Presentation by Mark Zirkelbach, Chief Information Officer, Loma Linda University Medical Center at the marcus evans National Healthcare CIO Summit 2017 in Pasadena CA March 13-14 2017

1. National Healthcare
CIO Summit
What is the Wellness Map?
Mark Zirkelbach
March 13, 2017

2. Presentation Objectives
• Describe:
• Applications of GIS in healthcare
• GIS application in patient and clinician engagement
• Location intelligence impact on personal health decision-making

3. What is GIS?
• Geographic Information System (GIS) –
• Captures, stores, manipulates, and present spatial or geographical data
• Commonly the spot on a map where the latitude and longitude appear
• Knowing Where Things Do Happen or Could Happen Helps:
• Customers, Suppliers, Workforce, Transportation
• Adds a spatial element to our data
• a visual “where” versus just data lists

5. Social Determinates of Health
Negative
Health
Outcome
Individual-level
health education
efforts
Poverty
Determinants of
health
Adaptedfrom:WHO(1990)

6. Accountable Care Ecosystem
Health
System Data
Community
Health Data
Community Health
Management System
CHMS
Clinical
Medical Staff
Administrative
Demographics
Resources
Cultural
Hot Spot
Analysis
Target
Intervention
Strategy
Predictive
Admission
Status
Real-time data linking
through geographic technology
Community - where location becomes clinically relevant and provides meaningful
context for diagnosis, treatment, and healing of patients.

7. What Is The Wellness Map?
• Personalized map to help patient’s achieve their health & wellness
goals in addition to addressing their socioeconomic needs.
• Map is seamlessly integrated with the Epic electronic health record
system & MyChart patient portal.
• Leverages a flexible and scalable central repository of community
resources mapped to appropriate diagnoses and conditions, any
other relevant information; e.g., Religion, Scheduled Appointments,
etc.

8. The Goals of the Wellness Map
• Bridge the gap of care between health care delivery systems &
patient’s home/community
• Provide a spatial view of community and clinical care resources to
patients
• Provide personalized and easy tool they can use at home or
smartphone
• Improve patient utilization of community resources and compliance
with wellness goals

9. The 7th Vital Sign
• Body Temperature
• Heart Rate
• Blood Pressure
• Respiratory Rate
• Pain
• Distress
•Place

10. Key Benefits
• Patient’s have a mobile map app to quickly find community resources
custom to their situations.
• Providers/Care Coordinators can quickly evaluate availability of community
resources.
• Health system has one consistent, up-to-date community referral database.
• Highly customizable to cater search results to different patient populations
& department needs.
• Can integrate with a wide variety of applications to create a synergistic user
experience.
• Able to measure which resources are frequently viewed.

11. • 3 month pilot at LLUH’s Center for Health
Promotion w/ Dr. Peters.
• Focused on patients dx w/ metabolic
syndrome & diabetes.
• Goal to have patients use map & community
resources.
• MDs spent up to 15 min counseling, sharing
Wellness Map, & how patient goals could be
achieved using community resources.
• Patient feedback, “cool”, “this is helpful”,
“needs more resources on map.”
• Provider feedback, “easy to use”, “has great
potential”, “need mobile version.”
Benefits Identified During Pilot

12. Workflow
Provider Performs
Evaluation, Management
& Set Patient Goals
Launches Map in
Epic Hyperspace
Reviews Resources
In Wellness Map
Staff Helps Patient
Enroll for MyChart
Patient Visits
Care Clinic
Patient Goes Home
Reviews Wellness Map via
MyChart or MyChart Mobile
Patient Uses Community
Resources to Improve
Health & Wellness
My Appointments
Medical
Health & Wellness
Social

13. Find resources by directly
searching for them
Resources are shown based
on distance from patient’s home
Patient’s appointments, Primary Care
Provider, and preferred lab & pharmacy
is automatically pulled from the EHR
There are 3 main categories of
resources with customizable
sub-categories that appear based
on the patient’s EHR diagnoses Map automatically centers on
patient’s home address from EHR
Resources can quickly be added,
updated & removed from database

14. Directions are
automatically generated
Bus, walk, & other
transportation modes
available
Business address, hours,
phone, website, & list of
services

15. ComparisonPersonalized
based on
patient’s EHR
diagnosis?
Accurate and
Up-to-Date?
Save favorites
& print map?
Easy to find
the right
health
resource?
Easy to use? Configurable?
Secure &
HIPPA
Compliant?
Mobile App?
No No No Yes Yes No No Yes
No No Yes No Yes No No Yes
No No No Yes No No No No
Yes Yes
No;
future
Yes;
automatic
Yes Yes Yes Yes

16. Identified Community
Resources
Epic Interconnect
Backend Services
Patient Provider
MyChart
Internet (External) via
Internet & Mobile
Epic
Hyperspace (Internal)
Survey
Service .ASPXGeoportal
Integrated-PHI
IEHP
Claims Data
LLUH Hub
Determine
Outcomes

17. Future Use Cases
• Understanding our population to help us make better decisions
(strategic – services and capital investments).
• Wayfinding to help people navigate outdoors and indoors in real-time
around the campus.
• Tracking of equipment and assets for improved security and
compliance (RTLS).
• Tracking campus shuttles for location and utilization for efficient
patient movement

18. Frequently Asked Questions
Q: How will POIs be deemed appropriate to add to the database?
A: Data governance along with guidelines will need to be created with
the help of all parties.
Q: Will a new map be generated when the patient’s diagnosis & other
health information is updated?
A: Yes, the map is dynamic and will automatically be updated when
there are updates to the patient’s EHR record in real-time.