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Just one percent of people receiving healthcare in the poverty-and-crime-afflicted city of Camden, NJ, account for 30 percent of costs. But a New Yorker article, a year old but still highly relevant, tells how Camden may become “the first American community to lower its medical costs.” The not-so-secret sauce could be the hotspot strategy, adapted from policing theories that call for special priority for high-crime areas, based on geo-linked statistics and other trends.
Doctors in Camden are focusing more than before on the sickest people and encouraging patients to seek early treatment and be monitored more closely. Kudos to Dr. Jeffrey Brenner of the Camden Coalition of Healthcare Providers, the family physician and medical activist behind so many of the changes.
Similarly, other healthcare experts are homing in on corporate employees with chronic health problems, and email is among the means of communications.
Is the hotspot strategy of potential use to America’s public libraries, with help from tablet and Internet technologies? Absolutely. I’ve suggested that low-income families receive tablet computers from which they could read to children (in addition to using paper books–as a gateway drug, so to speak). They same free tablets could work for multimedia instruction on topics ranging from prenatal nutrition to childcare in general. I can even envision Skype-style video being used in many cases instead of e-mail—to help reinforce traditional face-to-face rapport between patients and healthcare providers (and librarians and others). Keep in mind the billions of healthcare dollars squandered in the U.S. because patients didn’t understand or ignored physicians’ orders, whether prescription-related or not.
No, I don’t see the equipment as a panacea, just one detail. The tablets would simply be a delivery mechanism to augment a number of services. And local libraries could help deploy the tablets, help other government and nonprofit organizations produce localized instructional videos, and coordinate in general–in addition to encouraging patrons to use the hardware for early childhood education, family literacy, and other directly library-related applications. Librarians could work with families to make certain the tablets were put to good use, lest they be transferred to others.
Just what might be the role of the Digital Public Library of America, the Harvard-led library organization that the LibraryCity site tracks from a digital divide perspective? Well, the DPLA could be a great way for local libraries and other organizations to exchange information about what worked and what didn’t, as well as share content such as instructional videos of widespread interest. The DPLA could help public libraries directly address societal challenges and lower healthcare expenses, and thus gain new armor against budget-cutters.
Commendably, the DPLA cares about museums and preservation, and this should continue. But for now, the DPLA is engaged in the opposite of the hotspot strategy. Instead of helping public libraries reach the people who most need the services, it will be focusing too much on the most fortunate members of our society.
I’m gung ho on national and local digitization and other current priorities of the DPLA. But it can be so, so much more, and I’d love to be at the Dallas workshop on January 24 to share thoughts on how the DPLA could evolve to better address societal needs in partnership with local libraries. Hello, Chair John Palfrey and Audience and Participation Workstream leaders Peggy Rudd and Carla Hayden? Care to oblige?
Relevant quote from the Camden healthcare coalition—applicable to librarians and many other providers of government services, not just doctors and nurses: “Strategizing and plan development cannot be adequately implemented without fluid systems of communication. Efficiency of care—especially across specialties and institutions—can be easily impeded by a simple breakdown of communication. Often, this system needs to be in place before strategies are even set in place.” And and shouldn’t communications be not just with other professionals but also with the people being helped—hence the usefulness of tablets! They could work with both virtual and physical keyboards.
Detail: Perhaps small telecommunications surtaxes could help temporarily help pay for the tablets and support. Long term, given all the money to be saved, money could be diverted from other healthcare-related expenditures that didn’t offer the same bang-for-the-buck—especially executive salaries!
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