Profile: Camden ‘Hot-Spotting’ Healthcare Model Captures National Attention

Andrew Kitchenman | October 9, 2013 | Health Care, Profiles
Newly minted MacArthur Fellow Dr. Jeffrey Brenner takes follow-up healthcare to the streets

Camden Coalition of Healthcare Providers Executive Director Dr. Jeffrey Brenner is leading an effort to map "hot spots" where frequently hospitalized patients live, using the data to make healthcare more efficient.
Titles: Medical director of Urban Health Institute at Cooper Health System, executive director of Camden Coalition of Healthcare Providers

Age: 44

Why he has captured national attention: Dr. Jeffrey Brenner was recognized last month as a MacArthur Fellow and awarded one of the so-called genius grants. The foundation cited his success in Camden, which began with Brenner convincing different hospitals and healthcare providers to share patient data.

That allowed the coalition he founded to pursue “hot spotting,” in which neighborhoods and areas throughout the city with the highest number of frequent users of hospital emergency rooms are mapped, and healthcare services targeted before chronic problems become emergencies. “We’re going to catch every hospitalized patient — the most preventable costs in healthcare are unnecessary hospitalizations because we’re not paying attention to people when they get out of the hospital,” Brenner said.

Lessons learned: The coalition has learned how to build partnerships with both hospitals and primary-care doctors, putting its data to use to increase coordination of care. While this has led to an improvement in care for some people, Brenner’s goal is to scale up successful strategies to reach residents throughout the city.

His current focus: Coalition staff members have met many of the most frequent hospital users and helped them schedule meetings with their primary-care providers. But those providers’ offices often aren’t equipped — either with staff or technology — to deliver the level of follow-up care needed by patients with chronic illnesses to make lasting changes in their health. As Brenner puts it: “The next step is how do we get those offices reconfigured so that they’re paying attention to their recently hospitalized patients.”

How activism brought him back to his roots: Brenner once aspired to be a family doctor in a small Western ski town. “I’m not sure where I went off track,” he said, laughing.

While completing his medical residency in Seattle, Brenner became involved in an environmental activist group, which led him to the writings of Alan Durning. He was struck by a story that Durning told about a life-changing conversation with a woman while he was travelling in Asia, who asked him why he wasn’t working to help his own community. The example had a strong effect on Brenner. He realized that despite his time away from the state, he “really cared a lot about how healthcare was delivered in New Jersey.”

An advocate for replacing Camden’s police force with a county-level department: Brenner sees poorly run public safety and schools as contributing to residents’ ill health. He said the “excess mortality” caused by violent crime is largely attributable to the quality of police work in the city. He credits local business and political leader George Norcross and Gov. Chris Christie with making necessary changes.

His response to national attention for concentrating health services on hot spots: Brenner said the attention is unexpected and has led to daily emails and phone calls from medical students, doctors, and hospitals, asking how lessons from Camden can be applied elsewhere. That is allowing him to collaborate with people around the country on what he describes as “the Manhattan Project of our era, which is how to deliver better care at lower cost to everyone.”

On hearing of the MacArthur Fellowship: Brenner was in the middle of a busy workday and ignored a series of calls on his cell and office phone. He had no idea that the award was coming when — by chance – he picked up his office line.

“It’s a pretty amazing thing and they just call you out of the blue,” Brenner said. “I’m glad I picked up the phone.”

Brenner said that he was “humbled and honored” by the prestigious award.

“It’s so exciting, because trying to fix healthcare in America in the poorest city in the country is a pretty challenging task and this adds wind to our sails,” he said. “It gives momentum to the work.”

He credited three organizations — the Nicholson Foundation, which initially funded the coalition; the New Jersey Health Care Quality Institute and its leader David Knowlton, who provided advice; and the Cooper Health System, which has been a close partner — with being essential to making the MacArthur possible.

Brenner already has plans for the initial payments of the five-year, $625,000 fellowship: pay off the business loan that he took out to launch his primary care practice in Camden.