Thursday, October 6, 2016

Exploring Competition and Proximity: A Comparison of Basic Methods

Today, HealthLandscape is releasing the Geospatial Brief, “Exploring Competition and Proximity: A Comparison of Basic Methods.” Brief #4 looks at the importance of including local context when measuring access to health care providers by comparing two common distance measurement methods with actual service area data retrieved from the UDS Mapper.

Configuring and updating the data behind the UDS Mapper is a task that requires many hours spent looking at the tool to make sure that what appears on the screen is logical and accurate. As we go through this process every update cycle, I know that Jennifer will send me her comments based on towns in Texas, Mark will send his showcasing the northern half of the Cincinnati metro, and Michael’s will focus on Kentucky. We each tend to focus on the geographic area that we are most familiar with - either where we’re from, our where we find ourselves, today.

Last spring, I moved from Cincinnati to a small town just west of Seattle, Washington. As I explored the Grantees and Access Points in my new locale during the last UDS Mapper update, I started thinking about accessibility issues and common ways that people measure distance and proximity to places they need to go. For example, Google Maps tells me that my house is 21 miles to my favorite coffee shop in downtown Seattle. However, because we live on the western side of Puget Sound, access to the city isn’t quite as straightforward as it seems - it requires either a ride on the ferry or an 80-mile drive around the Sound - at least an hour of travel, on a good day. I wondered whether the Health Center Program grantees on the Seattle side of the water could draw in patients from my area, and vice versa.

I decided to tackle this issue in a Geospatial Brief - comparing two common ways to measure access to facilities (Euclidean Distance and Network Distance) to the actual service area footprint of Peninsula County Health Services, the Health Center Program grantee in my county. The Brief illustrates the importance of incorporating real local knowledge into research design and methodology and serves as the starting point for additional research into defining areas of competition and proximity.

Jené Grandmont, MA

Thursday, September 29, 2016

HealthLandscape’s Michael Topmiller named an Interdisciplinary Research Leader

As part of one of only 15 three-person teams selected, I’m excited to be named an Interdisciplinary Research Leaders Fellow, a new program led by the University of Minnesota with support from the Robert Wood Johnson Foundation. I’ll be joined by researchers and community leaders from across the country to collaborate and innovate to solve persistent challenges and advance a Culture of Health—one that places well-being at the center of every aspect of life.

Along with my colleagues, Jamie-Lee Morris (New Prospect Baptist Church) and Farrah Jacquez (Psychology Department, University of Cincinnati), our project will focus on identifying community assets and improving early childhood health in two neighborhoods in Cincinnati.  Our approach is place-based, and will utilize a variety of methods (including GIS) within a community-based participatory research (CBPR) orientation. While the details of the project are yet to be determined, my role in the project will involve utilizing innovative geospatial “bright spot” methods and participatory mapping to identify community assets. Integrating geospatial and mapping approaches with my team’s expertise in engaging community members and developing community research teams will help ensure that our approach is place-based, community-driven, and culminates in real improvements in early childhood health in our communities.

As our project moves forward I’ll share more details on our progress. The map below shows the location of the 15 amazing teams taking part in the Interdisciplinary Research Leaders program.

Participant Map

Michael Topmiller

Wednesday, September 21, 2016

HealthLandscape Attends AAFP Family Medicine Experience (FMX)

This week, the American Academy of Family Physicians, our parent organization, is holding their annual meeting, the FamilyMedicine Experience or FMX, in Orlando, Fla at the Orange County Convention Center.  Last year was the first year of this new type of meeting offering a more interactive and customizable experience, because “as health care becomes about more than patient care, this meeting is expanding to serve you with new topics and techniques.”

HealthLandscape is an innovation of the AAFP which also focuses on that portion of health care that is more than patient care.  HealthLandscape is both a team of people and an online mapping and data platform.  The team is made up of sociologists, informaticians and geographers with wide-ranging interests in that “more than patient care space.”  We perform research and lead projects related to access to care and supportive services; health workforce distribution; population health; hot, cold and bright spotting, and others.  The HealthLandscape team also develops, administers, and markets geospatial analysis software tools and professional services.  

HealthLandscape, the platform, is an interactive, web-based mapping platform that allows health professionals, policy makers, academic researchers, and planners to:
  • Combine, analyze, and display information in ways that make it easy to understand health and the forces that affect it;
  • Improve health outcomes through informed decision-making; and
  • Reduce costs and improve the quality of health and health care.

