concept: the history of SacDoc

In early 2000, I became medical director at the Turning Point Homeless Intervention Program, a pilot program for the homeless mentally ill, funded by AB34/AB2034. It was run by a dedicated, compassionate team, but organizationally it was a mess. With the support of the director, I started spending my evenings and weekends assembling some free and open source software modules to help with scheduling and document management. Then I started making customizations to the software, which was running entirely on a pair of junk servers -- one I had dug out of my closet at home, another I bought on eBay for $9. The computers were located in my living room, and reached the internet by one of Sacramento County's first DSL connections. All communication was protected by high-grade encryption to keep patient data secure.

At the program site, all that was needed to access the system was a thin client -- a basic, internet-connected computer running a web browser. As the program already had such computers at each desk, the cost to the program to access SacDoc was zero.

In a year or two SacDoc had become deeply integrated into the program -- it's hard to imagine how we could have functioned without it. A system where patients would have to arrive in the morning and wait hours to see the doctor was replaced by one where patients were given specific appointments and seen on time more than nine times out of ten. They felt respected -- many for the first time since becoming homeless -- and responded by doing what scores of people told me was unlikely: with astonishing consistency, these homeless, mentally ill citizens living in a chaotic environment kept their appointments and were nearly always on time.

This AB2034 program succeeded wildly, saving taxpayers piles of money. Its success was due to the dedication and tireless efforts of the staff, not to a collection of computer components. Yet it was the SacDoc system that improved the productivity of the doctors and staff, helped raise the self-esteem of the patients, and kept us all from getting burned out in that challenging environment.

Since then, SacDoc has been employed at the Sacramento County Primary Care Clinic, at the Center of Excellence for the Treatment of Huntington Disease at the UC Davis Medical Center, at the Northgate Point RST, at TCORE, at TLCS Passages, and at the Human Resources Consultants (HRC) RST.

Proceed to whence the savings?