Dr. Jeffrey Brenner: The IGINE Model

In Camden, New Jersey, Dr. Jeffrey Brenner is pioneering efforts to improve healthcare delivery through medical “hotspotting” (Doctor Hotspot, 2011), the geographical mapping of patient healthcare costs using computational statistics (Gawande, 2011). Medical hotspotting enables communities to identify residents receiving the worst health care by identifying hotspots of high medical costs and frequent emergency room visits (Gawande, 2011). As with all macro level change, Dr. Brenner pursued his goal of improving health care through a process of planning. His process closely follows the IMAGINE Model outlined by Kirst-Ashman and Hull (2012). The first step in the IMAGINE Model is to “start with an innovative idea” (Kirst-Ashman & Hull, 2012, p. 219). Motivated for change following a murder in Camden, Dr. Brenner joined a police reform commission. Dr. Brenner attempted to implement crime hotspotting in Camden by recommending

While the data was collected by identifying patients with the highest medical costs, lowering medical costs was never Brenner’s goal; “he was more interested in helping people who received bad health care” (Gawande, 2011). Although a clearly defined list of action steps is not outlined in the literature (Gawande, 2011; “Jeffrey C. Brenner,” 2013; Robert Wood Johnson Foundation, 2014) Brenner clearly began by using his funds to hire a staff and increase his pool of data, identified the most vulnerable patients by health care cost and emergency room and hospital visit frequency, met with the most vulnerable patients, acquired information about all of the factors affecting the patient’s health through forming relationships, and then based on the client’s needs, utilized a custom case plan to improve the delivery of health care services to the patient (Gawande, 2011; “Jeffrey C. Brenner,” 2013; Robert Wood Johnson Foundation,