The Robert Graham Center, Washington, DC, USA.
J Am Board Fam Med. 2010 Jan-Feb;23(1):22-31. doi: 10.3122/jabfm.2010.01.090097.
Despite growing acceptance and implementation of geographic information systems (GIS) in the public health arena, its utility for clinical population management and coordination by leaders in a primary care clinical health setting has been neither fully realized nor evaluated.
In a primary care network of clinics charged with caring for vulnerable urban communities, we used GIS to (1) integrate and analyze clinical (practice management) data and population (census) data and (2) generate distribution, service area, and population penetration maps of those clinics. We then conducted qualitative evaluation of the responses of primary care clinic leaders, administrators, and community board members to analytic mapping of their clinic and regional population data.
Practice management data were extracted, geocoded, and mapped to reveal variation between actual clinical service areas and the medically underserved areas for which these clinics received funding, which was surprising to center leaders. In addition, population penetration analyses were performed to depict patterns of utilization. Qualitative assessments of staff response to the process of mapping clinical and population data revealed enthusiastic engagement in the process, which led to enhanced community comprehension, new ideas about data use, and an array of applications to improve their clinical revenue. However, they also revealed barriers to further adoption, including time, expense, and technical expertise, which could limit the use of GIS and mapping unless economies of scale across clinics, the use of web technology, and the availability of dynamic mapping tools could be realized.
Analytic mapping was enthusiastically received and practically applied in the primary care setting, and was readily comprehended by clinic leaders for innovative purposes. This is a tool of particular relevance amid primary care safety-net expansion and increased funding of health information technology diffusion in these settings, particularly if the hurdles of cost and technological expertise are overcome by harnessing new advances in web-based mapping technology.
尽管地理信息系统（GIS）在公共卫生领域的接受度和实施度不断提高，但在初级保健临床环境中，领导者将其用于临床人群管理和协调的实用性尚未得到充分实现和评估。
在一个负责照顾弱势城市社区的初级保健诊所网络中，我们使用 GIS 来（1）整合和分析临床（诊所管理）数据和人口（人口普查）数据，以及（2）生成这些诊所的分布、服务区域和人口渗透率地图。然后，我们对初级保健诊所领导、管理人员和社区委员会成员对其诊所和区域人口数据的分析映射的反应进行了定性评估。
提取、地理编码并映射诊所管理数据，以揭示实际临床服务区域与这些诊所获得资金的服务不足地区之间的差异，这让中心领导感到惊讶。此外，还进行了人口渗透率分析，以描绘利用模式。对工作人员对临床和人口数据映射过程的反应进行定性评估，发现他们对该过程表现出极大的参与热情，这提高了社区的理解，激发了关于数据使用的新想法，并提出了一系列应用，以改善他们的临床收入。然而，他们也揭示了进一步采用的障碍，包括时间、费用和技术专长，这可能会限制 GIS 和映射的使用，除非可以在诊所之间实现规模经济，使用网络技术，并提供动态映射工具。
分析映射在初级保健环境中受到热烈欢迎和实际应用，并为诊所领导提供了创新用途，易于理解。这是在初级保健安全网扩大和增加这些环境中健康信息技术扩散资金的背景下，特别相关的工具，特别是如果能够利用网络映射技术的新进展克服成本和技术专长的障碍。
