Abstract 141: Using Geographic Information Systems (GIS) to Analyze Statewide Regional Data - A Feasibility Project from the Kentucky Stroke Encounter Quality Improvement Project (SEQIP)

Abstract

Background: The Stroke Encounter Quality Improvement Project (SEQIP) is a collaboration between certified stroke centers, the AHA/ASA and the Kentucky Department for Public Health (KDPH) to implement statewide QI initiatives to improve the care of stroke patients. From 2009 to 2018, 23 hospital in Kentucky participating in SEQIP have entered 76,222 stroke patient records into Get With The Guidelines® (GWTG) / Patient Management Tool™ (PMT). Purpose: Geographic information systems (GIS) tools can expand our understanding of care and outcomes based on patient location. The purpose of this project was to demonstrate the methods of linking a disease management registry with GIS mapping and analysis program,) to understand challenges when performing this link, and to derive meaningful insight on stroke care and outcomes by zip code. Methods: Stroke data from GWTG and PMT was compiled and downloaded by KDPH. The information was converted to a database file for use in ArcGIS. After excluding those who had missing or incomplete zip codes, records were Geocoded annually from 2009 to 2018. The data were then matched to one of 945 zip codes in Kentucky. Data were summarized by zip code, calendar year by the number of ischemic strokes; number IV alteplase administration; rate ischemic stroke receiving IV alteplase; number and rate of ischemic stroke patients arriving to hospital by EMS, privately owned vehicle or transfer; and median time from last known well to hospital arrival; and medical history of hypertension. Additional data including hospitals, certified stroke centers, drive time analysis, etc. were added to maps. Results: Mapping GWTG and PMT stroke data is feasible and may allow for additional analysis by location. Conclusion: Using GIS mapping and methodology can assist hospital stroke coordinators and public health officials in developing and implementing interventions to improvement stroke care and outcomes. Further analysis including socioeconomic, demographic and marketing/consumer preference data is planned to better understand variations by zip codes. This feasibility project provides an example of a useful application of GIS analyses applied to data registry including GWTG and PMT.