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Three Ways GIS Can Modernize Health Infrastructure for Smart Cities
As leaders across the spectrum aim to build more resilient and equitable communities, it’s not just transit and water systems that need upgrading. The infrastructure of our public health and healthcare systems also must be modernized. By Este Geraghty
Smart cities are taking a geographic approach to health—using maps, AI, and sensors to understand the needs of their communities, allocate essential resources, and streamline operations. And many federal, state, and local public health agencies as well as clinical providers of healthcare are integrating geographic information systems (GIS) into their infrastructures.
So, how are these organizations benefiting from the location intelligence GIS technology delivers?
• Maps are providing geographic context to healthcare practitioners, allowing them to understand the makeup and needs of communities and deliver more equitable care. • Public health officials use spatial analysis and predictive modeling to plan and prioritize where and when to allocate resources. • Hospital staff are using indoor mapping and wayfinding to automate and improve patient care while making operations more efficient.
These three geospatial innovations are laying the groundwork for how a modern health infrastructure will bean integral part of a smart city.
Maps Contextualize Health Equity and Visualize Care Services To improve access to services and address health equity, leadership at a large, 51 hospital healthcare system mapped their Community Health Needs Assessments (CHNA) process.
By integrating location data into the CHNA, hospital staff were able to focus more on people and their environments than rote box-checking for regulatory requirements. They saw first-hand where geographic information related to improving outcomes. By adopting GIS, the new digital needs assessment allowed staff to overlay data layers, including demographics, onto maps.
Staff use the map-based CHNA to visualize community issues— such as homelessness, chronic disease, and substance abuse—in real-time. They can also share the information with the public to drive awareness and inform collaborative outreach efforts, both through their community benefits program and a multi-hospital consortium working together to better serve their common population. At the leadership level, location intelligence from GIS maps guides strategic decisions around healthcare operations and initiatives and enables monitoring of local impact to measure success.
In the US state of California, San Bernardino County is the largest by area and officials there have used GIS for years tomonitor the health and well-beingof more than 2 million people. Seeing the impact that office shutdowns and stay-at-home orders from the COVID-19 pandemic were having on the 25 public services programs the county offered, analysts turned to GIS to develop the state’s first COVID-19 Hub. The team also created an interactive GIS dashboard to share information about how the virus was spreading in the county. This empowered decision-makers with near real-time information to act on travel restrictions, quarantines, screenings, and other response efforts.
Now, San Bernardino County analysts have leveraged that same geospatial technology beyond emergency response and daily program analysis for other projects. For example, county staff noticed their Women, Infants, and Children (WIC) program participation was at an extreme low after declining for
Sophisticated network analysis methods can help allocate surge resources based on projected hospital demands.
Photo courtesy of Esri
Photo courtesy of Esri
Health departments can use the CHIME forecasting model to show geographic information about cases, test results, and hospitalizations.
several years. By interviewing clinic personnel, the team learned that accessibility may be a key barrier to participation. In response, GIS professionals created smart maps with data layers showing where current and past program participants lived throughout the county and their geographic relation to local clinics. The WIC research also included aggregated data, bus routes in the area as a potential mode of transportation, and visual buffers to indicate walkability. This evidencebased analysis helped officials identify underserved communities and determine where new clinics should be built to serve those in need.
An infrastructure guided by smart maps—layered with local demographic and healthcare resource data—will be crucial to achieving equity in smart cities.
Answering Where and When with Spatial Analysis and Predictive Models Public health professionals use GIS to understand their communities—to see what is happening now, what could happen, and where more resources are needed. This ability proved essential when COVID-19 evolved into a pandemic. Slowing disease spread at the local level required a coordinated and data-driven effort from national agencies, local governments, and private organizations.
In the US state of Pennsylvania, the Predictive Healthcare team at a multi hospital healthcare system built an analytic model intended to predict COVID-19 surges, support decisions to “flatten the curve” of cases, and help lessen the burden on local hospitals. The resultingCOVID-19 Hospital Impact Model for Epidemics(CHIME) algorithm incorporated critical data like susceptible populations, hospitalization rates, and the average number of infection days. With the spatial perspective added to CHIME, decision-makers could visualize spread patterns and changes in the moment and also predictively map future spread based on data about average hospital stay length, ventilation percentages, and intensive care patient numbers.
In other locations, public health and hospital administrators, as well as government authorities, compared the CHIME model against their own data on current hospital capacity, available beds, ventilators, and supply data. This provided officials with a comprehensive view of the community to craft precise responses to spikes in case rates. Policymakers were also able to test scenarios to flatten the curve and plan what resources were needed and where.
Such precise analysis and predictive modeling capabilities will be critical for addressing future health crises.
Optimizing Hospital Operations with GIS-based Processes Some hospitals have already integrated geospatial technology into their processes to improve patient care. Inone case, a hospital treating 1.5 million outpatients per year relied on an electronic health records (EHR) system to manage patient data such as personal records, location, and status. But the EHR could not provide context and analysis on patient flow or give a holistic view of what was happening day to day in the hospital. Seeking to improve patient care, management integrated their EHR and enterprise GIS technology systems.
Using their new integrated system, staff gained real-time operational intelligence on patient location and status—with dashboards that visualized key metrics and data rich maps. The integration allowed employees to identify hot spots and other emerging trends for cross department coordination. Then, the hospital introducedGIS-based indoor navigation, enabling patients to quickly find the correct buildings, parking lots, clinics, and offices for their appointments. Indoor maps alsohelped hospital decision-makersoptimize space planning and facility management around patient needs.
In addition to creating efficient operational practices, hospital staff used GIS to enhance patientfacing dashboards. This automated process features wayfinding applications for appointments, wellness maps with locations for nutritional food and exercise, and care options to help patients manage chronic disease.Because the dashboards are also integrated with the hospital EHR, the patient experience is completely individualized to their location, their personal health needs, and their care team and community resources.
Given the rapid advances in real-time technology and affordable sensors, indoor mapping innovations and applications will be a key part of future healthcare infrastructure.
Beyond Emergency Response, GIS is a Crucial Tool for Healthcare Infrastructure While public health emergencies like COVID-19 capture global attention and provide valuable lessons, populations depend on public health departments and medical providers for vital services every day. Many in the health community have seen firsthand the benefits of integrating location intelligence into their infrastructure.
Health departments and medical providers are using GIS to predict where care and services will be needed most, meet those needs more equitably, and create more efficient ways of operating and delivering services. A geospatially smart health infrastructure is a crucial part of any smart city, and GIS is a necessary tool for empowering public health and healthcare professionals to create those systems.
Photo courtesy of Esri
GIS enables healthcare organizations to efficiently visualize the vast quantities of data being gathered through their engagement with community partners and residents.
Dr Este Geraghty
Chief Medical Officer, Esri
egeraghty@esri.com She leads strategy and messaging for the Health and Human Services sector at Esri, helping organizations use GIS technology to advance global health. Her work includes finding solutions for disease management, homelessness, health preparedness and response, strategic planning, healthcare access, resource allocation, and inequity. She is also the recipient of HIMSS Most Influential Women in Health ITAward 2021.
