eVO: focusing the power of spatial upon health services demand, planning and delivery.
Designing better local healthcare services means gaining a better understanding of the community.
Geographic Information Systems are the perfect tool for understanding the local area and uncovering complex cause and effect relationships that influence local health commissioning. It then goes further and aids in the planning, execution, management and review process.
To understand the dynamic of the health economy, commissioners need to be able to understand the national and local picture. GIS can quickly zoom to a national, regional, community, practice, post code or custom level. GIS can overlay and analyse multiple complex datasets to identify underlying issues and gaps in supply and demand. This diagram shows supply and demand gap analysis for GP surgeries.
Demand analysis for GP services and the rationalising and redesign of services to meet changing demographics and restructuring.
eVO assists health analysts and those designing and commissioning services to understand how their services need to operate within local, regional and national contexts. eVO provides simple or complex views of many different criteria which affect the services to be delivered now and in the future – particularly identifying current and predicting future demands on services.
NHS Lothian, a regional NHS Board within Scotland, have embedded geospatial intelligence into the planning, organisation and delivery of health services throughout the Lothian Region.
StatMap provides NHS Lothian with their corporate intranet-based Earthlight GIS, which provides for the analysis, maintenance, editing and dissemination of data and spatial data throughout the organisation.
Earthlight also enables the provision of user accounts and use of the system to partner and third-party agencies who work with NHS Lothian in the provision and commissioning of services.
Earthlight is increasingly widely used within NHS Lothian for planning and improving of services.
General Practitioner provision
General Practitioner (GP) reorganisation to rationalise services to improve efficiencies and balance out demand more evenly across GP surgeries throughout the Lothian Region. They key is to formulate a regime whereby GP practices can work together more effectively and enable them to identify, create and define geographical boundaries to create catchments which reflect better their core patients.
By reorganising the allocation of patients to GP practices, NHS Lothian is able to achieve an advantage for both patients and GPs. As an example, by reducing losses in travelling times for patients, and for GPs undertaking home visits. Of particular importance in achieving this has been the integration of the NHS Lothian patient databases with Earthlight, using StatMap’s DataPump ETL data integration software.
StatMap’s enterprise intranet GIS, Earthlight, has proven instrumental in this process through enabling the identification of locations of patients and has allowed for the collaborative redrawing of boundaries, so providing an optimisation of the boundaries for each GP surgery.
Because of Earthlight’s internet browser client delivery of functionality, NHS Lothian has been able to provide capabilities for defining, querying and analysing the locations of current patients to staff at each of the GP practices within the region. This has greatly assisted the collaborative process, achieving an equitable, fair and agreed outcome to the process.
eVO Population Density Grids
Population Density Grids were created, using the density kernel creation capabilities within Earthlight, to provide visual representation of the concentrations of patients who visited Accident and Emergency (A&E) services by their age ranges, in conjunction with their reason for visiting. As an example, of particular interest was the locations of those who visited A&E as a result of falling, and who are over 65 years of age.
These were used to identify hotspots and concentrations which assisted the various agencies and teams who were tasked with caring for this demographic. As a result, it is now possible to place NHS and agency staff in the right places to improve prevention, response and care.
On a wider scale, by creating hotspot mapping, NHS Lothian has been able to locate trends in population and identify gaps in service provision. It has also assisted in identifying where future service provision could be more usefully located.
The intention is to create and organise services so that they are more focused, structured and better located to provide for the local population that they are intended to serve. Of particular importance is:
- Identifying gaps in services provided.
- Finding out where your target populations are.
- Identifying patients living within the Lothian Region, and those patients who are using NHS Lothian services, but who belong to other regions.
- Characterising and understanding the broad population within localities, using socio-economic data for those defined localities (e.g. census-based data).
GIS and Planning for Long Term Health Service Provision
Earthlight is, and will be into the future, proving essential in achieving effective long-term and strategic planning for service provision for population within the Lothian Region.
As part of this, the eVO Platform is being used for:
- Monitoring planned new build sites and land allocated within Local Development Frameworks (formerly known as Local Plans) for housing and residential development in order to ensure that suitable and appropriate services are provided in the right places for the expected and projected populations of the future.
- Managing major emergencies – exchanging data relating to vulnerable and ‘at risk’ persons with social work sections and care providers, utilising common address identifier index references (UPRN) within national gazetteer products.
Rationalising and planning in the event of GP practice closure: because GP practices are, in effect, private entities – they can and do close if there are insufficient interest from qualified GPs to take them over if, and when, the current GPs retire, move away, etc. In these events, it is necessary to use GIS to identify patients registered with that GP and to reallocate those patients to the most appropriate GP practice, on a logical manner which minimises inconvenience to patients. Earthlight has proven essential in this regard.