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Shiraz E Medical Journal, Vol. 10, No.

4, October 2009

In the name of God

Shiraz E-Medical Journal


Vol. 10, No. 4, October 2009

http://semj.sums.ac.ir/vol10/oct2009/87055.htm

Applications of GIS in Health Sciences.

Najafabadi A T*.

*Department of Geoinformatic, pune university, Pune, India.

Correspondence: Aireza Taravat Najafabadi, Department of Geoinformatic, pune university, Pune,


India, Telephone: +91(20) 99601-26500, Fax:+91(20) 99601-26500, E-
mail:alireza.taravat@gmail.com

Received for Publication: January 26, 2009, Accepted for Publication: June 17, 2009.

Abstract:
GIS provides an excellent means for visualising and analysing epidemiological data, revealing
trends, dependencies and inter-relationships. It can acquire, store, manage, and geographi-
cally integrate large amounts of information from different sources, programmes and sectors.
GIS serves as a common platform for the convergence of multi-disease surveillance activities.
Standardised geo-referencing of epidemiological data facilitates structured approaches to
data management. Once the basic structure is ready, it is easy to convert it to a surveillance
system for any other disease. Public health resources, specific diseases and other health
events can be mapped in relation to their surrounding environment and existing health and
social infrastructures.
GIS helps generate thematic maps that depict the intensity of a disease or vector. GIS can
identify catchment areas of health centres and also locate suitable sites for a new health
facility. GIS allows interactive queries of information contained within the map, table or
graph. It permits a dynamic link between databases and maps so that data updates are
automatically reflected on the maps. Dynamic maps published on the Internet assist patients
in locating the most convenient health services easily.

Keywords: GIS, health, mapping, Epidemics, Management.

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Introduction: health facility. It can overlay different


pieces of information and carry out spe-
Most health and human service problems
cific calculations.
facing the world today exist in a geo-
graphic context and any analysis must
GIS allows interactive queries of informa-
consider this. Understanding issues rang-
tion contained within the map, table or
ing from medical epidemiology to health-
graph. It permits a dynamic link between
care access requires a comprehensive
databases and maps so that data up-
understanding of their geography. For
dates are automatically reflected on the
this reason, GIS is often used because it
maps. Dynamic maps published on the
provides an excellent means for visualiz-
Internet assist patients in locating the
ing and analyzing epidemiological data,
most convenient health services easily.
revealing trends, dependencies and inter-
GIS can process aerial/satellite images to
relationships. It can acquire, store, man-
allow information like temperature, soil
age, and geographically integrate large
types and land use to be easily inte-
amounts of information from different
grated, and spatial correlations between
sources, programmes and sectors.
potential risk factors and the occurrence
GIS serves as a common platform for the
of diseases to be determined.
convergence of multi-disease surveillance
activities. Standardized geo-referencing Advantages of GIS: GIS has several ad-
of epidemiological data facilitates struc- vantages over conventional methods
tured approaches to data management. used in health planning, management
Once the basic structure is ready, it is and research. GIS can be used to cap-
easy to convert it to a surveillance sys- ture, store, handle and geographically
tem for any other disease. Public health integrate large amounts of information
resources, specific diseases and other from different sources, programmes and
health events can be mapped in relation sectors; including epidemiological surveil-
to their surrounding environment and lance, census, environment and others.
existing health and social infrastructures. Surveillance of diseases requires con-
Such information when mapped together tinuous and systematic collection and
creates a powerful tool for the monitoring analysis of data. GIS can eliminate the
and management of epidemics. GIS helps duplication of effort involved in data col-
generate thematic maps that depict the lection across an organization, and hence
intensity of a disease or vector. It can substantially reduce the cost involved in
create buffer zones around selected fea- it. GIS serves as a common platform for
tures and then combine this information the convergence of multi-disease surveil-
with disease incidence data to determine lance activities. Each data record has to
how many cases fall within the buffer. It be georefenced to a desired level of ac-
can also map the impact zone of vector curacy. Standardized geo-referencing of
breeding site, where control activity epidemiological data facilitates structured
needs to be strengthened. GIS can iden- approaches to data management
tify catchment areas of health centers (Brewer, 2002).Once the basic structure
and also locate suitable sites for a new is ready, it is easy to convert it to a sur-

