ciate dean for academic affairs and student programs, Dr. Brenner successfully advocated for making HIPHOP an elective course, not an extracurricular club. “To me, community health education and outreach are just as important and valuable as dissection and anatomy,” he says. “HIPHOP is the essence of Jeff Brenner. He takes the risks and puts others out front. He gives people a sense of ownership,” says Anthony Mazzarelli, MD ’02, JD, MBE, assistant professor of emergency medicine and senior vice president and chief medical officer, Cooper University Health Care. “HIPHOP does 90 percent of the community service work at the medical school. The great thing is that today’s students feel it belongs to them, but it’s the core, the legacy, of Jeff Brenner.” Dr. Brenner’s commitment to HIPHOP shifted his interest from the research bench to the bedside. After graduation, he completed a residency in family medicine at the Swedish Health Center, in Seattle, before returning to New Jersey to practice and live in Camden, the nation’s most impoverished city. He eventually opened a private medical office in Camden, where he offered a full spectrum of family health services to a largely Hispanic population on Medicaid. COURTESY OF THE MACARTHUR FOUNDATION Gawande in “The Hot Spotters,” a profile published on January 24, 2011, in the New Yorker. He realized the potential for replicating the CompStat approach in a health care setting. Instead of mapping crime data, he would use discharge data to map hospital visits, particularly to the emergency department, by the city’s residents. The results would pinpoint health care hot spots by neighborhood, block, and building. With this knowledge, the coalition could begin planning to address the city’s core health needs. “M y goal is to continue bending the cost curve, to make Camden first in the nation in health care,” says Dr. Brenner. “The MacArthur Award has attracted new funding and provided a huge boost for that effort. Camden’s three hospitals serve a nine-square-mile city, ” competing for patients among its 77,000 residents. The stakeholders didn’t communicate, there was no flow of information across systems; Dr. Brenner had to work hard to persuade them to share patient-level information with the coalition. “It was like persuading a Target, a Kmart, and a Walmart in one community to allow you to get all their customer data, put it all into one database, and then convince the customers to stop shopping there,” says Dr. Brenner. Ultimately, Dr. Brenner demonstrated the value of sharing patient information: without a comprehensive database of information from all the city’s major providers, a patient could and would rebound in and out of different hospitals without anyone’s awareness, and as a result, they would continue to receive both too much and too little care. Discharge instructions and follow-up care, if any, would remain fragmented and disjointed, “like falling off a cliff,” says Dr. Brenner. The costs to the community would continue to skyrocket. Over a three-year period, Dr. Brenner and a dedicated skeleton crew, composed mainly of students, amassed an enormous quantity of patient-level information. In this vast effort, the coalition’s researchers had help from CamConnect, a Camden-centered nonprofit that offers other nonprofits technical assistance in areas such as geographic information system (GIS) mapping, research, and data management. Robert Wood Johnson I MEDICINE 39 Mapping the Hot Spots I n 2002, a small group of primary care providers began meeting regularly over breakfast to share the challenges and frustrations of practicing family med- icine in Camden. The group expanded as its members discovered common experiences and developed a common goal: to improve the delivery of health care and social services and reduce the astronomical cost of medical inefficiencies. From these informal beginnings, Dr. Brenner founded the Camden Coalition of Healthcare Providers, in 2005, serving as executive director. He continued in private practice, though declining reimbursements would force him to close the practice several years later. The coalition’s first project was to create a comprehensive database of patient-level information from Camden’s three hospitals and a few private practices. Dr. Brenner proposed the project based on his familiarity with CompStat, a data-driven model used by the New York City Police Department to identify crime patterns, or “hot spots,” and then develop and focus appropriate police, government, and community resources in those areas. “You can't fix a hard problem unless you have a way of counting the hard problem,” Dr. Brenner told Atul