1. + Cheryl AMOROSO, John DERIGGI, Nicole GREY, Danielle RICHEY, Peter BAREBWANUWE, Donn Gaede GIS – EMR Pilot Project Partners in Health – Rwanda GIS for Improving Health Service Delivery

2. + Why GIS project in the health centers we support? Improve patient services Assess and address public health risks Do some research…. to improve patient services and address public health risks

3. + Pilot in Rwinkwavu Sector Jan-June 09 Aim: Determine if collecting and using GIS data is feasible in our environment Estimate time of collecting data Estimate costs of “doing this properly”

4. + Resources for Pilot Resources: 2 MPH candidates for 5 months 1 local project assistant 4 GPS units $1500 3 pairs of rubber boots Getting this work done with only this and community health worker supervisor time,willingness and effort? Priceless

5. + Mapping and Training Outcomes of GIS Pilot Mapped all of the 48 villages, 14 schools,100+ water sources,homes of 157 CHWs, and homes of 600+ HIV, TB and chronic care patients Developed Kinyarwanda GIS training guide Informal and formal (by CGIS) training for community health workers supervisors to collect GPS data

7. + Collaboration and case study outcomes of GIS project Collaborated with the Rwanda GIS center to obtain high resolution base maps of our catchment from the US State Department Built strong relationships with local government and provided feedback Conducted a case-study project based on following 3 community health worker to document distances and challenges

8. + Data use outcomes of pilot Examine patient density in relation to health centers Examine patient quality of care (CD4 counts on time, visit attendance)

9. + Associating Coordinates to Patients 1 ) Patient address goes into the system 2 ) If the address is valid then get the coordinates umudugudu_idlatitudelongitude 0104020507-1.953452130.651238 ……… 3 ) Associate the coordinates to the patient's address address_idprecisionlatlon 341-1.953452130.651238 ………

10. + Associating Coordinates to Patients This patient's coordinates were derived from their address address_idprecisionlatlon 341-1.953452130.651238 2370-1.981212230.234525 This patient's coordinates were collected at their house with a gps device

11. + Using The Google Earth and Maps API Public internet connection Retrieve patient data in JSON Retrieve imagery from Google Web Browser Patient data

12. + Rendering Data In The Google Earth API

13. + Clicking on an icon renders patient data including great circle distance to the hospital Interactive Maps Using The Google Maps API

14. + Filtering The Data Filtering by CD4 count, on time CD4, Distance to Hospital, Time Since Last Visit

15. + Open Source Spatial Data Infrastructure PostGIS Shape Files GeoServer OpenLayers WMS Module Data Sources WMS/WFS Imagery uDig (Desktop App)

16. + Advantages of GeoServer No dependence on a connection to the internet Having spatial data outside of OpenMRS is more scalable Data is accessible from any application capable of communicating in WMS or WFS format

17. + uDig Displaying Data From GeoServer

18. + OpenMRS Displaying Data From GeoServer Using OpenLayers

19. + What we learned This work is possible – but we need to resource it There is an opportunity for GIS to integrate with OpenMRS The community is interested in GIS technology, and capable of understanding and using it with some initial support

20. + GIS and PIH: Future plans Continue to map villages in District Hospital catchment area Link GIS data with primary care data in EMR Make the technical architecture a reality Produce sharable products related to GIS and OpenMRS