Geographic Information Systems as Data Sharing Infrastructure for Clinical Data Warehouses

Abstract

Introduction: The sharing of patient location data is heavily regulated by lawsprotecting patient privacy and institutional review boards that are designed toprotect the rights and wellbeing of human subjects. Patient location data hasincredible value for research due to environmental social determinants ofhealth that heavily influence patient outcomes. The misalignment of sensitivityand utility creates a barrier for researchers wishing to understand the impactof neighborhood-level social determinants of health (SDOH) on health outcomes.Objectives: We aim to describe data warehousing solutions for the safe and ethicalenhancement of patient location data; these enhancements will enable easierdata sharing. Methods: We deploy geographic information systems (GIS) as a complementary datawarehousing service which imports patient addresses, processes the data, andreturns results back to the warehouse for others to use and disseminate.Results: We processed 1.3 million patients and added facets about their locationto our data warehouse where they may later be requested for research. Wefurther added de-identified information about the demographics of patientlocations from the United States Census Bureau which assists researchers inunderstanding the impact of location-driven SDOH.Conclusions: GIS support is a necessary component of a clinical data warehouse andsharing derived, de-identified data is both feasible and useful for research.Open-source software lowers the barrier of adoption and the cost associatedwith deriving these contextual data points.