Maged N Kamel Boulos
School for Health, University of Bath
Health organisations in developed countries regularly collect and store a vast array of data from multiple sources, much of which is linkable through some kind of unique person/patient identifier. These data sets can in turn be linked to many other data sets that contribute to “the big picture” from different government, public and private entities
There are vast strategic and operational benefits to be gained from sharing spatial information amongst as many people in the health sector as possible (including members of the general public for “empowered communities”). Health organisations in developed countries regularly collect and store a vast array of data from multiple sources, much of which is linkable through some kind of unique person/patient identifier. These data sets can in turn be linked to many other data sets that contribute to “the big picture” from different government, public and private entities, using location as main key/common linker. (According to the US Federal Geographic Data Committee (FGDC), geographic location is a key feature of 80-90% of all government data.)
Health organisations appreciate that the main “challenge” is to optimally use this information in decision support at all levels of the organisation. Professor Michael Goldacre’s work on medical data linkage represents one way of doing this (see, for example, goldacre_a.pdf). But there are also significant service benefits to be achieved through the use of GIS (Geographic Information Systems) as a key technology in order to meet this “challenge”. GIS have the potential to turn an organisation’s data into meaningful decision support information (Figure 1). GIS can also promote cooperation with other partner organisations and government departments, through a culture of data sharing.
GIS in Health and Healthcare
GIS has many potential applications in studying geographically differentiated health and healthcare phenomena, and changes in those phenomena over time, for example, cardiovascular disease in a given community.
Fig 1 GIS in the decision making loop (© 2005 MNK Boulos)
The traditional classification of what GIS can do in health and healthcare comprises of two broad types of GIS applications that also reflect the two traditions in health geography (geography of disease and geography of healthcare systems). These two application types are:
- Health outcomes and epidemiology applications
- Healthcare delivery applications
The former type also includes the more recent real time/near real time applications of GIS in health and environmental surveillance. The latter type includes the health service and resource allocation/management applications of GIS. There are also studies at the interface (overlap) between epidemiological and healthcare delivery applications, for example, in relation to healthcare commissioning and needs assessment.
With the advent of Internet GIS (Figure 2) and mapping, GIS information products (output) have become accessible to a much wider audience of decision makers who have no GIS skills (they just need to be able to use any standard Web browser). Internet GIS applications include:
Fig 2 Homepage of the NHS Informatics UK Health GIS Special Interest Group
- Helping identify services (including routing applications), or accessing health and related data sets based on location
- Enabling the integration and interactive visualisation of health indicators/outcomes, services and statistics through thematic mapping or other visualisation techniques
Examples include Dr Foster – Find a Consultant and Find a Hospital (https://www.drfoster.co.uk/consultant/welcome.asp and https://www.drfoster.co.uk/ghg), the Multi-Agency Internet Geographic Information Service (https://maigis. wmpho.org.uk), the Community Health Information Profile (CHIP) for Manchester, Salford and Trafford (https://www. healthprofile.org.uk), etc. Unfortunately, some of these resources are no longer updated or in routine use.