266728 Combining EHR data and geospatial mapping to more effectively target comparative effectiveness research

Monday, October 29, 2012

Katelyn Tambellini, MPH , Center for Pediatric Informatics, Children's National Medical Center, Washington, DC
Background: A novel research methodology to target clinical effectiveness research (CER) was developed incorporating geospatial mapping of electronic health record (EHR) data. We hypothesized that this methodology will enable researchers to more effectively develop hypotheses and target population covariables associated with healthcare conditions.

Objective/Purpose: By deriving patient characteristics, such as address data, from the EHR and combining this information with geospatial data sets, high density problem foci can be highlighted. This idea was piloted by mapping the body mass index (BMI) of approximately 48,500 children, along with co-variables of interest, such as fast food restaurants.

Methods: Retrospective data was queried from the EHRs of a children's hospital, as well as both inner-city and suburban pediatric ambulatory clinics in the DC metropolitan region. Data underwent statistical analysis to exclude unusable sets. Patient address data were de-identified and geocoded to produce GIS point data.

Results: 48,500 unique patient records from 2009-2010 were geographically aggregated and analyzed. 33% of children aged 2 to 20 in the targeted metropolitan region were overweight, obese, or severely obese. Popular fast food restaurants were not geospatially associated with childhood obesity when plotted against the BMI data on the regional map.

Discussion/Conclusions: The maps reveal high density focal areas of childhood obesity. CE researchers will likely utilize this tool to identify specific communities for hypothesis generation and research study recruitment. This methodology also has extensive applicability for other health care conditions.

By the end of the session, the participant will be able to:

1)Demonstrate effectiveness of mapping addresses concurrent with health conditions to identify potentially related environmental factors 2)Describe potential of geomapping EHR data as a tool for CE researchers to identify neighborhoods to target for subject recruitment 3)Describe potential of geomapping EHR data as a tool for CE researchers to generate hypotheses

Learning Areas:
Public health or related research

Learning Objectives:
Discuss the potential of EHRs to provide a population level database to identify research subjects Demonstrate the effectiveness of mapping tens of thousands of patients' addresses concurrent with a specific health condition in order to quickly identify potentially health related environmental factors Describe the potential of geomapping health record data as a tool for comparative effectiveness researchers to quickly identify neighborhoods to target for participant recruitment

Keywords: Geographic Information Systems, Research

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a clinical analyst and project manager of my organization's efforts to promote the geospatial mapping potential of EHR data in order to more effectively target health interventions and identify possibly related environmental factors to disease, specifically high BMI in children.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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