Hot spots help health care

PBS Frontline looks at how one urban physician, Dr. Jeffrey Brenner, has figured out how to fix our health care system – by using digital maps:

I went to the hospital that I worked for and submitted a proposal to collect patient-level information for everyone who had had an accident or injury, so this included people who had been shot, people who had been assaulted or fallen down the stairs. We got the data and began — it was a student project. I was working with a student, and we mapped it, graphed it, charted it, and it was just an unbelievable data set. …

It pretty quickly became clear that there were hot spots of everything. There were hot spots by disease, hot spots by patient; there were certain patients who had been [admitted] over and over and over. There were hot spots by ZIP code and by neighborhood. …

And because I knew the city so well, you could begin to take the data and tell stories with the data. And that’s an incredibly powerful tool for making change.

One percent of the city residents are responsible for about 30 percent of the hospital and emergency room costs. So it’s very, very concentrated. In a one-year period, half the population uses an ER hospital, which is higher than the national rate.

The leading reason to come to an emergency room in Camden over a five-year period is head colds. There were 12,000 visits for head colds. Number two is ear infection. Number three is sore throat. Number four is asthma. Number five is stomach virus. I mean, it’s all primary care problems.

By focusing on those hot spots – by making primary care house calls to the apartments where people were sickest – Brenner proved it’s possible to make limited resources stretch a whole lot further. He’s dropped costs by 40 to 50 percent. He also says there are similar programs to his all across America.

But there’s no billing codes for what they do….

[Hat tip to Mr. Goodstein.]