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Shiraz E Medical Journal, Vol. 10, No. 4, October 2009

veillance system for any other disease, Temporal satellite images can be used to
by replacing data of one disease with the monitor land use and land cover changes
data for another disease (O'Sullivan, over time.
2003).
GIS Integrates Data; A geographic infor-

GIS provides access to additional infor- mation system (GIS) is a computer-


mation from a wide variety of sources. based tool that organizes and displays
Global positioning systems (GPS) can be data. In health organizations, GIS pro-
used to obtain locations of point features vides powerful tools for geographic and
on a map, such as wells or septic tanks, spatial analysis, and it allows you to
precisely. GIS can process aerial or satel- visualize data that may have gone unno-
lite imageries to allow information such ticed in spreadsheets, charts, and other
as temperature, soil types and land use reports.
to be easily integrated, and spatial corre-
lations between potential risk factors and GIS puts information at your fingertips,

the occurrence of diseases to be deter- allowing you to obtain accurate informa-

mined (Brewer, 2002). High resolution tion quickly. By integrating database op-

satellite imageries and aerial photo- erations, such as query and statistical

graphs can be used to obtain accurate analysis, with geographical and spatial

and up-to-date maps of any region. Lat- visualization, you are able to predict,

est, accurate, low cast maps are essen- plan, and recommend interventions and

tial for epidemiological surveillance. strategies with confidence.

Figure 1: Different type of health organization data


is occurring in which parts of the country,
Visualization; GIS offers powerful tools to as this has important implications for the
present spatial information at the level of disease eradication strategy employed
individual occurrence, and to conduct (Longley, 2005). GIS can help in gener-
predictive modeling. It determines geo- ating thematic maps - ranged color maps
graphical distribution and variation of or proportional symbol maps to denote
diseases, and their prevalence and inci- the intensity of a disease or a vector
dence. For example, in studying the sur- (Figure 2). In comparison with tables and
veillance of poliomyelitis in India, it is charts, maps developed using GIS can be
important to find out which type of polio

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Shiraz E Medical Journal, Vol. 10, No. 4, October 2009

extremely effective means for communi- grammes, making it easier for policy
cating messages clearly even to those makers to understand. GIS permits a
who are not familiar with technology. GIS dynamic link between databases and
keeps track of the geographical locations maps so that data updates are automati-
of service providers, customers, re- cally reflected on the maps.
sources, and health plans and pro-

Figure 2: Environmental Health Risks in Port-au-Prince (Maximum combination technique using


the Geometric Interval classification method) (Myrtho Joseph, 2007)

Overlay analysis; GIS can overlay differ- of hazardous material. The user can
ent pieces of information. This helps in specify the size of the buffer and then
decision making and medical research combine this information with disease
through multicriteria modeling (for ex- incidence data to determine how many
ample, in understanding the association cases fall within the buffer. Buffer or
between prevalence of certain diseases proximity analysis can be used to map
and specific geographic features). the impact zones of vector breeding
sites, where control activity needs to be
Buffer analysis; GIS can create buffer strengthened.
zones around selected features. For ex-
ample, a radius of 10 km around a hospi- Network analysis; GIS provides the abil-

tal to depict its catchment area or 1 km ity to quickly access the geodemographic
around a pollution site or 5 m on both dynamics of an organisation’s existing
sides of sewerage to indicate the spread service area in contrast to the likely de-

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Shiraz E Medical Journal, Vol. 10, No. 4, October 2009

mand for services at a new location (Fer- Statistical analysis; GIS can carry out

guson, 2004). It can identify catchment specific calculations, for example, propor-
areas of health centres and also locate tion of population falling within a certain
suitable sites for a new health facility. radius of a health centre or dam. It can
Health services delivered at home can be also calculate distances and areas, for
scheduled in a more efficient manner by example, distance of a community to a
analyzing transportation factors and health centre, and area covered by a par-
street patterns, and by recommending ticular health programme or percent of
the most efficient route. GIS Provides area at-risk by using a classification
accurate and timely information about technique (Bell, 2007).
where health services are located and
instructions and maps on how to get
there.

