‘Hot Spotting’ Health
1/26/2012 2:05:20 PM
If you know me, you’ve probably read an article that was published earlier this year in The New Yorker.
You’ve probably read it because I wouldn’t leave you alone until you did.
The article, “The Hot Spotters,” was written by a physician, Dr. Atul Gawande, and detailed the tack that some healthcare providers are taking that could revolutionize how health care is accessed in this country.
Dr. Gawande begins by explaining the Compstat approach to community policing. Developed by William Bratton, a New York City police commissioner in the 1990s, Compstat used computer models to map crime, allowing the police to focus their resources on areas that were “hot spots” for criminal activity.
While there’s absolutely nothing criminal about being ill, some healthcare providers around the country are learning that a similar approach can be applied to focusing medical resources in the areas and populations where the need is the greatest – the healthcare “hot spots.”
In Camden, N.J. – a “city in civic freefall, on its way to becoming one of the poorest, most crime-ridden cities in the nation,” – Dr. Gawande points out a physician there who crunched the data and found that just 1 percent of the 100,000 Camden residents who utilized the city’s healthcare system accounted for 36 percent of its costs.
One patient alone had 324 hospitalizations during the past five years, and the most expensive patient in the city had cost insurers $3.5 million on his own.
The Camden physician who ran the numbers – Dr. Jeffrey Brenner, a family practitioner – explained that emergency room visits and hospitalizations are “failures of the healthcare system.” Effective, timely care – the right care at the right time – can often catch and treat health problems before they reach the point of putting a person in an emergency department or in the hospital.
For the 1 percent of people representing 36 percent of the costs in Camden, receiving the right care at the right time simply was not happening.
That’s food for thought for healthcare providers right here in west Georgia. Are we failing our patients? What can we do differently – do better?
At Tanner, we’ve long had a focus on expanding access to care to areas of the region where medical services are sorely lacking – places like Franklin, Tallapoosa and western Paulding County. This has been a sort of informal hot spotting, making primary care services – the kind that can catch and treat most illnesses early – easier for the elderly, the ill and the just plain busy to access.
But we’re also evaluating a new approach to care – establishing a “medical home” – which I will write more about later.