Public Health Organizations - ICMCC

icmcc.org

Public Health Organizations - ICMCC

Dr Winnie Tang

ICMCC 2005

ArcGIS in Health Organizations 1


Health Informatics

• Medical and Biomedical Informatics

• Definition

– The use of computer technologies in healthcare to store,

share, transmit and analyse clinical knowledge and data

• Another Definition

Health Informatics is seen as to be concerned with the

individual and group behaviour of all healthcare

stakeholders’ interaction with information and

information technologies

• Pressures to increase quality & decrease costs by

using IT in health care

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IT for Health Informatics

• Component to be involved:

– Broadband Intra-structure

– Wireless Network

– Smart Card

– Data Mining

– Network Security

– Geographic Information System (GIS)

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What GIS Can Do in Health Informatics

• Outbreak Analysis

• Facility Site Location Selection

Health Surveillance

• Emergency Notification

Health Net Portal

• Clinical Data Visualization

• Hospital Bed Management

• Environmental Health Analysis

• Disease Tracking

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What is GIS?

… simply a computer assisted technology

that links geography to all other types

of data creating analytical frameworks for

understanding and visualizing

spatial relationships.

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How Does GIS Work?

• Linking geography to data

• Linking map to database

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Geocoding a land feature

Pikes Peak… (land data)

GPS receiver reading from climber

Converts to this… (geographical data)

38.5026 degrees latitude

-105.0238 degrees longitude

(A system of geopositioning satellites.)

ArcGIS in Health Organizations 7


Geocoding an address

My street address… (administrative data)

address matching to a street file

380 New York Street

Redlands, CA 92373

Converts to this… (geographical data)

34.0575 degrees latitude

-117.1949 degrees longitude

(The postal service maintains a comprehensive address coding guide.)

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Creating Data Layers

. . . linking digital data to “geography”

Bed Location

Fluids/Air Lines

Dedicated Electric Circuits

Fire and Smoke Sensors

Occupancy Zones

Negative Pressure Zones

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Linking Data Layers - Hospitals

Service Events

• Admissions

• Registrations

• Encounters

Program Data

• Demographics

• Utilization

• Service

• Revenues

• Outcomes

Administrative

Boundaries

• Districts

• Service Areas

• Planning Areas

• Legislative Area

• Special Districts

Infrastructure

• Buildings

• Roads

• Land Features

• Attributes

Facilities & Services

• Provider Locations

• Locations of Service

• Asset Distribution

• Employer Locations

Environmental

• Topographic

• Biohazards

• Market Data

• Toxic Sites

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Linking Data Layers – Public Health

Vital Events

• Birth

• Death

• Marriage

Infrastructure

• Buildings

• Roads

• Features

Program Data

Facilities & Services

• Demographics

• Permits

• Clients

• Inspections

• Utilization

• Variances

• Resource Distribution

• Locations

• Assets

Administrative

Boundaries

Environmental

• Districts

• Topographic

• Service Areas

• Biohazards

• Toxic Sites

• Planning Areas

• Legislative Area

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Linking Data Layers – Medicare

Member Data

• Births

• Disease

• Demographics

Cost/Utilization Data

• Product Lines

• Members

• Utilization

• Revenues

Policy Data

• Need

• Quality

• Accessibility

• Outcomes

Facilities

• Hospitals

• Physician Offices

• Clinics

• Employers

Administrative

Boundaries

• Districts

Health Referral Areas

• Service Areas

• Planning Areas

• Postal, Census

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The “Digital Community”

Permits

Inspections

Address Master

Building

Public Works

Water Infrastructure

Sewer Infrastructure

Storm Drain System

Street Infrastructure

Irrigation

Aesthetics

Landscape

Public Facilities

General Plan

Land Use

Zoning

Planning

Health Facilities

Physicians & RN’s

Drug Stockpiles

Public Health

Base Data

TM

Data Server

Streets

Parcels

Address

Census

Utilities

Elevations

Aerials

Hydrants

Water Tanks

Fire Districts

Fire

Beats

Crime Incidents

Reporting Districts

Police

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Who Uses GIS?

