RT Journal Article
SR Electronic
T1 Using Geographic Information Systems (GIS) to Identify Communities in Need of Health Insurance Outreach: An OCHIN Practice-based Research Network (PBRN) Report
JF The Journal of the American Board of Family
                Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 804
OP 810
DO 10.3122/jabfm.2014.06.140029
VO 27
IS 6
A1 Heather Angier
A1 Sonja Likumahuwa
A1 Sean Finnegan
A1 Trisha Vakarcs
A1 Christine Nelson
A1 Andrew Bazemore
A1 Mark Carrozza
A1 Jennifer E. DeVoe
YR 2014
UL http://www.jabfm.org/content/27/6/804.abstract
AB Background: Our. practice-based research network (PBRN) is conducting an outreach intervention to increase health insurance coverage for patients seen in the network. To assist with outreach site selection, we sought an understandable way to use electronic health record (EHR) data to locate uninsured patients. Methods: Health insurance information was displayed within a web-based mapping platform to demonstrate the feasibility of using geographic information systems (GIS) to visualize EHR data. This study used EHR data from 52 clinics in the OCHIN PBRN. We included cross-sectional coverage data for patients aged 0 to 64 years with at least 1 visit to a study clinic during 2011 (n = 228,284). Results: Our PBRN was successful in using GIS to identify intervention sites. Through use of the maps, we found geographic variation in insurance rates of patients seeking care in OCHIN PBRN clinics. Insurance rates also varied by age: The percentage of adults without insurance ranged from 13.2% to 86.8%; rates of children lacking insurance ranged from 1.1% to 71.7%. GIS also showed some areas of households with median incomes that had low insurance rates. Discussion: EHR data can be imported into a web-based GIS mapping tool to visualize patient information. Using EHR data, we were able to observe smaller areas than could be seen using only publicly available data. Using this information, we identified appropriate OCHIN PBRN clinics for dissemination of an EHR-based insurance outreach intervention. GIS could also be used by clinics to visualize other patient-level characteristics to target clinic outreach efforts or interventions.