Figure 3: Environmental Health Risks in Port-au-Prince (Percent of area at-risk by classification tech-
nique (Myrtho Joseph, 2007)

Query; GIS allows interactive queries for American Indians and Alaska natives
extracting information contained within from the 2000 census (Figure 4).
the map, table or graph. It can answer
queries of location, condition, trends, Extrapolation; GIS provides a range of

spatial patterns and modeling. For exam- extrapolation techniques. For example,

ple, using GIS in a first national mapping vector distribution in inaccessible and

of functional disability among older unsampled areas can be mapped using


GIS.

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Shiraz E Medical Journal, Vol. 10, No. 4, October 2009

Figure 4: Using GIS in a first national mapping of functional disability among older American Indians
and Alaska natives from the 2000 (CDC, September 2006).

Web GIS ments to medicine and health research,


and can assist in the following profes-
One of the recent advancements in GIS sions:
technology is web-based GIS. Health E Public Health Professionals
data is stored in a central server which E Administrators
can be accessed from various terminals E Epidemiologists
connected to the server through internet E Health Researchers
or intranet. Statistical and epidemiologi- E Health and Human Services Profession-
cal methods need to be developed to als
protect individual confidentiality while E Hospital Directors
accessing data. Internet based GIS tech- E Policymakers
nology eliminates the traditional method E Preparedness Coordinators
of flow of information, and the informa- E Paramedics
tion is instantly available across the E Community Health Worker
globe. Dynamic maps published on the Public Health Professionals; GIS provides
web allow patients to locate the most a common analytical framework in which
convenient services to their home or public health authorities can understand
work easily. problems and formulate a response, im-
proving incident management and health
Applications of GIS in Health Sciences
planning.
E Disease Surveillance
It is obvious that GIS has a lot to offer
E Program Evaluation
the health sciences. On the other hand,
E Data Management
GIS involves concepts and analytic tech-
E Emergency Response and Preparedness
niques that can lead to the uncritical use
E Epidemiology Research
of the technology. Epidemiology, statis-
E Case Management
tics and geographic information science
E Outreach and Promotion
combined can bring important improve-
E Administrative Systems using GIS

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Shiraz E Medical Journal, Vol. 10, No. 4, October 2009

The underlying factors that are likely to


GIS and Epidemiology; Understanding the lead to increases in the incidence of cer-
determinants of a disease, and its spread tain diseases, including adverse environ-
from person to person and community to mental, behavioral and socio-economic
community has become increasingly conditions, need to be monitored regular-
global (Ezatti, 2003). GIS plays a vital ly. By tracking these sources of diseases
tool in strengthening the whole process and the movement of contagions, health
of epidemiological surveillance informa- agencies can respond more effectively to
tion management and analysis. GIS pro- the outbreaks of epidemics by identifying
vides excellent means for visualizing and populations at risk.
analyzing epidemiological data, revealing Software packages such as BodyViewer
trends, dependencies and inter- by GeoHealth help medical personnel vi-
relationships that would be more difficult sualize clinical data. Integration of clinical
to discover in tabular formats. Public information is accomplished by linking
health resources, specific diseases and unique codes directly to a graphical re-
other health events can be mapped in presentation of the human body and to
relation to their surrounding environment the geographical location where the pa-
and existing health and social infrastruc- tient has originated (Ezatti, 2003). Such
tures. Such information when mapped geoclinical information system is a useful
together creates a powerful tool for mon- tool when evaluating environmental risks
itoring and managing diseases and public and exposures.
health programmes (Figure 5).

Figure 5:HIV/AIDS Incidence Density among Teens and Youth (13-24) Dallas County 1999-2003(CDC,
2005).

