Healthcare Optimization using GIS

Optimizing healthcare is very important as it has the potential to transform healthcare outcomes through accelerated improvements in the impact of interventions. Public health optimization is crucial as it is a deliberate data-driven process to improve health interventions and implementations. Public health intervention in some cases requires getting to the targeted population within the shortest possible time. This requires implementing specific public health interventions at the lowest geographic disaggregation level (communities and wards). In some cases, some of these locations may not have well-defined addresses for ease of accessibility and this may also be where the bulk of the target population resides. The notable link between geography and health makes GIS an indispensable tool in healthcare.

Micro-planning is critical to the success of any healthcare implementation program as it is a more detailed operational plan created to identify and reach the target population. It is very effective in health interventions like vaccination campaigns and distribution, disease prevention, mass drug administration, supplementary immunization activities, emergency preparedness and disaster response, and active case detection. For this to be effective, knowledge of the target population, identification of its hotspots, characteristics of its population, and information on the available healthcare facilities and their current conditions are key. Geospatial data can bring out hidden information on the socioeconomic factors influencing health outcomes. Location intelligence is key to identifying the targeted communities. These are critical to the successful implementation of any healthcare program.

Providing and delivering health services at the micro level entails service points at health facilities, house-to-house delivery, and temporary outreach points. To achieve this, knowledge of the location, characteristics of the target population, demographic of the population and available resources can be obtained by leveraging the power of location intelligence. In today`s world, we need to go beyond overlaying data onto maps to tap into geographic intelligence locked up in the health sector and patient data. Knowing how many health facilities are in the target community, and their distance from each other is important in estimating its accessibility to the population. Microplanning helps identify potential coverage gaps due to inaccessibility and aids in establishing more service delivery points. Location intelligence serves as a guide for where these service points will be set up. For optimal results, the information obtained must be accurate and current which geospatial data can provide. Outdated or incomplete information can result in inefficient resource allocation and inability to reach the target population needing the most intervention. These gaps can lead to health inequity, poor accountability and transparent service delivery.

A service assessment must be carried out for the health facilities by conducting a Community Health Needs Assessment (CHNA) while considering the following:
1) Health Facility type (Primary, Secondary or Tertiary).
2) Administrative system.
3) General management.
4) Facility capacity for patients.
5) Specified catchment area.
6) Condition of facility infrastructure.
7) Finance system.
8) Availability of operational resources.
9) Services and costs.
10) Human resources management.
11) Health management information systems.
These details will aid proper, adequate, and timely preparation to reach the communities and map the demographic and socioeconomic characteristics of the target community.
This map of Nigeria visualizes selected healthcare facilities in some Nigerian states (figure 1). Some states have huge landmasses like Kaduna and Katsina which may mean that some potential target communities may not be captured at these health facilities. A mobile or temporary health service point may be required in such cases. Conducting CHNA routinely will aid in-depth understanding of the target community and lead to positive strategic outcomes by channeling and concentrating services to where they are needed the most.

Figure 1: Selected Health Facilities

The second map of Nigeria shows the number of patients registered in the health facilities by the Local Government Area (LGA). The hot spot analysis reveals a high concentration of registered patients in the South-East, South-West and South-South regions. This map informs us that more resource deployment will be needed in these zones than in the others. A CHNA will provide a detailed demographic and geographic breakdown of the communities. This will allow hospital resources to align with the targeted community needs precisely like determining if and where supplies can be kept there, how many patients the facilities can handle, the health services that can be rendered, accessibility planning solutions for entering the community, and efficient routes to locate them and deploy resources. This way, resources are also properly managed and accounted for and the outcomes are effectively monitored. Mapping healthcare resources helps to identify communities lacking adequate healthcare services and facilitate planning for new ones. This will help healthcare providers enhance resource allocation, understand the demographics of the targeted population, plan efficient emergency response routes, and identify areas that need healthcare the most.

Figure 2: Facility Hotspot Analysis

GIS is a proven tool for improved and efficient planning in healthcare. It is increasingly being used to develop better business models and make critical decisions. It describes and provides insight that helps understand the changing spatial organization of healthcare and examines its relationship to healthcare outcomes and access. GIS supports additional examinations of opportunities for optimization. Informed assessment of the targeted community`s mobility and vulnerability can aid in prioritizing areas of focus for growth and service expansion. Spatial analysis can help identify neglected populations, untapped markets within the target communities, possible expansion, and facility evaluation. Its significant impact on healthcare delivery and decision-making processes provides valuable insights for policymakers.
Aliogo, Rukevwe Akpevwe is an Abuja based GIS Specialist.