Using Geography to Combat the Opioid Crisis

Posted on January 10, 2018 I Written By

Colin Hung is the co-founder of the #hcldr (healthcare leadership) tweetchat one of the most popular and active healthcare social media communities on Twitter. Colin speaks, tweets and blogs regularly about healthcare, technology, marketing and leadership. He is currently an independent marketing consultant working with leading healthIT companies. Colin is a member of #TheWalkingGallery. His Twitter handle is: @Colin_Hung.

When it comes to the opioid crisis, the numbers aren’t good. According to the latest CDC numbers, over 66,000 Americans died from drug overdoses between May 2016 and May 2017. Unfortunately this continues the rapid upward trend over the past five years.

Credit: New York Times, The First Count of Fentanyl Deaths in 2016: Up 540% in Three Years, 2 Sept 2017, https://www.nytimes.com/interactive/2017/09/02/upshot/fentanyl-drug-overdose-deaths.html

One of the biggest drivers for this increase is the prevalence of opioids – a class of drugs that includes pain medications, heroin and fentanyl (a synthetic opioid). The opioid crisis is not the stereotypical street-drug problem. It is not confined to inner cities or to any socio-economic boundaries. It affects all neighborhoods…and therein lies one of the greatest challenges of dealing with the crisis, knowing where to deploy precious resources.

As governments and public health authorities begin to take more aggressive action, some are wisely turning to geographic information systems (GIS) in order to determine where the need is greatest. GIS (also called geospatial mapping) are designed specifically to capture, store, manage and analyze geographical data. It has been a mainstay in mining, engineering and environmental sciences since the early 1990’s. For more information about GIS, please see this excellent PBS documentary. In recent years, GIS has been applied to a number of new areas including healthcare.

Esri is one of the companies doing pioneering GIS work in healthcare and recently they have focused on applying their ArcGIS technology to help tackle the opioid crisis. “One of the basic challenges that public health authorities face is clearly defining the scope of the opioid problem in their local area.” says Estella Geraghty MD, Chief Medical Officer & Health Solutions Director at Esri. “The good news is that the information to map the extent of the problem is available, it’s just stored in disparate systems and in incompatible formats. We help bring it all together.”

Geraghty points to their work with the Tri-County Health Department (TCHD) as an example of how effective GIS can be. TCHD is one of the largest public health agencies in the US, serving 1.5 million residents in three of Denver’s metropolitan counties: Adams, Arapahoe and Douglas. Using Esri’s ArcGIS solution, TCHD created an open data site that allows internal teams and external partners to pool and share their opioid health information using a visual map of the region as a common base of reference.

According to Esri: “Since the creation of the Open Data site, there has been a dramatic increase in both the information available to the public and the community’s understanding of the opioid crisis.” You can see the Open Data site here and if you scroll down you will see six different maps available to the public. Particularly sobering is the Opioid Overdose Deaths from 2011-2016, which allows you to zoom in down to specific streets/blocks. Another interesting map is the Household Medication Take-Back Locations which seems to indicate there is a lack of coverage for the city of Denver.

Esri itself has created its own site to bring attention to the opioid crisis at a national level. Two maps in particular stand out to me. The first is the map of Opioid Prescriptions per Provider. The red zones on that map represent areas where a high number of opioid prescriptions are being made by relatively few providers. This points to potential areas where opioid abuse may be occurring.

By mapping the data in this way, some interesting insights emerge. Take Taliaferro County in Georgia for example where 2,069 claims out of a total of 29,016 were for opioids, yet the county only has 2 providers. Or Clinch County in Georgia where a whopping 10% of all claims were for opioids.

The second interesting map is Lost Loved Ones (located at the bottom of the Esri site). This is a completely open map where anyone can pay tribute to a loved one who has been lost to the opioid crisis. Each dot is a person – a stark reminder that behind each statistic is a son, daughter, mother, or father who has died from opioids. Anyone can add to the map by clicking the button at the top of the map.

There is something to be said about seeing data overlaid onto an interactive map. It takes data from abstract lines, bars or numbers on a page and transforms it into something more tangible, more “real”. I suspect that for many on the front lines of this crisis, having the opioid data visualized in this manner helps to drive home the need for additional resources.

“Esri is helping public health officials all over the country make better decisions,” continued Geraghty. “We are helping them determine if they have enough coverage for places where people can drop off expired drugs, places where Naloxone is available and mental health program coverage. We can visually present the types of drugs being dropped off by region. We can track where first responders have had to use Naloxone. We plan on continuing to collaborate closely with customers, especially with public health authorities. This opioid crisis is impacting so many neighborhoods. We can make a difference.”

Given the continued upward trend in opioid-related deaths, healthcare can use all the difference makers it can get.