A family doctor’s GIS story

A family doctor discovers that GIS is central to improving patient care

An eye-opening encounter with GIS

A Nova Scotian family physician, Ajantha Jayabarathan, also known as Dr. AJ, discovered GIS in 2011 at a medical conference in Philadelphia.  A presenter, also a family doctor, conducted a GIS project that made it clear to policy makers that neighbourhoods where demand for healthcare was high have few services available.  He said that promoting equity in healthcare system means making healthcare services go to disadvantages communities, not the other way around.

It seemed both simple and obvious to Dr. AJ.

When she returned home to Halifax, Dr. AJ sought help from Esri Canada to map her patients’ addresses. It was eye-opening to see that of the 1,400 people visiting the clinic, only 30% were in a 50 km range of her clinic. She realized that some quite elderly patients were travelling up to 2 hours to spend 15 minutes with her.

Health checkups should consider patient’s location

Where people live matters to their health. In parts of Nova Scotia, natural carcinogens such as radon or arsenic are significantly higher than health guidelines. In fact radon is the second biggest cause of lung cancer in NS.  When Dr. AJ came across the Nova Scotia radon map, she thought of screening her patients living in high impacted areas, more for lung cancer.

Dr. AJ is also convinced that all her colleagues should have this location information readily available with their patients’ medical records. Such simple but critical information would help them make more effective decisions for their patients’ healthcare.

A geo view of a patient’s location

In the summer of 2020, a rural clinic lost two doctors which orphaned 2500 patients. Nine doctors from across the province agreed to work virtually, but Dr. AJ realized that, in a different part of the province, the doctors didn’t know the locally available health services.

To create a virtual network of care showing all health service providers in the area, demands  a geo view of each patient’s location and so that, during a virtual visit, the doctor can see where other health care services -like appropriate and available specialists - are in that neighbourhood.

An interactive map with all health services mapped is the quickest way to provide the solution to doctors working virtually. Without the geoview, finding a nearby specialist can be extremely time-consuming. Currently, most health workers default their patients to bigger centres where the waitlists are long.

Imminent challenge - orphaned rural patients

Dr. AJ sees GIS as both central to healthcare delivery and a game changer for the imminent healthcare revolution – retiring doctors.

A 2018 study showed that 834 doctors in Atlantic Canada were 65 or older. All the knowledge they’ve acquired about the local health risks, finding local specialists, relationships they have with local hospitals and other healthcare providers, disappears with them.

The effect on NS healthcare could last a decade.

Doctor recruitment and local knowledge takes time to build, so in the meantime a virtual team of doctors will fill the need. So patient records must be digital to ensure that local knowledge stays with their records and is easily shared among visiting nurses, hospitals, pharmacists, nurse practitioners and others. They need GIS to be the eyes of the virtual network, so they understand local communities while working remotely.

It’s never about just the technology

What struck me talking to Dr. AJ is that technology is the easiest part of the solution to these issues and GIS could address many of the health system issues she wants improved. Her bigger challenge is that most health care workers have no idea how much easier GIS could make their lives and feel they don’t have the energy to learn something else. Dr AJ is working hard to prove to her colleagues that GIS would not only make their work easier, it would also save the healthcare system a great deal of money.

She is hopeful that once her colleagues see what is possible, they will jump in and help. Her ask of all GIS professionals? Talk to healthcare people and help them see what others can’t.

Listen to the full podcast interview with Dr AJ here.

This post was translated to French and can be viewed here.