Public Health Organizations

• Hospitals and Medical Centers

• Academic Health Science Centers

• Managed Care Organizations

• Medical Suppliers

• Pharmaceuticals

• Medical Research Organizations

Health Insurance Organizations

• Medical Review Organizations

• Social Service Agencies

ArcGIS in Health Organizations 14


What people do with GIS

• Policy Analysis

• Disease Tracking

• Market and Strategic Planning

• Routing Health Workers

• Clinical (ICD9 & 10) Data Visualization

• Environmental Health Monitoring

• Site Location Analysis

• Facility Care Management

• Birth/Death/Tumor/Immunization/STD Registries

• Location Services (web based)

• Service/Provider Network Analysis

• Bioterrorism Preparedness

• Fraud and Abuse Detection

ArcGIS in Health Organizations 15


Some GIS Health Users

• Amgen/Pfizer

• Kaiser Permanente/Medicare

• CDC

• Pan American Health Organization

• National Institutes of Health

• World Health Organization

• Provincial Health Ministries (CN,AU, FR)

• Baystate Medical Center (teaching hospital)

• Downey Regional Medical Center

• 5,000+ Users World-wide

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Spatial Relationships Visualized

. . . through analysis and interpretation

• Understanding relationships

• Illustrating spatial issues

• Taking action

some examples …

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Outbreak Analysis

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Facility Site Location Selection

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HealthSentry

Cerner’s s Bio-Surveillance Network

ArcGIS in Health Organizations 20


Environmental Health

Toxic Spills

Toxic Exposures

ArcGIS in Health Organizations 21


Real-time Environmental

Monitoring

WTC – September 11, 2001

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Health Data Collection

ArcGIS in Health Organizations 23


Health Professionals Will

Manage Health data

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Emergency Notification

Spray Zone

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Dispatch Vehicles

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Real-time Dispatch

& Route Change

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Routing Health Workers

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Incident Response Portal

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Clinical Data Visualization

BodyViewer

ICD9 & 10

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Bed Capacity Management

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ArcGIS in Health Organizations 32


Public Health Preparedness

Wide-Area Surveillance

Incident Response

Mitigation Planning

ArcGIS in Health Organizations 33


Natural Resource

Accounting

ArcGIS in Health Organizations 34


Poverty

Indicators

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Kenya – HIV/AIDS

ArcGIS in Health Organizations 36


World Food Programme:

Afghanistan

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National Disease Surveillance –

Case Study

Comprehensive GIS Application for

West Nile Virus Surveillance

ArcGIS in Health Organizations 38


National Disease Surveillance -

Introduction

• A retrospective spatial analysis of an epidemic and

epizootic of West Nile Virus (WNV) infections was

conducted in 2002

• Human case rates were three times higher in

geographic areas with a high density of earlyseason

crow deaths

• Combine with other studies early season and

other avian deaths is related to eventual human

cases of WNV

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National Disease Surveillance –

Introduction – Cont

• Goal –

• Gather information in real-time from disparate data

sources

• Process and summarize geographic data

• Report results in a consistent and standardized

format

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National Disease Surveillance –

Data Source

Human Cases

of WNV

Mosquito Data

WNV Data

Repository

Dead Birds

Data

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National Disease Surveillance – Analysis & Response

• WNV maps are used to target mosquito abatement and

evaluate the larvicide program

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National Disease Surveillance – Analysis & Response

• Census tracts with significant spatial clustering of bird

deaths need intensified surveillance

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National Disease Surveillance – Summary

• Spatial analysis of dead bird sightings is used in

identifying areas of potential human risk

• Geographic hotspots and high risk areas identified serve

as an indicator of increased WNV activity

• Focus mosquito monitoring and abatement activities

around these geographic locations

• Methodology adopted could be used for other types of

disease surveillance systems

• GIS solution allows policy makers to focus surveillance

and control measures in areas bearing higher risks

ArcGIS in Health Organizations 44


SARS Mapping Web Site

ArcGIS in Health Organizations 45


Case Study -

Tracking SARS in Hong Kong

ArcGIS in Health Organizations 46


Background

• Hong Kong SARS Outbreak in 2003

• ESRI China (HK) voluntarily built and

hosted SARS Mapping Web Site

• Disseminate geographic distribution

information of SARS cases in H.K.,

China and world

• Simple spatial analysis of SARS cases

ArcGIS in Health Organizations 47


SARS Mapping Web Site

• Built on ESRI ArcIMS web mapping technology

• Launched in both Chinese and English

• Classify information based on suspected,

actual and recovered SARS cases on map

• Highlight the most recent SARS cases updates

• Show spread of disease and pace of recovery

geographically

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SARS Cases Distribution in H.K.

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SARS Cases Distribution in China

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SARS Cases Distribution in World

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Proximity Analysis of SARS Cases

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SARS Mapping Web Site – Summary

• Produce 12,000+ maps per day

• Generate 250,000+ maps through the entire

duration of the crisis

• Lessons learnt

– Clear and early notification of outbreaks

– Accurate and open dissemination of information

– Importance of geography and location

ArcGIS in Health Organizations 53


Conclusions

Health organizations come under intense

pressure to provide higher quality service

• Geographic context and analysis become

important and essential in healthcare

• GIS provide a common analytical framework in

– Identification of problems

– Formulating of response

– Improving incident management

Health planning

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Thank you

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