Ontario Ministry of Health’s ‘Public Health WebGIS’

In February 2003, a traveler returning to Toronto from Hong Kong started an outbreak of Severe Acute Respiratory Syndrome (SARS). First diagnosed in a Toronto Area hospital, SARS eventually spread to over two hundred and fifty people and caused more than thirty deaths. The human and societal impact ran deep. The World Health Organization (WHO) even issued a travel advisory recommending people limit travel to Toronto. While SARS was brought under control within two months, it exposed a need for improved preparedness for managing health emergencies in the Province of Ontario.

The Ministry of Health established an expert panel on SARS to identify key lessons learned from this experience. The goal was to deliver practical, focused, and forward-looking recommendations regarding the management and control of infectious diseases and the capacity of Ontario to handle public health emergencies in the future.

Early on, a need was identified for a web-based GIS resource to enable non-GIS staff to better visualize and understand the geographic factors that influence public health in Ontario. Infonaut Inc., a Toronto-based GIS solutions provider with public health/pandemic planning expertise, was hired to build the application. Built on Geocortex IMF, this application is now used in strategic planning, monitoring, and emergency response.

First rolled out to a select group of users nearly four years ago, ‘Public Health WebGIS’ has evolved into an important component of the decision-support strategy across the ministry and Public Health division.

There are two aspects to Public Health WebGIS which make it valuable. First are the comprehensive data sets made available to all registered users. These layered data sets greatly improve analysis possibilities by revealing relationships between things such as context, needs, service providers and system performance.

Second is what Niall Wallace, CEO of Infonaut, describes as ubiquitous GIS for a common operating picture. He explains, “A key lesson learned from SARS was simply the importance of getting everyone on the same page. Better surveillance and communication are absolute requirements for effective strategy, monitoring, and emergency response.”

Prior to the introduction of this tool, the insights and capabilities that GIS offers were limited to staff with specialized GIS skills, using high-end desktop applications. Equipping all public health personnel with a readily available mapping / GIS tool facilitates the following:

• Quick understanding of complex relationships between the Ministry, health units, hospitals, regional health authorities, and other health entities;
• Determining how funding correlates with population health;
• Widespread dissemination of relevant metrics (e.g. Blastomycosus, C. Difficil, HIV activity);
• Surveillance activities monitored from anywhere, anytime;
• Rapid identification of hotspots and potential problem areas, detailed information on an emergency area, including who may be affected; and,
• Identification of geographic and temporal trends in resource allocation, identifying locations of personnel for outbreak planning and response.

Instant, secure, web-based access ensures that health officials are equipped with a common operating picture of the health system and the geographic factors that influence public health. This enables faster, more informed decisions from anywhere—critically important when lives are at stake.

As it proves its worth, GIS in public health is garnering increased attention from government and research organizations around the globe. The World Health Organization (WHO) cites application of GIS in the realms of determining geographic distribution of diseases, analyzing spatial and temporal trends, mapping populations at risk, stratifying risk factors, assessing resource allocation, planning and targeting interventions, and monitoring interventions over time.

Introduced by chance from half a world away, SARS sent a clear message that in an era of global travel and commerce, no jurisdiction can deem their geography immune. Ontario’s 2003 epidemic also suggests that some threats to citizen safety cannot necessarily be prevented—which underscores the importance of advance planning to mitigate potential impact and regain control as swiftly as possible.

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