Carl Kinkade, geospatial information system specialist at the Atlanta-based Centers for Disease Control, uses GIS technology in a variety of ways at the federal agency. Asked about the uneven adoption of GIS in the health industry, he asserts that it boils down to a lack of leadership at local health systems. Even state health departments rarely use the technology to full capacity--in an integrated fashion across multiple departments. Success often comes down to one person, he says. Is there a go-getter? If a group really shines, its often one person driving it.
At Baystate Health, that one person has been Richard Wait, M.D., chairman of surgery at the Springfield, Mass.-based integrated delivery system. Wait spearheaded a GIS program in the late 1990s as part of an injury prevention effort in the trauma division. The program expanded, spawning a GIS departmentwhich was housed in surgery. But Waits vision of an enterprise effort was sidelined when the GIS program was dissolved in 2008. It was difficult to get everybody to buy in, Wait says. We met resistance.
Today, Baystate runs several GIS-enabled projects, but theyre owned by individual departmentssuch as the strategic planning areaand there is no enterprise GIS with shared data, Wait says. The strategic planning department uses GIS technology to assess population demographics as it forecasts demand for various service lines. And GIS is still used by the surgery department, where geospatial data comes into play with a number of other analytics, including types of surgeries, outcomes and costs. We know what parts of the community are more likely to have antibiotic resistance, Wait says. The data is compiled in part from Baystates Cerner EHR and parsed against U.S. Census data.
Jane Garb, a biostatistician at Baystate, uses GIS as part of an effort to monitor breast cancer. We want to see the areas of the city where women are not getting mammographies, she explains. That would provide us a target for education. Garb says there is no direct way to track the absence of mammographies easily using available data sources, so she does the next best thing: she extracts data from Baystates tumor registry, which can be linked to a patients address, and then generate maps showing where advanced tumors are most likely to originate among patients. The data is de-identified, but we can assign it a census block. Its a proxy for women who did not get a mammography but should have.
Although Wait is disappointed that Baystate has not opted for an enterprise approach to GIS, he says the emerging payment models under the accountable care umbrella will drive future use. By mapping disease prevalence in the population, Baystate will do a better job of managing populations, he says. With diabetes, we can map A1C levels, see whos control and whos not, he says. We can see the distance from the nearest physician office and get an idea of where to focus our interventions.
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