Prognosis for GIS in Health Care Is Excellent

The most trite cliché in business is “location, location, location.” Yet even this overused phrase has gained new power through analytics. In fact, geography is beginning to look like a new kind of business destiny.

Geographic analytics is even pumping new life into a field where geographic analytics is venerable — health care. Back in 1854, John Snow used mapping to analyze a major London cholera outbreak, changing the course of public health.

The good Dr. Snow would probably be happy to see the way health care as an industry is embracing the use of geographic information systems (GIS). A recent conference in Cambridge, Massachusetts organized by Esri, a standard provider of GIS software and services, highlighted some work by the Louisiana Department of Health and Hospitals, which is using GIS to do fine-grained mapping of data to find health trends such as clusters of low-birthweight babies and disease outbreaks.

Those maps, or visualized data, can be used to help shape public health policy, much like John Snow’s did 160 years ago in London. Today’s software is far more sophisticated than Snow’s handmade maps, of course. But in many areas of health care, practitioners and institutions haven’t gotten all that far past Snow’s methodology. GIS tools are only now coming into their own for many kinds of uses in healthcare systems.

While Esri’s Bill Davenhall noted that the company has been working in health care for 17 years, Amy Sadler, a management and program analyst at the Veteran’s Administration office of informatics and analytics, says that when she goes to major Esri events, only a small percentage of attendees seem to work in health care.

That may be changing. Sadler says there’s great interest in GIS analytics at the VA, where she works with leaders at the regional, hospital and clinic level. “People are fascinated by it. They think GIS is the coolest thing,” Sadler said. “They want to integrate it into their practice, because they are able to see a big picture of how their system works.”

For instance, it’s one thing to know what percentage of patients in the 152-hospital VA system have diabetes. Knowing how many patients living near a specific VA hospital have diabetes is something altogether different, and more valuable; it can help the VA more effectively allocate its medical resources.

GIS analytics can also reveal patterns in specific neighborhoods. Where average life expectancy in a state might be 77, GIS analytics can show that in a specific neighborhood, it might only be 65. Such information can also help VA administrators in planning.

Sadler says her three and a half years at the VA have been spent helping it to transition from paper-based maps — literally, people putting pins into paper maps to help look for patterns — to Web-based maps that allow clinicians to do their own searches. She’s worked with a team of statisticians, researchers and programmers to develop a variety of tools for using GIS. One lets hospital planners track enrollment, to help decide where to base future facilities. In January, they’ll begin testing an app on drive times to see patients in the VA’s home-based patient practice, to help plan the most efficient routes for VA medical workers.

Sadler noted that while Google Maps can be used for geographic analytics, its application programming interface cannot be brought inside an organizational firewall, raising security questions for healthcare organizations.

Meanwhile, other parts of the public health system are just beginning to use mapping. Kathyrn Kulbicki, a GIS analyst at Westat, a research company in Rockville, Maryland, said that “social work and mapping hasn’t really been happening.” She has been working with the National Resource Center for Child Welfare and Technology to help it figure out how to use GIS tools for child welfare. For instance, when children have been taken from their parents and placed in a foster home, can child welfare organizations map those children in context of resources like schools, welfare offices and the like? Can they be used to show how far families are located from the homes their children have been placed in? These questions are useful, but only beginning to be answered.

Kulbicki is exploring exactly this topic in her doctoral research at George Mason University; her dissertation will use GIS to examine placement stability for foster children. She says that there is very little academic research on GIS and child welfare — fewer than two dozen published papers.

As healthcare continues its digital transformation, it is only a matter of time before Dr. Snow’s innovative methodology of mapping disease patterns — a century and a half ahead of its time — becomes widespread in tracking health issues and healthcare needs nationwide.

Will a good dose of GIS cure what ails the U.S. healthcare system? It’s hard to say — but as any physician can tell you, before you can fix the problem, you have to identify its cause. GIS is less of a panacea than it is a diagnostic test — but it is undoubtedly an important step in the right direction.