Health system executives noticed something odd in their data: patients on Chicago's West Side were visiting the hospital for asthma-related complications at a far higher rate than anywhere else in their system.
Clinicians consider asthma hospitalizations to be generally avoidable with proper management. Yet after providing patients with superb treatment, subsidizing their medication, and empowering them with knowledge, they watched the same patients return to the hospital only weeks later.
This hotspot was not notable for anything they could think of that typically causes or exacerbates asthma. It was full of parks, far from highways, and immediately next to a world-class medical district.
Metopio gave the health system access to what they weren't able to see in just their clinical data: the community context.
Combining de-identified, aggregated data from the health system with Metopio’s curated data sets made it easy explore factors that set the West Side apart and correlated strongly with asthma.
What stood out in particular was the old housing stock in the target neighborhoods - particularly buildings that had not been well-maintained since they were built in the early 20th century. A dataset of building violations provided the clearest evidence for this.Hover over the trend line for details. A regression analysis within Metopio shows that building violations have a highly significant relationship with asthma admissions, even after controlling for demographics and socioeconomic status.
On average, these asthma hospitalizations cost $11,000 per patient, and as the patients were generally on Medicaid or uninsured, the hospital was providing these services with little to no reimbursement.
Metopio moved the hospital from a reactive understanding of asthma to a contextualized and predictive approach. Using these insights, the hospital developed a pilot to screen patients who had been to the hospital for asthma in the past year to understand their living conditions.
Patients who met the screening criteria were offered in-home assessments and subsequent minor home improvements to address asthma triggers such as mold remediation, HVAC repairs, furnace cleaning, carpet replacement and integrated pest management.
Not one of the 20 patients in the initial pilot were readmitted for asthma and their outpatient visits fell by 80%.
On average, the hospital had a $7,300 positive variance between the $11,000 emergency room admission and the $3,700 it cost for screening, inspection and remediation of asthma triggers in the home.
This pilot is now being used as the basis to talk with insurers about payment for the program, potentially turning the large cost of treating repeated asthma admissions into a reimbursable program that keeps the patients healthier and saves the broader healthcare system money.
This is just one way Metopio can create insights to meet your healthcare challenges so you can chart your course of action. What’s your biggest challenge?