FEATURE

The Geography of Just About Everything
The Health Geographics Program Maps the Rectum, Disaster Footprints, Truck Routes and More

Why does a hospital need a Geographic Information Systems department? After all, that’s the technolology that MapQuest uses to overlay convenient hotels onto your driving route. But GIS is comprised of computer hardware and software that can be used to store, manage, display and analyze any spatial data. "Baystate has the distinction of being the only hospital in the U.S. to have a fulltime GIS department," says Dr. Richard Wait, Director of the Health Geographics Program. HGP's wide-ranging projects over the past 8+ years include:

• Population Served by Emergency Room—Distance isn't the sole geographic predictor of who will use the ER. HGP found surprising other factors, including where patients live in relation to physical and political boundaries such as the Connecticut River or the state line also have an effect.

• Youth Violence—Using data from the Springfield police on violent incidents involving youth, HGP identified characteristics about the locations of both the incidents, and the youths' residences, that increase the risk for violence.

• Medical Crisis Information Management System Mapping Extension—Working with a commercial partner, HGP's for-profit arm, Baystate Health Geographics, developed an extension that integrates information about demographics, service areas, facility capacities, etc. into the HC Standard™ M-CIMS application.

The Landscape Beneath the Scalpel

An article in an upcoming issue of the International Journal of Health Geographics describes HGP's innovative use of GIS to develop a model of rectal anatomy, then study associations between spatial characteristics of rectal lesions (such as distance from dentate line and whether above the rectosigmoid junction or on the anterior/posterior plane), their clinical characteristics (such as outcome, size, histology, recurrence), and the procedural failure of Transanal Endoscopic Microsurgery (TEM). TEM is a minimally invasive procedure to remove rectal lesions.

According to Jane Garb, Spatial Epidemiologist and Biostatistician, GIS had been used to map anatomic features, but HGP was the first to use location or topology and spatial statistics to analyze clinical events. Their results did show that lesions in certain locations were more problematic—they can now use this information to help guide their decisions about when to use TEM.

Interpolating a Square Estimate from Round Data

It’s not always about being on the cutting-edge, though, according to Garb. Their emergency preparedness and response project makes a positive contribution to Homeland Security because it puts an easy-to-use tool in the hands of those who need it - emergency preparedness and response planners. Disaster planning necessitates estimating the size of populations that will be affected. This is difficult because the geographic units for which population counts are available, such as census tracts, rarely coincide with geographic areas affected by a disaster, such as water drainage basins, traffic corridors, or the footprint of a toxic plume.

Using areal interpolation, HGP is promoting a technique for population estimation that is simple and quick, and can be easily recalculated if the hazard changes, or to compare “what-if” scenarios.

On the Road Again

Starting in April, a new Baystate Reference Lab Logistics System will be put into operation to replace their current paper-based process. Trucks are being outfitted with GPS, and through a central dispatch center, can be tracked in real time. Drivers will be able to enter information into PDAs. HGP developed custom applications that will be used by the new system to optimize its routing. According to Ric Skinner, Senior GIS Coordinator, this project demonstrates HGP's ability to collaborate on practical implementations of GIS, even commercial applications, as well as on research projects.