Analyze

“Under a 1986 federal law titled the Emergency Medical Treatment and Labor Act (EMTALA), hospitals are required to treat people who come to the ED presenting with an emergency medical condition, defined as a condition that, without treatment, will likely lead to serious impairment or death. … EMTALA is one of the largest federal mandates to provide services to have gone unfunded (Friedman 2011); costs instead fall on states and local health care systems.” 481

“In bringing ethnographic attention to hot spotting as a technique of governance, we find that it provides lifesaving humanitarian interventions while operating within the racialized structures of violence that produce continual life crises. The institutional rationality of hotspotting and the encounters of care that it produces illustrate the often-contradictory role of medicine in the lives of poor people: both caring and coercive, it intertwines care and violence.” 475; “we conclude by suggesting that economic investment and return are becoming a reigning logic in the governance of poverty, generating hot spots as sites of interest for both policing and health care and decentering normative assessments of deviance, illness, and social problems” 476; “Neoliberal social assistance, as it is practiced in the health care safety net, is conceptualized as an “investment “in the population, as a strategic and targeted deployment of basic resources, one that promises to generate a return on investment for the state or health system in the form of cost savings.“ 485

 The authors examine the practice of “hot spotting,” a form of surveillance and intervention through which health care systems in the US intensively direct health and social services towards high-cost patients.  Health care hot spotting is seen as a way to improve population health while also reducing financial expenditures on healthcare for impoverished people. The authors argue that argue that ultimately hot spotting targets zones of racialized urban poverty—the same neighborhoods and individuals that have long been targeted by the police. These practices produce “a convergence of caring and punitive strategies of governance” (474). The boundaries between the spaces of healthcare and policing have shifted as a “financialized logic of governance has come to dominate both health and criminal justice” (474).

The system was built to serve organizations and individuals with humanitarian goals. The system gathers data from report, reviews, and users and compiles it into comprehensible information to help inform decision-making for humanitarian concerns. Portions of the app also focus on education and technical support for field researchers looking to collect large quantities of data.

The system is primarily used by researchers, scholars, and organizations with humanitarian interests. The app also has functions which would attract users that are beginning research and do not have established connections within the field as the app provides a support system.

The development of Twine was funded primarily through donations from individual investors interested in the data sharing aspects of the software and humanitarian aid organizations who benefit from the accessible data.

Twine provides information and software to set up compatible data collection systems that pool information into the larger system, which the app then makes available to its users. The system also includes a publishing and collaboration aspect which allows groups of people from all over the globe to access the same data and report on the findings together.

Data visualization is primarily determined by the type of data being gathered and the system for data collection being used. The app integrates data in order to both make large quantities of data easily viewable and understood, as well as compare studies with existing data stored on the system.

Users must be registered with the site to access any of the available features, and the registration is free. Once registered, users can immediately begin gathering their own data, analyzing the existing information, publishing reports or reviewing existing publications. The system also has several active data collection locations that are only available to registered users.

The technical aspects of the site are quite complex, as the system has over 1,000 active data sites to compile in addition to the reports and reviews stored. The data collection software is the main function that the software supports as it relieves the users from needing their own data bank to work off of.  The publication functions are also supported by the storage system of the app allowing all users to access all publications.