Let’s Talk Data-Driven Justice

Exostar’s Director of Health IT & Life Sciences Kenny Kong participated in a roundtable discussion at the White House’s Office of Science and Technology about the administration’s focus on Healthcare and Information Technology.

This past week, I was fortunate to be invited to participate in a discussion at the White House’s Office of Sciences and Technology. The discussion group consisted of stakeholders from academia and non-profit research institutions, senior policy advisors, and military personnel.  As we shared our thoughts on the state of health IT and the current administration’s initiatives, one particular initiative caught my attention: Data-Driven Justice (DDJ).

DDJ is one of the latest bipartisan initiatives that the President has launched specifically focusing on breaking the incarceration cycle and reducing care costs by using data-driven strategies to divert low-level offenders with mental illness out of the criminal justice system and into treatment.

Using Data Analysis to Identify Gaps in Patient Care

Over 10 million individuals move through the 3,000+ jails on misdemeanors and non-violent charges costing local governments across the nation over $21 billion annually.

Of those offenders in local jails:

• 64% suffer from a behavioral health disorder
• 68% are substance abusers
• 44% suffer from chronic health issues

Many offenders also lack proper healthcare and have a non-existent health record. The potential for re-admittance due to adverse drug-drug or drug-allergy interactions becomes a real danger with healthcare providers “flying blind” as they administer care, which inherently leads to additional care costs.

In a briefing the White House released, they gave a real world example from Miami-Dade, Florida where they found that a group of 97 people with serious mental illness:

• Accounted for $13 million in services over 4 years
• Spent more than 39,000 days in either jail, the emergency room, state hospitals, or psychiatric facilities

The county’s response was to provide de-escalation training to their first responders and within the following 5 years, the results were clear.

• Of the 50,000 mental health crises calls to which the Miami-Dade police responded, there were only 109 arrests
• Over 10,000 people were diverted to services or safety stabilizing situations instead of being arrested
• Jail population fell from over 7,000 inmates to a little bit over 4,700
• The county was able to close an entire jail facility saving over $12 million a year

Sharing Data to Improve Care and Reduce Costs

DDJ is comprised of a coalition of 67 city, county and state governments committed to using data-driven strategies to divert offenders with mental illness out of the criminal justice system. The initiative also aims to change approaches to pre-trial incarceration, in hopes to keep these same offenders from being cycled through jails, hospitals, shelters and other public systems, where they receive fragmented and uncoordinated care leading to poor outcomes and costing tax payers billions of dollars.

Key points:

• Using data to identify and proactively break the cycle of incarceration. To help improve the fidelity and success of patient care amongst offenders with mental illness, communities are sharing data across criminal justice and health IT systems. Identifying the individuals with the highest number of contacts with police, ambulance, emergency rooms and other services and connecting them to health, behavioral health and social services in the community will help reduce both the reliance on emergency healthcare and encounters with the justice system.
• Equipping law enforcement and first responders with the tools to respond and divert. Recognizing that police, emergency medical technicians, and firefighters are often frontline and first responders to people experiencing a mental health crisis, DDJ communities are creating processes and protocols to effectively de-escalate situations and safely divert people to appropriate services rather than arresting them.
• Using data-driven, validated, pre-trial risk assessment tools to inform pre-trial release decisions. DDJ communities will work towards using objective, data-driven, validated risk-assessment tools to identify low-risk defendants held in jail in order to ensure opportunities for their safe release.

As healthcare embraces information technology in the inpatient and outpatient setting, the practical application outside of the typical clinical environment is somewhat new. Real world evidence suggests that there are additional use cases where we can tie information technology in with clinical data to find alternative means of moving towards more meaningful outcomes through a more proactive approach rather than being reactive.

Kenny Kong Bio:

Serving as Exostar’s Director of Health IT & Life Sciences, Kenny Kong leads Exostar’s Health IT practice. He has consulted and advised some of the world’s largest Health IT and Biopharmaceutical enterprises in establishing digital identities to securely extend trust across traditional enterprise boundaries. His thought leadership supports the development of Federal Health IT Standards and in his tenure, he has worked in all areas of Health IT from Meaningful Use compliance, launching Electronic Prescribing of Controlled Substances (EPCS) nationwide, to co-founding federal programs that bring Health IT to Medically Underserved Areas across the United States.