Since the SARS outbreak in 2003, we have seen a revolution in applied geography through web-based tools, so that now, as we deploy these tools to protect human lives, we can ingest real-time data and display results in interactive dashboards, explains Este Geraghty, Chief Medical Officer, ESRI.
Modern epidemiology is closely based on spatial science and information. However, the use of spatial information in public health goes back to ancient times. Can you throw some light on that?
The earliest visualization of the relationship between place and health was in 1694 on the topic of plague containment in Italy. The value of maps as a communication tool blossomed over the next 225 years in the service of understanding and tracking infectious diseases such as yellow fever, cholera and the 1918 influenza pandemic. From the 1960s, when computerized geographic information systems were born, the possibilities for analyzing, visualizing and detecting patterns of disease spread dramatically increased. But ever since the SARS outbreak in 2003, we have seen a revolution in applied geography through web-based tools so that now, as we deploy these tools to protect human lives, we can ingest real-time data and display results in interactive dashboards like the Coronavirus dashboards built by the World Health Organization and Johns Hopkins University using ArcGIS.
Can you tell us something about the use of location or geographical information in modern healthcare?
There are numerous ways in which GIS is being deployed in healthcare. From my experience, the use cases can be loosely categorized as those that support patient care and those that improve operations. Among the patient care examples, there are applications that connect patients to community resources and clinical trials. Other applications support medical decision-making like identifying patients at high risk for readmission based on their level of access to primary care or specialty services. We have also seen research projects that focus on connecting patient outcomes to social determinants of health and geographically targeting interventions to improve population health management.
Operationally, healthcare organizations use geographical information for strategic planning and market development. Similar to commercial patterns of GIS use, site selection and messaging are important when large capital decisions are made. If a healthcare organization, for example, decides to add a multi-specialty clinic to their system, they will want to include the services relevant to the local population needs. There would be no point in adding a pediatrician if the clinic is located in a retirement community. To draw patients to new or existing offerings, healthcare organizations use Esri’s Tapestry Segmentation data to inform communication preferences for their demographic targets.
Can you cite some examples of spatial information/technologies being used successfully to combat COVID-19?
To simplify the various opportunities to employ spatial information to combat COVID-19, we can summarize them in five key steps:
- Map the cases — Map confirmed and active cases, deaths, and recoveries to identify where COVID19 infections exist and have occurred. The World Health Organization and Johns Hopkins University dashboards are good examples of that.
- Map the spread — Time-enabled maps can reveal how infections spread over time and where you may want to target interventions. The University of Virginia Biocomplexity Institute has included a time slider in their dashboard to provide information on daily spread of the virus.
- Map vulnerable populations — COVID-19 disproportionally impacts certain demographics such as the elderly and those with underlying health conditions. Mapping social vulnerability, age, and other factors help you monitor at-risk groups and regions you serve.
- Map your capability to respond — Map facilities, employees or citizens, medical resources, equipment, goods, and services to understand and respond to current and potential impacts of COVID-19. In the U.S., the Homeland Infrastructure Foundation-Level Data (HIFLD) is provided in an ArcGIS open data environment, making this resource, among others, available to those who need such information.
- Communicate with maps — Use interactive Web maps, dashboard apps, and StoryMaps to help rapidly communicate your situation. Several jurisdictions are bringing their COVID-19 stories to life with ArcGIS Hub.
The John Hopkins University is tracking COVID-19 cases in real time with the help of Esri technologies. How has the Esri team been involved in this effort?
We were pleased to see Johns Hopkins University deploy ArcGIS Dashboard through their own initiative and innovation to share COVID-19 case information with the world. As their dashboard gained international popularity, Esri supported the JHU team with a few cartographic tips, automated data feeds and infrastructure enhancement to manage the viral load for their application.
Esri has also launched the COVID-19 GIS Hub to centralize access to maps and GIS data relating to the Novel Coronavirus. Can you tell us more about this initiative?
ArcGIS Hub is the perfect tool for sharing data, applications and information on COVID-19. Once we noticed the plethora of global and regionalized dashboards being created to support response efforts around COVID-19, we wanted to find a way to organize and share the good work efficiently. ArcGIS Hub works as a “one stop shop” for sharing these resources. The site is being updated regularly with new content that we believe will inform, inspire and educate people about this pandemic and the positive role that spatial information can play.
How can advancements in location technologies and analytics, and Artificial Intelligence help us further in this area?
Location analytics provides useful tools to model behaviors and inform actions. From maps that analyze the genetic profile of the virus as it spreads from place to place to AI techniques that make sense of human movement data, we can enhance our understanding of viral transmission, determine if public health recommendations are being followed, and predict whether travel bans and other measures will quell the spread of the disease. Many of these workflows require very large datasets and significant computational capacity to manage the load. ArcGIS has a suite of Big Data and GeoAI tools to support these endeavors.
How can we use this technology more efficiently in combating epidemics such as COVID-19, beyond plotting cases on data portal?
I think we need to recognize that while plotting cases is a critical step to understanding information, emergencies like the COVID-19 pandemic require informed action. The ArcGIS Platform has tools to support actions like gathering and storing foundational data and newly collected data, analyzing inputs, providing decision support, prioritizing resource allocation, performing fieldwork and evaluating outcomes. Every year, we see health organizations deploy more and more of these capabilities to drive entire workflows. Once we move beyond COVID-19 and into “blue skies”, as my preparedness colleagues say, it is my hope that health organizations will review any lessons learned from this experience and begin to put comprehensive systems in place that will further improve response efforts in the future.