An executive forum that focused on the use of GIS in Tasmanian health and community services was hosted by the Tasmanian Spatial Information Council (TASSIC) in Hobart on the 12th August 2015.

The forum was officially opened by the Hon Michael Ferguson MP, the Tasmania Minister for Health. He said that his department was confronted by two main issues, the demographic time bomb and the obesity issue. He suggested that spatial technologies could assist in better understanding these issues and help find ways of better dealing with them. The concerns of dealing with an ageing population and the increase in health costs was raised by a number of speakers during the afternoon.

The Hon Gary Nairn AO, TASSIC chair, provided the welcome and introductory address. He highlighted the difficulty of selling spatial technology and the lack of easy to understand financial benefits. He summarised a number of studies that highlighted the impact of spatial technologies on the GDP of a number of western countries. Despite this, Infrastructure Australia could not be convinced that spatial data was in fact infrastructure. There is a perception that infrastructure must consist of hard assets such as bricks and concrete rather than vital spatial information that underpins so many economic activities and developments within a country.

Lands Tasmania dominated the first session by presenting the services/infrastructure that they now have on offer to benefit the Tasmanian Community. The original Lands Department have come a long way from the days when they published spatial information on maps. Spatial information is now delivered via web services so that it can be consumed by third party systems using multiple devices and technologies. In the past it was a matter of making one size fits all maps and flogging them off to everyone that needed the information including state government departments, local government and the general public. The expectation now is that the same information must be free, readily available, on line and adaptable so that it can be used in a variety of unplanned-for scenarios. Lands Tasmania are responding to those needs with their award winning systems.

The benefits of these new Lands Tasmania services was clearly illustrated by Andrew Betlehem who is using these services to underpin the development of the Housing Management System. Andrew says that these new services allow integrated systems to be built with significantly less duplication of effort and spatial data storage. This results in time and cost savings for the initial development and for ongoing maintenance. These benefits will apply to any new system in Tasmania that requires spatial technology including those developed for health and community services.

Dominic Morgan, the CEO of Ambulance Tasmania, gave an enthusiastic presentation on harnessing spatial intelligence for interoperability and rapid response. As a young paramedic Dominic found it exciting to drive on the wrong side of George Street in Sydney but now gets more excited about spatial information. He provided many practical examples of using spatial technology to assist in the planning and management of their resources such as the need to locate ambulance stations near aging communities. He also discussed the mapping of heart defibulator stations and how emergency call recipients used these maps to direct people to the nearest station. This was considered a better approach as every second counts when responding to heart attack emergency calls which only represent 1% of total calls. This is particularly the case in remote areas of Tasmania.

Craig Quarmby from the University of Tasmania spoke about innovating for better health. He said that if current costs for Health services were to continue then we would eventually become bankrupt. However he said the focus should be on care; simply trying to drive down the costs will not solve the problem. Focusing on care will drive down the costs. Craig also discussed the issue of connectivity in our hospitals which are not constructed with ease of patient navigation in mind. He indicated that it is much easy for a passenger to navigate the world through our transport system (across multiple jurisdictions) than it is to navigate the health system. The transport industry have achieved this by constructing nodes and trunk routes so the most cost effective way of getting from point A to Point B is not often via the most direct path.

In his opening address Michael Ferguson indicated that it is possible for Health and Community Services to solve problems without spatial information. However he did concede that they could not do it as well and that the technology also provides them with confidence it what they are doing. The ability to cope with out it is open for debate as there are many examples of spatial technology being used to help understand and then solve a community health problem. In these cases it is hard to imagine how the problem could be solved without spatial technology. I will refer to 2 cases.

In their book titled “Health and community design. The impact of the built environment on physical activity” Frank, Engelke and Schmid describe how the built environment discourages physical activity. Their research indicated that the older the suburb the more likelihood of a grid like street network while newer suburbs have more curvy street layouts. People were less likely to use cars in gridded streets and more likely to walk or use bicycles or public transport. However allotments in curvy street networks tend to be larger and encourage the use of motorised transport. This reduces activity and would have a direct impact on the obesity issue. It also increases pollution which has an impact on community health. It is difficult to image how this observations could be made without analysing the relationships through the use of spatial technology.

Mean number of non-auto trips based on age of neighbourhood.

Mean number of non-auto trips based on age of neighbourhood. Graph taken from https://www.health.qld.gov.au/epidemiology/documents/gis-ph-spatial-app.pdf

The second case was referred to by many speakers during the afternoon and is well known. It is the case of Dr John Snow and how he used spatial technology to help solve the 1854 Cholera Epidemic in London. Dr Snow used a geographic grid to plot the cholera deaths and through analysis discovered that the source of the outbreak was the Broad Street water pump. The map was not only important for determining the source but also for changing the minds of sceptics who believed that cholera was caused by breathing vapours in the atmosphere. This case is often referred to as one of the first uses of spatial technology in solving community health problems.

John Snow's map showing cholera deaths in London in 1854 (courtesy of The Geographical Journal).

John Snow’s map showing cholera deaths in London in 1854 (courtesy of The Geographical Journal).

For an excellent article on this topic please refer to Report on GIS and public health spatial applications by Public Health Services Branch Queensland Health.