Medical Center Improves
Community Programs with GIS

By Karen P. Kolb

Although GIS is a well-established management tool for tax assessment, planning, and transportation, health care GIS applications are relatively new. Baystate Medical Center in Springfield, Massachusetts, treats illnesses, addresses medical issues, and analyzes health abnormalities using GIS. GIS gives health care providers at Baystate a better understanding of the medical needs of the community so they can improve care.

The GIS program at Baystate is part of a communitywide resource-sharing effort. Baystate has partnered with the planning, police, and health and human services departments of the City of Springfield. Led by Amy Pasini, manager of GIS and Injury Prevention in the Department of Surgery, the Baystate GIS program takes a multidisciplined approach toward solving community problems and meeting patients' needs. "The GIS program enables us to track what injuries occur, where, when, and to whom," says Pasini. Because Baystate is one of the busiest trauma centers in New England, Pasini notes that, "GIS is an incredibly helpful tool for us."

Understanding Causes in Context

According to Jane McCall, an epidemiologist/research biostatistician with the Department of Surgery, "GIS allows us to link environmental, demographic, and temporal factors with health events to better understand their causes. This helps us in planning effective treatment and prevention strategies." Using GIS, health care professionals can confirm or deny perceptions about the cause and effect relationships of illness and accidents. By combining traditional data analysis with spatial data, analysts can see relationships that would not otherwise be apparent. Understanding the population that uses Baystate's services lets the medical center better allocate resources and focus efforts based on fact, not perception.

Although Baystate shares data with City government partners and community organizations such as the Citywide Violence Prevention Taskforce, all personal identifiers have been removed, ensuring confidentiality. Data is recorded on diskettes and hand delivered rather than transmitted over the Internet. Maintaining data confidentiality and integrity is a paramount concern and vital to Baystate's success and credibility.

Demonstration Projects

Initially, the program has focused on two demonstration projects--the After-School Youth Violence Program and the Late-Stage Breast Cancer Program. The Community Policing Unit, Injury Prevention Department at Baystate, and the Violence Prevention Task Force of Springfield work on the youth violence program. Baystate receives reports of violence from the Springfield Police Department. The department and Baystate map the data temporally and geographically, locating hot spots in the community. Relating the hot spots to other factors, such as vacant housing sites, liquor establishments, and schools, helps police focus activities in those areas. The youth violence program uses information about incidents and the youth involved to target demographically appropriate intervention strategies.

Using a strategy similar to the one used in the After-School Youth Violence Program, the Late-Stage Breast Cancer Program identifies barriers that prevent women from receiving regular screening mammograms. This program, supported by a Baystate fund-raising event called the Rays of Hope Walkathon, uses data obtained by the City of Springfield and the tumor registries of Baystate and Mercy Hospital.

The program looks at women diagnosed with late-stage breast cancer during the last 10 years. "We are integrating individual-level and community characteristics together in a GIS environment to determine which characteristics may play a role in having a late-stage diagnosis," says Jessica Schueler, GIS coordinator in the Department of Surgery. "Individual-level characteristics include age at diagnosis, race, family history, geography, and the distance to the nearest mammography center. Community characteristics include educational attainment, socioeconomic status, primary language spoken, and poverty level. This information will help health care workers target appropriate resources for breast cancer screening programs." By determining if a pattern, or multiple patterns exist, education or early screening programs can be developed. For example, if the data suggests that language is a barrier to screening, Baystate may implement language-specific educational materials and programs.

Reducing Unnecessary Emergency Room Visits

GIS may also help reduce the volume of emergency department [ED] visits. "We hope that GIS will help us to learn how we can intervene to reduce the number of ED admissions," says Richard Wait, M.D. and chairman of the Department of Surgery at Baystate Medical Center. "The people treated in our emergency department often do not need emergency care. If we can identify a pattern that brings people to the ED, then maybe we can meet their needs in other ways and thus prevent unnecessary ED visits."

A more immediate application of GIS was implemented last year during a shigella outbreak. Shigella is a highly contagious bacterium that infects the intestinal tract. Weekly maps were created and shared between Baystate and the City of Springfield Department of Health and Human Services. Mapping the onset of new cases assisted health practitioners in limiting the spread of the disease.

"GIS has wide-reaching benefits for Baystate..."

Wide-Reaching Benefits

Says Dr. Wait, "GIS has wide-reaching benefits for Baystate, its physicians, the community, and the other partners. It has set the groundwork for the future of health care delivery in Springfield. Hopefully we can look at areas of crime, disease, and accidents and also determine where we can intervene in a proactive way to help create a healthier community. These tools provide a true community benefit."

For more information about the Baystate GIS program, visit the Baystate Health System Web site or contact Amy Pasini, manager of GIS and Injury Prevention in the Department of Surgery, at 413-794-4753.

Table of Contents for the July–September 2001 issue