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Shiraz E Medical Journal, Vol. 10, No. 4, October 2009

across space at regional, local and


Service Routing; Health services delivered neighborhood scales. The accurate,
at home can be scheduled in a more effi- timely, relevant and clear demographic
cient manner by analyzing transportation and social service information have be-
factors and street patterns and by rec- come a powerful tool that enables deci-
ommending the most efficient route to sion makers to do the monitoring, plan-
and from each patient’s home. ArcLogis- ning, and evaluation more rationally and
tics™ Route software provides a dynamic effectively. This field consists of the fol-
solution to improve on your existing lowing units:
scheduling and routing method by linking E Service Planning
directly to an existing Admission Dis- E Point of Service Geo-coding
charge Transfer (ADT) system (Smith, E Case Management (Figure 6)
2007). E Client Tracking
E Location Services
Hospitals and Health Systems; Private
E Data Management
healthcare providers and hospitals can
capture data, analyze and prepare quality
visual presentations in forms of reports
and maps for use in product planning,
market fore-casting, and more. This field
consists of the following units:
E Market Planning
E Strategic Planning
E Marketing
E Research and Evaluation
E Preparedness and Emergency Response
E Population Health
Figure 6: Method for mapping population-
E Point of Service Geo-coding
based case-control studies: an application
E Location Services using generalized additive models, T Webster,
V Vieira1, J Weinberg and A Aschengrau, Int J
Health Geogr 5:26 JUN 2006; (CDC, Septem-
Social Services; One of the most impor- ber 2006).

tant issues concerned by both the public


Customer Service; Providing accurate and
and government in a community is the
timely information about where services
availability and quality of social services
are located and providing instructions
such as childcare support, health care,
and maps on how to get there is becom-
and housing. In recent years, Geographic
ing a requirement of good customer ser-
Information Systems (GIS) has been in-
vice. Putting dynamic maps on the Inter-
creasingly used to assess the adequacy
net allows patients to locate the most
and quality of social services by various
convenient services to their home or
government agencies and community
work easily. MapObjects® Internet Map
organizations (Bell, 2007). GIS helps to
Server (IMS) allows the user to publish
reveal the dynamics that underlie the
site-specific information, travel direc-
demand, supply, and use of services

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Shiraz E Medical Journal, Vol. 10, No. 4, October 2009

tions, and maps based on where the equipment in a safe condition are func-
caller is located (Smith, 2007). tions that require information that can be
visualized quickly. Linking the physical
Site Selection; Identifying a new service location and the condition of equipment
location is one of the most basic func- and/or supplies in a large plant facility or
tions of business development. Having in a widely distributed medical campus is
the ability to quickly access the geode- a powerful new management tool.
mographic dynamics of your existing ArcView GIS can provide a visual link to
markets in contrast to the likely demand other enterprise applications that track
for services at a new location requires a resources and their consumption or dep-
flexible, yet powerful analytical software loyment (Smith, 2007).
tools. ArcView Business Analyst, ArcView What Is GIS Doing for Health Organiza-
GIS, Atlas GIS, and BusinessMAP PRO tions Today?
software all provide varying levels of ca- GIS technology is powerful and afforda-
pabilities for site selection (Smith, 2007). ble. Its strengths lie in its ability to
create access, integrate, and publish
Managed Health Care; Arranging and
large amounts of geographically relevant
paying for healthcare is an important ac-
information. Here are just a few of the
tivity in any health organization. GIS
ways GIS is working in health organiza-
provides an efficient way to organize and
tions today:
manage a wide variety of administrative,
E Track infectious diseases and identify
medical, and social services to patients
gaps in child immunizations.
or clients. Health organizations are using
E Conduct market studies and document
GIS to help their workforce deliver higher
health care needs of a community.
client service. GIS can be applied to
E Manage materials, supplies, human re-
manage health care such as: home
sources, and logistics.
health and social service case workers,
E Maintain locational inventories of health
hospital discharge planners, disease
care facilities, providers, and vendors.
management, lab couriers, for getting
E Route health care workers, equipment,
clients and workers to the right place
and supplies to service locations.
efficiently has become a business im-
E Publish health care information using
perative for many organizations. This
maps on the Internet.
field consists of the following units:
E Manage patient care environments and
E Network Management
clinical resources.
E Data Management
E Distribute clinical data in a visual and
E Point of Service Geo-coding
geographic form.
E Enrolment Management
E Locate the nearest health care facility or
E Population Health
health care provider on the Web.
E Disease Management

Resource Management; Knowing where


Conclusions:
medical equipment and supplies are lo-
cated as well as maintaining clinical

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