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Empowering Stakeholders to Meet Shared Vision for Local Health Care Delivery

The Central East Local Health Integrated Network (LHIN) in Ontario is turning to digital maps and location-based analytical tools to empower its stakeholders. Find out more about their journey from data visualization to data analysis and the successes they have accomplished on the way.

“Transforming the health care system requires the ability to combine facts and figures with the lived experience of patients and health care providers. With the launch of our interactive web maps, location-driven data analytics is supporting conversations and engagement in our organization and with our partners, supporting the realization of shared visions and empowering stakeholders,” remarked Marilee Suter about the interactive decision-support tool that the Central East Local Health Integration Network (Central East LHIN) developed two years ago.

Indeed, location-based analysis and the resulting insight it produces empower organizations to make smarter, well-informed decisions by considering the where along with the why. Users are empowered to capture the world in a way that analyzes critical information and lays the foundation for a better understanding and conversations about complex situations.

Marilee Suter is the Director for Decision Support at the Central East LHIN in Ontario. Across the province, LHINs are mandated to engage with local health service providers, patients and caregivers and anyone who is impacted by the health system, in order to manage the local health care system and now, since 2017, deliver Home and Community Care services.

As crown agencies of the Ministry of Health and Long-Term Care (MOHLTC), LHINs continually strive to understand the health care needs of the communities they serve and the capacity of the local health care system they manage in order to make value-driven, cost-effective and efficient decisions aligned with provincial priorities and direction.

The Central East LHIN spans a mix of urban and rural geography and is the sixth-largest LHIN in Ontario by land area. Its coverage stretches from Victoria Park in Toronto to Algonquin Park, which has a rich diversity of community values, ethnicities, languages and socio-demographic characteristics.

The LHIN has an annual budget of $2.3 billion, which it allocates among hospitals, community health centres, long-term care homes, mental health and addiction agencies, community support services organizations and contracted service provider organizations. The budget is prioritized so that local residents–who live in the region’s densely populated urban cities, suburban towns, rural farm communities, cottage country villages and remote settlements–have access to the care they need to live healthily at home.  

Through the planning lens of seven sub-regions across its 16,667.8 km2 area, the Central East LHIN is leading the development of local integrated systems of care to serve a population of over 1.5 million people. Looking at the network at a sub-region level helps the LHIN to better understand and respond to local patient needs so that people living in those communities have access to the care they need, when and where they need it.

Static Maps to Digital Cartography

In 2016, the Health System Strategy, Integration, Planning and Performance (HSSIPP) division at Central East LHIN launched the Sub-region Profiles for Central East LHIN, an interactive tool created by the LHIN’s Decision Support team to enable better collaboration, planning and decision-making with stakeholders across its seven sub-regions. This interactive tool provides an environmental scan of demographics, population health, social determinants of health and health system information at the LHIN sub-regional level.

Maintaining a record of all the information required to make effective health care decisions can result in voluminous amounts of data.

“Our original paper-based profiles were comprised of over 2,000 pages of data. In 2016 when we migrated to ArcGIS Online, we created an interactive tool to share information, which immediately enhanced our engagement and collaboration with planning tables across our sub-regions,” said Suter. “This was the first time such a vast amount of authoritative and relevant data was easily accessible to the over 100 service providers in our LHIN and the planning tables that support the LHIN in designing and managing the system.”

The Sub-region Profiles interactive tool is an excellent means for visualizing location-driven data in the form of choropleth maps of population descriptors and health service utilization layered with an overview of LHIN-funded organizations and community services.  The tool is publicly available and is the Central East LHIN’s largest project to date to map information and make it easily understandable.

Migrating from paper-based or electronic map images to GIS-enabled digital maps has proved to be a milestone in supporting strategic conversations with the LHIN’s partners.

