How a Postal System Can Keep Us Healthy

Joe Dickinson and Pritpal S Tamber

November 22, 2013

“Give me an example.”

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This is the most common request we get at Wellthcare, the most recent being over lunch in Manhattan. I was dining with Scott Liebman, one of the Wellthcare Explorers, and his friend wanted a concrete example. I replied with my favourite example, Jersey Post’s recently launched ‘Call & Check’ service and today we’re lucky enough to be sharing an interview with its founder, Joe Dickinson.

MedCrunch: So, Joe, tell me about the proposed service of ‘Call & Check’?

Joe:  It was based on the needs of a rapidly aging population and how a postal operator could help in the community’s jigsaw. It’s a very simple idea. The postal guy, who visits everyday, will knock on the door and ask, “How are you?” and just check and see how they are that day, and give a little bit of social interaction for five or six minutes. If they require things from the community, be it medical or social, the postal guy could then link them back to the right people.


MedCrunch:  Oh really?

Joe: Yeah, basically every postal system has a big problem; they’re all losing their revenues because of new technologies, such as email and social networking. So they have to find new things to do. It seemed logical that what you would want to do is to utilise this great infrastructure; they’re the only organisation that has the ability to visit every house on a daily basis. The last thing you would want to do is to lose that ability.

MedCrunch:  Very interesting. What is it about the Jersey population that needs this?

Joe: The truth is our population is really no different to any Western Europe population.  We’ve got this tsunami of ageing coming towards us, the health services are saying that they don’t know how they are going to cope, and, at the same time, they are saying they would like to keep people in their homes as long as they can. I think ‘Call & Check’ is part of that jigsaw of solving the problem.

MedCrunch:  So is that actually what inspired the idea directly?

Joe: Exactly that. It just became obvious the more I thought about it. The one thing that would be terrible is for any locality, not just Jersey, to lose its postal service. You would never rebuild a structure like it again. We needed to find ways to use that infrastructure for the good of the community and it just matched up with an aging population. It’s a simple system that could become quite effective for isolated and aging population.

MedCrunch: I understand you have an outcomes framework; what are you looking to achieve?

Joe: I’m looking at the benefits that ‘Call & Check’ would give to the aging population in terms of connecting them back into the community using the resources of the community in a more joined up way. A lot is going to be based on information given by the actual clients themselves: how they found the service; did it connect them to the community more; and did it really have an effect on their health? A lot of the people in the pilot are referred to as “revolving door” patients; they spend quite a lot of time going in and out of hospitals. So the question can regular visits be an effective early warning system to stop things that they eventually end up in the hospital with? There are various criteria that we are trying to measure during the pilot both from a medical and from a social aspect.

MedCrunch:  So what is the plan in terms of monetisation?

Joe: Jersey Post is funding the pilot. Our CEO, Kevin Keen, is an innovator so he said that if we are going to try this we will fund a pilot. Part of the pilot will be building the business case that this is a cost effective service and that the state should pay for it.

MedCrunch: This could then potentially be copied by other postal services internationally, right?

Joe:  Absolutely. In theory, this could work for any postal service. They are all looking for new revenue streams and nearly every country has the same problem of aging populations. It would be illogical to create new services that aren’t connected to the present infrastructure; use your present infrastructure and try to do just sensible things. We’ve sent information about the pilot to over 20 countries.

MedCrunch:  Finally, Joe, tell us a bit about your background?

Joe:  Yes.  I’ve had sort of two existences; one has been in IT field, the other one is in medical research; I’ve done work in cardiac imaging and cancer. I have a quite varied background and worked in the UK and America. We came back to live in Jersey, which is a small island between England and France, and I was asked by the CEO of Jersey Post to come up with new ideas to develop the postal system.

MedCrunch: Thanks, Joe; come back and tell us how the pilot went.

Joe: Will do, and thank you.

This is a great example of Wellth – new, health-related value, based on what people want, supported by their nano networks. Will ‘Call & Check’ work everywhere? No, I suspect not because what underpins the service is the trust that a small island community has in its postal workers. In business terms, it’s the most distributed infrastructure on the island but in personal terms it involves the same people that the island residents might have a drink with on a Friday night. It leverages community.

What also excites me about ‘Call & Check’ is that no one really knows if it’s going to succeed – not the health care system, not Jersey Post, not even the inimitable Joe Dickinson. However, they have the courage to try, to seek new value. Faced with the “tsunami of ageing coming towards us”, as Joe describes it, we need this (as I have described elsewhere).

We’ll be staying abreast of Jersey Post’s pilot and will let you know how it goes in due course.

This interview was conducted by Pritpal S Tamber in collaboration with MedCrunch where it was first published.

Pritpal S Tamber

Independent Writer, Researcher & Consultant | pritpal@pstamber.com

I'm an independent writer, researcher and consultant focussing on community health and medical information. I'm a former physician, medical editor and medical publisher, and also the former Physician Editor of TEDMED. I began my career at The BMJ. For more information, see the About page.

