Geographic and geospatial information systems offer profound insight for any type of industry. Health care is an example of one that can benefit greatly. One area that is proving promising is in the analysis of how consumers use hospitals. With some help from staff with GIS training, hospital executives should be able to identify so called super users — those who make the heaviest use of the facilities — and devise strategies to help deliver better care while lowering costs.
The concept has been demonstrated by Dr. Jeffrey Brenner, a family physician in Camden, N.J. who was given a so-called genius grant by the MacArthur Foundation. His approach of “hotspotting” the super users allowed the area to cut health care costs by half, according to the Robert Wood Johnson Foundation.
“[We] spent $100 million for a city of 79,000 people,” the foundation quotes him. “We wasted a lot of money. Good doctors at good hospitals go to work every day and deliver disorganized and fragmented care.”
By using GIS techniques and analyzing usage patterns, Brenner and his team found that an oversized amount of spending was concentrated on a relatively small number of citizens. One patient had literally gone to the hospital 113 times in a single year. Super users in just two buildings accounted for an aggregate of $30 million in health care spending. The amount is staggering, and yet becomes clearer if you recognize that people without a recognizable alternative will make use of one of the most expensive delivery mechanisms for care that there is.
An outreach team comprising a nurse practitioner, a social worker, and a health outreach worker, with additional help available from a family medical doctor, can travel to a patient’s location. Once there, they work to stabilize their conditions as well as help them apply for various benefits such as temporary shelter if homeless and government assistance.
The approach is expanding elsewhere. The state of Maryland has used Esri software and data from the state health information exchange to identify their own super users and provide preventative care that could keep people from landing in a hospital in the first place.
One effort was the creation of five Health Enterprise Zones, providing patient-centric care with a physician and assistants in areas of Annapolis that had high emergency room use and hospital admissions and readmissions. The state had the goal to lower readmissions by 15 percent by 2015. The reduction so far has already hit 11 percent to 12 percent.
The only way to reform health care is to recognize what available data shows and find ways to change behavior, putting the emphasis on preventative care rather than reacting after the fact to emergencies caused by chronic conditions. GIS, and the people who know how to implement it, will be key in that effort over the coming years.