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GIS for
Improving
Health Service
Delivery
Cheryl AMOROSO, John DERIGGI, Nicole GREY, Danielle
RICHEY, Peter BAREBWANUWE, Donn Gaede
GIS – EMR Pilot Project
Partners in Health – Rwanda
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Why GIS project in the health centers
we support?

Improve patient services

Improve patient services

Improve patient services

Assess and address public
health risks

Do some research….
to improve patient services
and address public health
risks
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Pilot in Rwinkwavu Sector Jan-June 09
Aim:
Determine if collecting and using GIS
data is feasible in our environment
Estimate time of collecting data
Estimate costs of “doing this properly”
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Resources for Pilot
Resources:

2 MPH candidates for 5
months
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1 local project assistant

4 GPS units

$1500

3 pairs of rubber boots
Getting this work done with
only this and community
health worker supervisor
time,willingness and
effort?
Priceless
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Mapping and Training Outcomes
of GIS Pilot

Mapped all of the 48
villages, 14
schools,100+ water
sources,homes of 157
CHWs, and homes of
600+ HIV, TB and
chronic care patients
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Developed
Kinyarwanda GIS
training guide
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Informal and formal
(by CGIS) training for
community health
workers supervisors
to collect GPS data
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Collaboration and case study
outcomes of GIS project

Collaborated with the Rwanda
GIS center to obtain high
resolution base maps of our
catchment from the US State
Department

Built strong relationships with
local government and
provided feedback

Conducted a case-study
project based on following 3
community health worker to
document distances and
challenges
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Data use outcomes of pilot

Examine patient density in
relation to health centers
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Examine patient quality of
care (CD4 counts on time, visit
attendance)
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Associating Coordinates to Patients
1 ) Patient address goes
into the system
2 ) If the address is valid
then get the coordinates
3 ) Associate the
coordinates to the
patient's address
umudugudu_id latitude
longitude
0104020507
-1.9534521
30.651238
…
…
…
address_id
precision
lat
lon
34
1
-1.9534521
30.651238
…
…
…
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Associating Coordinates to
Patients
address_id
precision
lat
lon
34
1
-1.9534521
30.651238
237
0
-1.9812122
30.234525
This patient's coordinates
were derived from their
address
This patient's coordinates
were collected at their
house with a gps device
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Using The Google Earth and Maps API
Web Browser
Retrieve
patient data
in JSON
Retrieve
imagery
from Google
Public
internet
connection
Patient data
+Rendering Data In The Google Earth API
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Interactive Maps Using The Google Maps
API
Clicking on an icon renders
patient data including great circle
distance to the hospital
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Filtering The Data

Filtering by CD4 count, on time CD4, Distance to Hospital,
Time Since Last Visit
Open Source Spatial Data
Infrastructure
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OpenLayers
WMS Module
WMS/WFS
WMS/WFS
uDig (Desktop App)
GeoServer
Shape
Files
Data Sources
PostGIS
Imagery
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Advantages of GeoServer

No dependence on a connection to the internet

Having spatial data outside of OpenMRS is more scalable

Data is accessible from any application capable of
communicating in WMS or WFS format
+ uDig Displaying Data From GeoServer
+ OpenMRS Displaying Data From
GeoServer Using OpenLayers
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This work is
possible – but we
need to resource it

There is an
opportunity for
GIS to integrate
with OpenMRS
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The community is
interested in GIS
technology, and
capable of
understanding
and using it with
some initial
support
What we learned
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GIS and PIH: Future plans
 Continue
to map villages
in District Hospital
catchment area
 Link
GIS data with
primary care data in
EMR
 Make
the technical
architecture a reality
 Produce
sharable
products related to GIS
and OpenMRS