+

Cheryl AMOROSO, John DERIGGI, Nicole GREY, Danielle RICHEY, Peter BAREBWANUWE, Donn Gaede

GIS – EMR Pilot Project Partners in Health – Rwanda

GIS for Improving Health Service Delivery

+ 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

+Pilot in Rwinkwavu Sector Jan-June 09Aim:

Determine if collecting and using GIS data is feasible in our environment

Estimate time of collecting data

Estimate costs of “doing this properly”

+ Resources for PilotResources:

2 MPH candidates for 5 months

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

+ 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

Developed Kinyarwanda GIS training guide

Informal and formal (by CGIS) training for community health workers supervisors to collect GPS data

+ 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

+ Data use outcomes of pilot

Examine patient density in relation to health centers

Examine patient quality of care (CD4 counts on time, visit attendance)

+Associating Coordinates to Patients

1 ) Patient address goes into the system

2 ) If the address is valid then get the coordinates

umudugudu_id latitude longitude0104020507 -1.9534521 30.651238… … …

3 ) Associate the coordinates to the patient's address

address_id precision lat lon34 1 -

1.953452130.651238

… … …

+Associating Coordinates to Patients

This patient's coordinates were derived from their address

address_id precision lat lon34 1 -

1.953452130.651238

237 0 -1.9812122

30.234525

This patient's coordinates were collected at their house with a gps device

+Using The Google Earth and Maps API

Public internet

connection

Retrieve patient data in JSON

Retrieve imagery from Google

Web Browser

Patient data

+Rendering Data In The Google Earth API

+

Clicking on an icon renders patient data including great circle distance to the hospital

Interactive Maps Using The Google Maps API

+Filtering The Data

Filtering by CD4 count, on time CD4, Distance to Hospital, Time Since Last Visit

+ Open Source Spatial Data Infrastructure

PostGIS

Shape Files

GeoServer

OpenLayers WMS Module

Data Sources

WMS/WFS

WMS/WFS

Imagery

uDig (Desktop App)

+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

+ What we learned

This work is possible – but we need to resource it

There is an opportunity for GIS to integrate with OpenMRS

The community is interested in GIS technology, and capable of understanding and using it with some initial support

+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