The HealthLandscape platform brings together various sources of health, socio-economic, and environmental information in a convenient, central location to help answer questions about and improve health and health care.  HealthLandscape can be used to create visual advocacy tools and maps from publicly available, private, and organization-owned datasets to discover community characteristics that can be shared with health professionals, policy makers, and legislators.
We hope to see you at FMX this year to tell, and show, you more about HealthLandscape.  We will be in the Expo Hall at Booth 549 Wednesday, September 21 from 4:30-6:30 PM, Thursday, September 22 from 10 AM - 4 PM and Friday, September 23 from 10 AM - 3 PM.

Not attending FMX this year?  Learn more about our mapping tools at one of our webinars or visit our revamped website at

Jennifer Rankin
Sr. Manager for Research and Product Services

Wednesday, September 14, 2016

People are Attracted to Certain Geographies

Places draw people in.  People search for cool ocean breezes on tropical beaches or the challenge of climbing a mountain or the diversity of life in a rainforest or a large city.  Beyond aesthetics, financial opportunities of a particular landscape can be the main attraction- water source, raw materials for building, or even the kinetic energy of a waterfall.  People have been drawn to the Mississippi River over the years for the many things it has to offer and in Minneapolis they benefit from the only natural waterfall on the entire river.  In the late 19th Century, people came in droves to Minneapolis to take advantage of the St. Anthony Falls to work in industries such as textiles, saw mills and flour mills.

I, myself, am attracted to such geographies as mountains, rainforests, water networks, and rocky outcroppings.  On a recent vacation to Minnesota, where I learned about the St. Anthony Falls, I also visited the Boundary Waters Canoe Area which is a designated wilderness area. I’ve been to various parks and wilderness areas, and couldn’t help but feel an appreciation for the lack of crowds and buildings, and the abundance of parking (for the canoe). I like these kinds of places because they put a smile on my face, they’re calming, beautiful, and they remind me that not everything is about technology

Place matters to me because of opportunity and availability. I visit these places because they provide a means of adventure and immersion. In 2009, I moved to the Washington, D.C. area solely for the lucrative job market.  Seven years later, I’ve come to appreciate that it hasn’t only been the positions that I’ve held that have kept me here. It’s been the environmental diversity that allows me to explore new interests, the plethora of ethnicities that have opened my palate to new flavors, the events calendars in and around D.C. that’s always full, and constantly meeting others who have also uprooted their lives to live in the D.C. area.

HealthLandscape is an application with a variety of valuable tools that help users explore place. For more information on HealthLandscape’s products see our webinars at:

David Grolling
GIS Strategist

Thursday, September 8, 2016

2016 UDS Mapper Updates

On August 26th, we rolled out the newest version of the UDS Mapper with updated and new data, and new UDS Mapper Mobile functionality. The UDS Mapper is the premier tool built on the HealthLandscape platform and is designed to visualize areas of potential need for new federally funded health centers. Check out these new features and updates:

Improved User Support:
  • User Support
    • We now have a chat tool in order to help you as you are using the tool; all of the user support tutorials will be updated during September

Updated Data:
  • UDS data
    • Updated to 2015 reporting year data
  • Population Indicators
    • Demographic layers updated
  • Basemaps and Optional Layers
    • County Subdivisions
    • Primary, Dental and Mental Health Care HPSAs
  • Uninsurance by Income Level.
    • Due to changes in data availability the layers for uninsured below 100% FPL and uninsured between 100%-400% FPL could not be updated and have been removed; the other three layers have been updated

Dental Care HPSAs

New Data and Features
  • New Mobile UDS Mapper Functionality
    • Generate a list of all Health Care Facilities within your selected Area
  • New Demographic Data
    • New Age and Social Environment breakdowns in the Main Maps tool
  • New 2 year % Change in Layers for Insurance Categories
  • New Health Care Facilities
  • Locations where there are other than Primary Care National Health Service Corps (NHSC) providers
  • Coming Soon- Veterans Administration health care sites

% Population Aged 18-64

Upcoming Webinars:
Introduction to the UDS Mapper:
(appropriate for all users of the UDS Mapper)
Monday, September 19, 2:00PM - 3:00PM (Eastern Time)   Register

What's New in the UDS Mapper:
Wednesday, September 28, 11:00AM - 12:00PM (Eastern Time)   Register

Claire Meehan
User Engagement Specialist

For more information or to just begin using the UDS Mapper, please visit and plan on attending one of our free webinars!

