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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.

I don’t care about c-stat or PPV or
Sensitivity!
Show me the value.
COPYRIGHT 2019 PCCI. All Rights Reserved.

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!
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Design Thinking Framework
Iterative
&
Non-Linear
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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
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.
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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
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MULTI-TENANT ARCHITECTURE WITH CLOUD SCALABILITY
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Personalized Medicine at
Scale
SCALABLE MACHINE LEARNING
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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
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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
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Case Study: Pediatric Asthma

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

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
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Sustained cost savings
over 3 years
• ~$18M saved in 3
years
• 5X ROI
PROGRAM IMPACT - COST
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• 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
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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
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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
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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
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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
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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
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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
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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.