10 thoughts on “How a Postal System Can Keep Us Healthy”

  1. Love this idea…so obvious. The question is whether they can find a financial model to support it, and if they can, how they build a culture and competence among the post office staff to operate it effectively. I’d pay the post office a monthly subscription to check out my parents and give me a quick text all is well… when the time comes!

    1. Hi Clive
      You are so right about the financial model which may well have public and private elements of funding. A fundamental is how we support an ageing population to stay in their own homes for as long as possible.

    2. Yes, this is a service I would be happy to pay a small regular fee for as well, so that my mother (who lives alone, in a different city to me) would be visited and checked on each day. If the checking “system” was digitised, it’d be a nice comfort to be able to check in myself online and see if there are any downward trends that might indicate an unmet need of some sort … Perhaps there is some sort of privacy issue there that would require an individual’s agreement of course.

      1. With information gathered during our Call&Check pilot we will be designing an APP and digital system which can be accessed in deal time (subject to security of course).
        There are privacy agreements in place sign by our clients.

  2. What an absolutely wonderful idea. I’ve often wondered if older, retired, non-tech-savvy people find it even harder socially because younger people are all now spending more time in communities online — Australian (if not global) culture is moving away from actual in-person interaction, with the exception of “mate-finding” (a slightly crass assumption perhaps, but real in my opinion and observation) — and increasingly that is now happening online too (because you can pre-screen, so it’s considered a more “efficient” or even a “safer” approach)…. Anyway, I have digressed!
    The point I was getting to was that I even wonder if many low-grade illnesses are somehow the outworking of worry and loneliness (as a child I learned subconsciously that “sickness attracts active love”). A simple visit each day may provide enough human interaction to reduce some of those psychosomatic issues (see: http://en.wikipedia.org/wiki/Psychosomatic_medicine).
    It’s fantastic that there is an existing infrastructure that could meet this daily need. But is there a large expense (e.g. re-training staff), or could it be as simple as a checklist they go through each time? I imagine you could have a web-based (secure of course) checklist that would automatically alert a trained supervisor if there was any further action required for an individual.
    Of course, digital data would serve as an excellent indicator on a broad variety of levels because they could easily track progress, make comparisons, learn seasonal trends for groups and individuals (e.g. “Florence gets the flu every December, so we’ll organise XYZ supplements for her at the end of each November”), quantify the value of the program itself, etc etc.

    1. Hi Matt
      The Call&Check is really a little daily chat which can also act as an early warning system of problems or a way of connecting our clients into the community both medical and social. The cost of training our Posties (Postmen/women) is minimal compared to the benefits it can bring to our community.
      Joe

  3. Dear Clive and Matt,
    I believe Joe has offered answers to your questions about Jersey Post but I thought I would offer a broader Wellthcare perspective.
    Both of you have effectively asked about finding a way to fund the service (Clive overtly and Matt by wondering if a large expense is involved). While important questions, I fear that such immediate concerns about business models can serve to limit creativity. While there is much hand-wringing about the cost of health care right now, the simple truth is that “need” is increasing so we have to find new sources of value. How much we spend on health is going to go up.
    That does not, however, mean we need to spend more on health *care*. Indeed, given the poor returns we’re increasingly seeing in health innovation, whether it be drugs, devices or process improvements, it’s perhaps logical to spend less on health *care* but more on health.
    The challenge is going to be how we transition our pounds or dollars from the health care system to a different one, especially with the former claiming both expertise and efficacy (although more and more people are seeing such claims as hollow). Doing this will require time; time to illustrate the health-related value that can be created from outside the traditional health care system. The more we can do to give these more courageous innovations time and space to mature, the better we’ll serve health and society.
    As Joe knows, Jersey Post’s C&C service is but one example of Wellth. Its growth and sustainability will require the same courage and clarity of purpose that got it off the ground. My view is that it’ll only grow with a deeper understanding of what people want – whether it be the service users or their carers. It’s by understanding their health-related needs will the service grow – and grow beyond the thinking of the local health care providers’ needs.
    Pritpal

  4. It can be a bugger at times trying to convince people about C&C, then you get an email like this and it makes it all worthwhile.
    Dear Joe,
    Thank you so much for your call this morning to pass on the concerns of the postman who checks regularly on one of our clients. Thankfully there was a happy outcome in this instance as further checks proved that the client was ok but it was very helpful to have the information that she had not been answering her door and had previously expressed that she was unwell. Had the lady met with an accident or become very ill it is possible that the alarm raised by your service could have saved her life. We at the Jersey Blind Society think that the service Jersey Post has been providing in the West of Jersey is excellent. We do hope that it can become an island wide service so that sick and vulnerable people everywhere can be monitored regularly and any concerns for their health or safety reported to the appropriate support services.
    Best wishes,
    Sarah

    1. Pritpal S Tamber

      Dear Joe,
      Thanks for sharing this feedback from a service user. It’s clear that Call & and Check is adding great value to health. Keep up the amazing work!
      Pritpal

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