1. Diabetes Hotspots Mapping Using GIS tools to Target Quality Gaps CQI “Right Care” Initiative Nicole Lurie, M.D., MSPH & Allen Fremont, MD, PhD September 29, 2008

2. 2 Fremont, 2008 National Health Plan Collaborative (NHPC) Public-private partnership to improve care quality, reduce disparities 11 plans, > 87 million members Technical support from RAND and CHCS Sponsored by AHRQ and RWJF

3. 3 Fremont, 2008 What information about your member population & individual patients could help you serve them better? (What tools would help you use that information?)

4. 4 Fremont, 2008 Can use queries and filters to highlight areas of interest >66% not receiving LDL test & large # of diabetics in census tract

5. 5 Fremont, 2008 Users can instantly access salient information by selecting or clicking on areas of interest

6. 6 Fremont, 2008 Diagnosing a ‘hot spot’

7. 7 Fremont, 2008 Diagnosing a ‘hot spot’

8. 8 Fremont, 2008 Missouri Health Literacy Level by Tract

9. 9 Fremont, 2008 St. Louis Health Literacy Level by Tract

10. 10 Fremont, 2008 GIS Tools can help target potential opportunities for intervention GIS Tools can help highlight “Hotspots” or areas with clusters of members with worse than expected rates Diabetic Members with and without LDL Test

11. 11 Fremont, 2008 Adding spatial perspective can increase understanding of contributing factors

12. 12 Fremont, 2008 Adding spatial perspective can increase understanding of contributing factors Limited English Proficiency Inside Cluster: 43 % Outside Cluster: 29 %

13. 13 Fremont, 2008 Mapping tools can help provider groups see their performance patterns more clearly

14. 14 Fremont, 2008 Mapping tools can help provider groups see their performance patterns more clearly

15. 15 Fremont, 2008 Geospatial tools can help target medical outreach interventions to community

16. 16 Fremont, 2008 GIS tools can also help coordinate efforts of local medical and public health providers Community Intervention Sites Hot Spots (Clinical) Standardized rates of uncontrolled diabetes

17. 17 Fremont, 2008 Conclusion Better understand the populations being served Identify local “hotspots” Assess local factors Recognize possibilities for shared action Emerging mapping and decision tools can help target improvement interventions more efficiently

18. 18 Fremont, 2008