific impact: 21-26% drop in asthma ED visits Controlled Analyses 2015-2017: PROGRAM IMPACT ON ED VISITS PERSISTS IN CONTROLLED ANALYSIS COPYRIGHT 2019 PCCI. All Rights Reserved.
  18. 18. HOW DESIGN THINKING DELIVERED VALUE TO PCHP AND ITS MEMBERS • Observe • Engage • Immerse • Working families with busy lives need help to better manage asthma conditions of kids in their families • Engaged individuals are healthier individuals • ED Visits for Asthma are terrible for everyone Empathize to Gain Insights Insights COPYRIGHT 2019 PCCI. All Rights Reserved.
  19. 19. HOW DESIGN THINKING DELIVERED VALUE TO PCHP AND ITS MEMBERS • Draw a line from empathy to problem definition • Working families with busy lives need help to better manage asthma conditions of kids in their families • Appointment Reminders • Education • Resource Availability • Engagement • Their needs vary based on Asthma acuity, individual family conditions and their social-economic conditions Define to Express The Problem Problem Definition COPYRIGHT 2019 PCCI. All Rights Reserved.
  20. 20. HOW DESIGN THINKING DELIVERED VALUE TO PCHP AND ITS MEMBERS • Ideate is the mode in which you generate radical design alternatives • Use a predictive model to risk stratify populations to deliver precise, targeted interventions in an efficient manner • Use text messaging to educate and engage • Drive richer engagement with mobile applications • Think of newer modes of communications such as Alexa • Try radical alternatives like gamification to drive engagement Ideate to Innovate Fiercely Potential Innovations COPYRIGHT 2019 PCCI. All Rights Reserved.
  21. 21. HOW DESIGN THINKING DELIVERED VALUE TO PCHP AND ITS MEMBERS • Prototypes are most successful when people can experience and interact with them Prototype to Understand, Explore & Inspire Engaging Health: Richer application for patient education and engagement COPYRIGHT 2019 PCCI. All Rights Reserved.
  22. 22. HOW DESIGN THINKING DELIVERED VALUE TO PCHP AND ITS MEMBERS • Testing may reveal that, not only did you get the solution wrong, but also framed the problem incorrectly Test to Learn & Refine Learnings from Tests COPYRIGHT 2019 PCCI. All Rights Reserved.
  23. 23. DESIGN THINKING HELPS US EVERY SINGLE DAY “If you don't know where you're going, you'll end up someplace else.” It provides us our true north! “Delivering value in healthcare is 90% care-redesign, and the other half is technology” It keeps us away from being infatuated with technology for technology’s sake COPYRIGHT 2019 PCCI. All Rights Reserved.
  24. 24. QUESTIONS? “If you don't know where you're going, you'll end up someplace else.” "Baseball is 90 percent mental, and the other half is physical.“ Contact: vikas.chowdhry@pccinnovation.org www.pccinnovation.org Thanks to the great philosopher, Yogi Berra for those pearls of wisdom! COPYRIGHT 2019 PCCI. All Rights Reserved.

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