Application of Geographic Information Systems to support Collaboration in Rural Osteopathic Medical Education and Community Health Initiatives
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Purpose: Geographic Information Systems (GIS) support collaboration in public health program planning, implementation, and evaluation, but there is an absence of models for the application of GIS to enhance collaboration between rural health and medical education initiatives. Rural communities experience entrenched health disparities as a result of poor access to healthcare and other barriers inherent to remote circumstances. Although varying across rural populations, urgent issues include shortages and poor retention in the primary care workforce; lack of resources for population-specific needs; and threats to financial sustainability for rural practices. Challenges are posed by the need to span diverse geographic regions, administrative systems, and professional backgrounds. Collaboration between medical education and community health initiatives offers an opportunity to maximize the impacts of scarce rural health resources. The Texas College of Osteopathic Medicine, (TCOM) Department of Family Medicine began implementing an articulated Rural Family Medicine Track program in 1996. This community-based curriculum prepares students for life and practice in rural and underserved communities; it includes real-world experience of living and working in rural Texas with faculty from all specialties, and providing free, mobile clinic services. SaferCare Texas is a department at the University of North Texas Health Science Center whose mission is to eliminate preventable harm through innovation. SaferCare Texas' community health initiatives including health literacy programs and community health worker (CHW) training to expand the rural workforce, improve access to preventative care services, engage citizens in care decisions, and promote healthy living; these, in turn, may lead to the reduction of chronic illnesses, improved management and control of chronic conditions, and the early detection of treatable diseases. The purpose of this study is to explore the potential of Geographic Information Systems to enhance collaboration between existing Rural Family Medicine initiatives and the development and implementation of programs to increase CHW capacity in the Big Bend region of Texas, with a long-term goal of innovation and research to address rural health disparities. Methods: An interdisciplinary team has identified public datasets to advance collaboration. ESRI ArcGIS software is used as a mapping platform. Initial datasets include 1) Texas county boundaries obtained from Texas Department of Transportation (TxDOT) with the designation of hospital districts; 2) Texas census tract Social Vulnerability Index (SVI) which is comprised of 15 Social Determinants of Health and is developed by the Centers for Disease Control 3) location of Critical Access Hospitals and other clinical services, 4) Rural Family Practice preceptor and mobile, free clinic sites. Results: A preliminary map has been developed for use by project team members. Potential CHW sites and synergies to address unmet community health needs are being investigated. Identification of additional spatial data to support service coordination and collaboration is ongoing. Conclusions: Preliminary results indicate that data integration and visualization through GIS, may allow Rural Scholars and SaferCare Texas to more effectively engage rural health partners, develop a shared understanding of rural health issues, identify synergies to maximize the benefit of available resources, and provide a foundation for evaluation and research.