Camden Coalition’s Tracking of Healthcare ‘Hot Spots’ Could Spread Statewide

Andrew Kitchenman | January 10, 2014 | Health Care
Nationally recognized program to work with five communities to gather data to better target medical resources

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.
New Jersey already has one organization that’s received national attention for targeting healthcare by mapping “hot spots” where frequently hospitalized patients live, but soon it may have several groups pursuing the same approach.

The Camden Coalition of Healthcare Providers will be working with five other groups or hospitals to develop “hot-spotting” tools to improve patient care, as part of a project sponsored by the Nicholson Foundation.

Coalition Executive Director Dr. Jeffrey Brenner has led an effort to use data to better understand why some people become frequent users of hospital emergency departments and why some areas have a higher frequency of inpatient admissions.

For example, the coalition mapped out where patients with chronic diseases like diabetes and congestive heart failure live, then targeted those areas for intensive visits from nurses and others to make sure the patients were taking their medication and keeping appointments with healthcare providers.

The effort has received national attention, and Brenner recently was named a MacArthur fellow.

Now the coalition is working the Affiliated Accountable Care Organizations (AACO), a coalition of groups focused on improving healthcare by better coordinating care, to spread the model across the state.

Other organizations interested in coordinating care provided by multiple healthcare providers could apply to be a part of the “hot-spotting” initiative. Project organizers said participation by local hospitals is crucial, since they must provide the patient data needed to create the “hot-spotting” tools.

Brenner said careful analysis of patient data could result in big opportunities for savings.

“Everywhere we look, we find waste and lack of productivity in healthcare, so I think we all have our work cut out for us,” he said during a webinar held yesterday by the AACO, an initiative of the nonprofit New Jersey Health Care Quality Institute, and the Camden Coalition, to provide details about the project.

Brenner encouraged healthcare providers to approach the data gained by “hot spotting” in the same way that businesses use marketing data to track the spending patterns of different groups of customers.

Patients can be categorized and tracked based on their specific diseases, alcohol use, age, geography or other factors, but healthcare providers can know how to tailor their efforts only if they have access to such data.

Coalition research manager Aaron Truchil reinforced that point, noting that 10 percent of Camden patients are responsible for nearly 75 percent of healthcare costs.

“There’s a tremendous concentration in healthcare costs in Camden and we see that as an opportunity to dig deeper into who those patients are, what’s driving their ineffective hospital utilization, and how can we work to provide better care at a lower cost,” Truchil said.

Organizations that want to join the project must apply by February 10; participants will be chosen by March 3.

Groups that are chosen will participate in a conference call with Camden Coalition staff members and submit encrypted claims data for analysis. In July, they will receive “hot spot” data analysis and a conference will be held in Trenton to present all of the data.

The benefits of the Camden Coalition’s “hot-spotting” tools won’t be limited to the five project participants. The coalition is making these tools available to anyone with an interest in the subject. Brenner said this “open source” approach could also help lower healthcare costs.

“We really think the model used in healthcare of hiring vendors and hiring consultants has not gotten us to where we want to be – we’re trying to lower the point of entry to all of you so that you can (put these data tools) together in your own institution or community,” he told webinar participants.

From this small start, Brenner is aiming for a national database of patient information that can be used by healthcare providers.

Brenner cautioned that gathering the data isn’t the biggest obstacle to “hot spotting” — it’s getting the proposal through hospital legal departments concerned about sharing patient data. While federal privacy laws protect personal health information of the type needed for the project, its use for “hot spotting” is considered permissible as long as privacy safeguards are maintained, coalition attorney Mark Humowiecki said.

These legal concerns can be overcome if hospital officials focus on the potential gains in patient care, lower costs and improved planning, Brenner said, adding that it’s important for key hospital officials, such as chief medical officers or emergency department heads, to become advocates for “hot spotting.”

“You need to find people who have an emotional reason to care about the problem,” Brenner said.

The Nicholson Foundation, which is paying all project costs, saw an opportunity to help patients in underserved communities, according to Deputy Director Joan Randell.

“We are very strong supporters of communities getting together and sharing information and working together to plan in improving the healthcare for the people in the community,” Randell said.

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