Conference Review: ESRI Health GIS Conference

October 1, 2009
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The plenary session speakers at ESRI's Health GIS Conference in Nashville (Sept. 21-23) focused on some of the deficiencies in healthcare services and how these can be reduced or eliminated by providing the best information possible, on demand, to those who need to know. With the country embroiled in policy debates on the direction of the U.S. healthcare system, the conference theme of "Improving Our Health with GIS" was particularly timely.

Dr. David Goodman, a professor of Pediatrics and of Community and Family Medicine at Dartmouth Medical School (Hanover, N.H.) and the co-principal investigator of the Dartmouth Atlas of Health Care, delivered the keynote address. His remarks focused on the realization that availability of healthcare services in an area does not always translate into more cost effective services for citizens or better health. In fact, healthcare costs were potentially higher where more services were available. He found that per-capita Medicare spending, for example, had higher spending associated with discretionary services, suggesting that the lower spending regions are more efficient.

Kim Pemble, the executive director of the Wisconsin Health Information Exchange (HIE) (Milwaukee, WI), provided a presentation on "Impacting Health and Care Regionally: Role of HIE." His goal in Wisconsin is to position the HIE to become an "integration engine" for communities throughout the state. When implemented, patient records will be accessed electronically by any care facility, regardless of location, in which the patient decides to seek medical help, potentially reducing the time to diagnose, and decreasing the likelihood of misdiagnoses or drug interactions. He believes that "it is a transformative tool for patient-centered care," but admitted that it would be a culture change for clinicians and patients. He believes that access to information will influence safety, quality and efficiency of care.

Chris McInnish, deputy commissioner of the Alabama Department of Children's Affairs (Montgomery, AL), has led the development of the Alabama Resource Management System (ARMS) to provide state and local agencies with detailed demographic information, in addition to ancillary location-based information about retailing, psychographic profiles and spending habits for the regions they serve. He discovered that even basic information such as the location of stores that sell tobacco in proximity to schools can have a far-reaching impact helping local communities assess their healthcare needs. The result is ARMS, an online resource to help local officials access and utilize the types of information mentioned above.

A simple map of high poverty areas can correct misperceptions about where the poorer populations are centered. McInnish's data and maps changed the nature of the conversation within the county government and allowed the authorities to more efficiently meet the demands of the community by locating food stamp centers in areas that could benefit from them most.

The ARMS project provides pre-made reports and data by county, for counties and local governments. An online tool is now available as a useful resource to support policymakers and elected officials. ARMS View is a Flex-based mapping application that leverages ArcExplorer.

Bill Davenhall, ESRI's global manager for Health and Human Services Solutions, articulated a very complex situation in the nation's healthcare system. Location-based healthcare management systems are often segmented by city, township or county and, of course, vary from state to state, as well. Davenhall emphasized that one of the goals of the Obama administration is to have complete interoperability of healthcare records statewide, at a minimum. He said that some health information exchange systems have been involved in pilot programs for a few years. The ultimate goal is to establish interstate programs, though personal information security may be a major hurdle.

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