By Ross H. Capaccio, President, r��s design + consulting

American College of Healthcare Executives staff in Chicago presented various territory realignment proposals to perspective new chapters.

Today's health care executives are looking to their associations for everything from valuable professional education and career development to networking. The Chicago, Illinois-based American College of Healthcare Executives (ACHE) is committed to meeting these needs. ACHE is the leading professional association of health care executives worldwide.

ACHE has a 70-year history of serving executives across the health care industry by providing new educational opportunities, media products and services, professional credentialing, career development services, and networking opportunities. To respond to the changing needs of the health care management profession, ACHE's long-term goal is to form a network of local independent chapters to deliver education, career, and networking services in close-to-home venues.

In November 2002 ACHE's Board of Governors formalized its plans to develop the network by implementing the Partners for Success Chapter Deployment Project—a master plan to improve opportunities for serving the growing needs for education and networking. ACHE wanted to charter existing affiliated groups as independent ACHE chapters.

The prospectus requires each group to prepare a territory boundary analysis to decide if its desired market area is unique and doesn't overlap other jurisdictions. "We knew that managing the process of resolving overlapping market areas was going to be a daunting task," says Thom Freyer, ACHE's vice president of Regional Services in Chicago. "Managing this aspect of the project in an efficient way would require us to tie together ACHE databases with the appropriate units of U.S. geography (i.e., states, counties, and ZIP Codes). The solution would require preparing highly detailed GIS maps zoomable to the ZIP Code level for each ACHE district. A GIS consultant experienced with Esri technology was hired to manage the GIS tasks."

Method

ACHE's Partners for Success prospectus contains tools to assess a group's readiness to become a chapter. Tools include market data that gives the number of ACHE affiliates living in various combinations of states, counties, regent jurisdictions, and ZIP Codes. For this task ArcView was used to perform the territory overlay analysis. ArcGIS Desktop software's ArcMap application joined the attributes of features by their location. ArcMap was first used to integrate membership data derived from ACHE legacy systems with ZIP Code geography. Since the membership data and ZIP Code geography are not unique, a database relate was established to accommodate the one-to-many relationship in the data structure.

Following the data integration phase, identifying and resolving territory issues required using many of ArcGIS Desktop software's geoprocessing tools to study spatial parameters, including issues relating to access, allocation, proximity, adjacency, and containment. The territory analysis required mapping existing affiliate group boundaries and members' home locations to identify territory overlap. This was accomplished by using ArcMap to create individual map layers for each territory, overlaying the maps, and having the software highlight ZIP Codes contained in two or more territories.

To make the maps easy to understand, a data classification and color scheme was developed with ArcGIS Desktop software's many tools for analyzing data distributions and preparing data for mapping. When the map layers were overlaid, it became easier to visualize the pattern of ZIP Codes belonging to more than one territory. This allowed ACHE regional directors and chapter organizers to focus their efforts on resolving the issue of overlapping areas. After identifying all overlapping ZIP Codes, an overlapping ZIP Code was allocated to one of several neighboring territories, ultimately making it unique to one chapter only. This decision was based on various chapter characteristics such as hospital service areas, membership home addresses, and access distance. This phase of the project required two additional data development and GIS analysis steps. First, 120 existing affiliate locations were geocoded, placing points on the map showing the physical location of each affiliate's headquarters. To determine to which territory to allocate a ZIP Code, the distance to an affiliate's headquarters was used as one selection criterion. Second, distance contours were generated at 25-mile intervals up to 100 miles around each affiliate's headquarters, giving map users information on the distance to an affiliate's location.

The final phase was to map an affiliate's new market area, reflecting agreed-upon territory boundaries as identified in each new ACHE corporate charter.

Results

GIS technology made it possible to solve very complex problems throughout this project. The negotiation process for resolving territory boundary disputes was an ongoing process over a period of several months. At the regional level, existing affiliate groups were required to negotiate mergers among themselves before submitting a proposal to regional directors in Chicago. Once the proposal was submitted, Chicago staff would review it against territory criteria. GIS helped streamline the process, making it possible to make quick decisions and, in some cases, resolve issues the same day. Territory disputes were analyzed during morning conference calls, issues were discussed and resolved in a matter of hours, new maps reflecting boundary changes were made, and the maps were redistributed by e-mail in the afternoon.

For more information, contact Thom Freyer, vice president of Regional Services, ACHE, Chicago, Illinois (e-mail: tfreyer@ache.org), or Ross Capaccio, r��s design + consulting (tel.: 847-635-4752, e-mail: rcapaccio@roosdesign-consulting.com).