The new ArcGIS Online-based maps offer enhanced flexibility–instant visualization of the geographical boundaries of the sub-regions, restructured data class intervals and symbologies, integrated map layers–and better visualization of the Central East LHIN’s spatial data. As a result, the LHIN’s planning partners, health service providers, caregivers and patients are now interacting with the data, using and sharing it readily and asking for more.

Visualization to Analysis

The LHIN recognized early on how GIS could empower its stakeholders with access to data and its analysis. Combining the extensive data that it generated in-house with Statistics Canada’s census data offers vast insight into the socio-economic characteristics of the seven sub-regions, so that the Central East LHIN and its stakeholders are investigating spatial patterns, assessing health care needs and identifying healthcare gaps to support planning and decision-making.

Following the success of its interactive Sub-region Profiles tool, the Central East LHIN has launched the Sub-Region Analysis Application. The web app allows users to spatially filter data and perform their own basic analysis. Not only can they easily map the different services available in specific areas using the Legend function, but they can also map the top- and bottom-ranking neighbourhoods with respect to population descriptors and health system utilization statistics. Moreover, various health system planning scenarios can be developed using this web app.

Sub-region Profiles: Mapping Hospitalizations for Hip Fractures (+75) against the location of Exercise and Falls Prevention Classes allows the Central East LHIN and its partners to better assess the location of any additional services. This is just one example of the fixed analysis that the current tool provides.

Central East LHIN’s Sub-Region Analysis Application: Evolving from the Sub-region Profiles which displays predefined combinations of variables, this application allows users to select their own indicators and data to analyze unique health system scenarios. The image above displays Central East LHIN Neighbourhoods with the Top 5 Rates of Hip Fracture in Populations 75+ Years of Age overlaid with the locations of Physiotherapy Clinics and Exercise Fall Prevention Classes.

Dr. Sheila-Mae Young, a family physician based in Lindsay and one of seven sub-region Primary Care Physician Leads in the Central East LHIN, attests to the value of the interactive Sub-region Profiles tool and the recently launched Sub-Region Analysis Application.

“There is no other tool currently available that provides this level of detail to support health care service delivery planning,” said Dr. Young.  “This tool is unique.”

With the tool’s enhanced functionality, Dr. Young is now able to better assess the capacity of health service providers to meet current and future local health care needs at the organizational practice pattern level. “Our ongoing collaboration with our primary care partners, the LHIN and other stakeholders is now being taken to the next level,” said Dr. Young.

Earlier this year, the Central East LHIN procured Esri Canada’s Enterprise Advantage Program (EAP) to maximize its investment in GIS technology. Through the EAP, not only has the LHIN received access to expert advice through a dedicated strategic advisor, as well as training solutions, but it has also succeeded in speeding up its adoption of new technology. Using the EAP aligns with the LHIN’s business goals and objectives in a cost-effective, accessible and timely manner.

The LHIN is now looking to do more with the data it has as the Decision Support team heads into the second phase of its GIS application implementation, which will expand the functionality of the Sub-Region Profiles Tool.

Users will be able to do interactive temporal and relationship analysis as well as multivariate spatial analysis. With the ability to do comparisons between different time periods and multiple variables, the expanded tool will allow users to find answers to more questions: What are the factors that have impacted health in a specific area? How does one variable relate to another in a sub-region? What are the long-term impacts of certain socio-economic conditions? How can we plan for the upcoming demographic changes? and so on.

This increased adoption of analytical tools will support the LHIN to better engage and empower its stakeholders who assist it in creating integrated systems of care and improving the patient experience.

“The ArcGIS interactive tools are giving us a better way to complete environmental scans of health needs, identify social determinants of health, and generate health system utilization information across our region’s demographics. This has enabled better collaboration and planning with our health service partners, including patients and caregivers, and supported more effective decision-making by our Board,” remarked Stewart Sutley, Vice President of the Central East LHIN’s Health System Strategy, Integration, Planning and Performance division.  

This article originally appeared in the Fall 2018 issue of ArcNorth News.