A Cure for Global Health – Build an SDI

Contributed by: 
Ajay K Gupta, CISSP, MBA CEO, HSR & OGC Health DWG Chair. Health IT, Cybersecurity Expert & Sports aficionado

 

For much time now, the OGC Health DWG has been working on a white paper to communicate to the health and geospatial communities the value that a Spatial Data Infrastructure (SDI) can bring to healthcare – and to encourage the development of such a resource for the global community - as SDI can be a platform to aid efforts to achieve healthcare’s twin goals of improving quality while reducing costs.  This value will be felt by a wide set of players in, and associated with, healthcare, including:

  • Solution Providers – to understand market needs and add value to services
  • Market Participants – to understand where OGC standards can be applied to support improved health outcomes
  • Government and Institutes – to understand market priorities surrounding the need and use of data in healthcare, and to design health-oriented SDIs
  • Standards Organizations - to understand opportunities to develop or improve standards to support health applications and the healthcare industry overall
  • Researchers – to have a foundation of elements for advancing research on SDIs and health-related applications using OGC Standards
  • Health and Medical Researchers – to understand how geospatial analytics on health and social data sets can causes and consequences of poor health outcomes that may be in need to further research towards identifying viable treatment options, as well as advancing the research towards solutions to population health challenges
  • Health Systems - to understand how such a framework could contribute to clinician point-of-care decision support and inform and improve patient care
  • Insurers – to understand how geospatial analytics on health and social data sets can indicate long-term health risks of populations, as well as potential means of intervening on those risks

Use Cases of a Health SDI

By bringing together health and social data along with geospatial tech, a Health SDI will provide value by allowing for the creation and hosting of applications addressing a wide range of current population health challenges – a few of which are listed below and further examined in the planned White Paper:

  • Climate Health – changes in climate can impact at-risk populations by threatening the availability of steady and reliable electrical power. A Health SDI can provide access to applications such as the emPOWER layer produced by the U.S. Department of Health and Human Services (HHS) which identifies by area (state, county, and ZIP Code) the number of people dependent on electrically-powered life-saving medical devices.
  • Healthy Aging - Some populations, including the elderly, are more vulnerable than others to changes in health status. In order to address and reduce the vulnerability of the aging population, health organizations are increasingly turning to geospatial analysis to assess and prioritize areas for intervention based on locational factors, such as social determinants of health and healthcare costs & outcomes, which can be hosted on a Health SDI.
  • Global Indicators - In order to successfully leverage global indicators to help nations meet and track progress towards the goals of improved health status and health outcomes, such as the U.N. Sustainable Development Goals, a Health SDI can store data, track progress, and give decision- and policy-makers access to the data to empower appropriate and necessary action to improve that health status. It can also provide the world at large access to these global indicators and create global awareness of current health status.
  • Health in the Smart City - Smart Cities provide an exciting opportunity to continue and further drive advancements in the delivery of public services. Distributed Internet-of-Things and Internet-of-Medical-Things sensors on wearables, mobile medical devices, and even perhaps implantables, a Smart City infrastructure allows for new means of gathering data on all aspects of life-in-the-city and provide health systems new and innovative means of responding to the specific needs of individual patients.
  • Disaster Resilience – A Health SDI can support disaster resilience efforts by geocoding and providing color-coded risk index (see Figure 1) and specific health data to the disaster response planning effort as well as on-the-ground emergency medical response personnel. This will lead to greater visibility into the health and medical needs of disaster-impacted populations - avoiding health complications and saving lives that may otherwise be lost to the disaster. The Health Risk Index, currently a working demonstration, was developed through the recent Phase 1 of the OGC’s Disaster Resilience Pilot.  

Figure 1: A Health Risk Index for disaster-related health risks at the ZIP Code level
Figure 1: A Health Risk Index for disaster-related health risks at the ZIP Code level

 

Health SDI Architecture:

A generic data workflow for a Health SDI is shown in Figure 2. The workflow is aligned with the architectural approach presented in The SDI Cookbook, developed with the support of the Global Spatial Data Infrastructure community. Alternate workflows and architectures are certainly possible to accomplish specific goals.

Figure 2: Simple Health SDI Architecture
Figure 2: Simple Health SDI Architecture

The first step in putting together a Health SDI is to identify relevant health and social data. U.S. health datasets can be retrieved from organizations including the Centers for Disease Control and Prevention (CDC), Centers for Medicare and Medicaid Services (CMS), and the Department of Health and Human Services (HHS).  U.S. social datasets can be retrieved from the Census Bureau (Census) and Bureau of Labor and Statistics (BLS) among others. Global datasets can be accessed from the United Nations (U.N.); the World Health Organization (WHO) and its regional organizations, such as the Pan American Health Organization (PAHO); from national level health departments and data portals, such as the Bayanat.ae data portal of the United Arab Emirates. Additional sources of data include health Registries, disease-specific healthcare industry organizations and affinity-groups, university and research organizations as well as other public and private organizations that make data available for public consumption.

Geocoding, processing, and aggregating the curated and harvested data will result in a catalog, or an SDI, with a theme of health. This centralized catalog of health (and non-health data that is relevant to health outcomes) is valuable in and of itself: it provides an invaluable resource into population health status as well as aids research into the causes of, and potential remedies for, health challenges facing populations.

Data from the Health SDI can be retrieved in open, standard formats, can be geocoded, and prepared for analysis. The resources on the Health SDI can be made available to users in numerous ways, potentially including but not limited to:

  • Linking to a data provider
  • Direct download
  • Through OGC Open Standards including WFS and WMS

One value of an SDI, especially one utilizing Open Standards, is its ability to links to other SDIs, who themselves are engaged in aggregating, harvesting, and collecting data. This is especially valuable in the health field given concerns over the privacy and confidentiality of medical records. An institution with the medical records, such as a hospital, a health system, or an insurance company, can connect to a national or global Health SDI to leverage the population level data sets, to inform its research and data analytics without exposing personal medical records.

These topics and the technical details around a Health SDI will be discussed in greater detail in the White Paper – as well as discussed in DWG meetings during the Technical Committees (TC) sessions. OGC and the Health DWG invite all who are interested in the intersection of health and geospatial tech to join these discussions. This is a great time to join as we are close to finalizing the full White Paper and plan to present it for broad consideration at the Toulouse TC this November.

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As well as being the OGC Health DWG Chair, Ajay is the CEO of Health Solutions Research (HSR) and has been working in the health IT field for the past 4 years focusing on leveraging geospatial tech to merge, analyze, and discover the relationship between health outcomes & costs and social determinants of health. He is the named inventor on numerous filed US patents on the relationship between these disparate data and supports health systems effort to address health challenges by responding to social factors. In addition to his work at HSR, Ajay is the Secretary of the Board of Directors of Holy Cross Health, a multi-hospital social safety net health system in Montgomery County, MD. He also serves on the Board of Governors for the University of Maryland College Park's Alumni Association. 
When he isn't using HSR's geospatial systems to map disease rates against social factors to identify solutions to population health challenges, such as the opioid epidemic or maternal mortality, you can find him at sporting events (#LetsGoNats) or behind the mic, busting ear drums, while belting out his favorite pop music tunes from U2, Sting, George Michael, or Imagine Dragons. 

Ajay can be contacted via LinkedIn at: linkedin.com/in/ajayguptacissp