Friday, August 12, 2016

HealthLandscape's New Zika Mapping Tool

Whether you’re a physician looking to respond to the Zika threat or just an individual interested in the most recent Zika developments, HealthLandscape has a new web-based mapping tool to help you keep up with the rapidly evolving Zika virus.

The Zika Mapping Tool displays the number of reported travel-associated and locally-acquired Zika cases by state, as well as state-specific Zika resources and information. This tool will be updated in conjunction with CDC data releases to provide a snapshot of the spread of the virus across the country. The data come from a variety of sources including the CDC and state health departments.

Zika Cases: Travel Associated

Follow us on Twitter or Facebook for updates as we add newly released data to the Zika Mapping Tool!

Visit HealthLandscape to start using the Zika Mapping Tool today!

For more information on the Zika virus, visit AAFP’s Zika Virus Outbreak Resource page.

Claire Meehan
User Engagement Specialist

Monday, July 25, 2016

Identifying “Bright Spot” Regions in Healthcare

Today HealthLandscape is releasing the Geospatial Brief, “Where are “Bright Spots” for AppropriateDiabetes Preventive Care?” Using appropriate Diabetes preventive care as a case study, Brief #3 provides an example of how geospatial methods can be used to identify high-performing (“bright spot”) regions. This blog reviews “bright spots” approaches that have been previously used in the healthcare field.

A recent Editorial by long-time primary care advocate Thomas Bodenheimer advocates for finding the “bright spots” in primary care, so that we can “learn from them, and arrange for the bright spots to illuminate the dark corners,” (Bodenheimer, 2014).  Bodenheimer and his colleagues at Stanford’s Clinical Excellence and Research Center (CERC) define “bright spots” as physician groups that are successful at providing high quality care while keeping healthcare costs low. In-depth study of these “bright spots” allowed CERC to identify ten features of primary care delivery associated with higher quality care and lower spending (CERC, 2014). The work of CERC builds from the positive deviance (PD) approach, which is an asset-based framework for identifying organizations or individuals that are successful despite facing more difficult or similar circumstances than others, determining the features which make them successful, and applying the features to other organizations or individuals (Pascale et al., 2010).  The PD framework has been applied in several different healthcare settings, including medical homes (Gabbay et al., 2013), hospitals (Bradley et al., 2009), and local health departments (Klaiman et al., 2014). While they are not referred to as PD or “bright spot” approaches, the Veterans Affairs (VA) is also pushing forward with innovative strategies for improving care for the Veteran population (Elnahal and Littlefield, 2016).

Positive deviance approaches offer great potential in the healthcare field. By identifying successful strategies for improving care and reducing costs, we can apply these strategies and target scarce resources to areas of need.  Using appropriate Diabetes preventive care as a case study, Geospatial Brief #3 details geospatial approaches for identifying “bright spot” regions. This research builds on the first two HealthLandscape Geospatial Research Briefs, which explore the relationship between preventive care, preventable hospitalizations, and spending, and identify priority regions for improving preventive care (Topmiller, 2016a; Topmiller, 2016b).  Future research can use the results of these geospatial briefs for in-depth study of “bright spot” regions, and then apply lessons learned to priority regions.

Michael Topmiller
GIS Strategist 

Bodenheimer, Thomas S., (2014). Find the" bright spots." Joint Commission journal on quality and patient safety/Joint Commission Resources40(4), pp.147-147.

Bradley, Elizabeth H., Leslie A. Curry, Shoba Ramanadhan, Laura Rowe, Ingrid M Nembhard, and Harlan M Krumholz, 2009. Research in action: using positive deviance to improve quality of health care. Implementation Science 4:25.

Clinical Excellence Research Center (CERC), Stanford University, 2014. “America’s Most Valuable Care: Primary Care.” Clinical Excellence Research Center at Stanford University, Bright Spots Research.

Elnahal, Shereef, and Patrick Littlefield. “VA Diffision – spreading and implementing best practices to improve care for our nation’s Veterans.” (blog, March 2, 2016). Accessed at

Gabbay, Robert A., Mark W. Friedberg, Michelle Miller-Day, Peter F. Cronholm, Alan Adelman, and Eric C. Schneider, 2013. A Positive Deviance Approach to Understanding Key Features to Improving Diabetes Care in the Medical Home. Annals of Family Medicine 11(S1): S99-S107.

Klaiman, Tamar A., Athena Pantazis, and Betty Bekemeier, 2014. A Method for Identifying Positive Deviant Local Health Departments in Maternal and Child Health. Frontiers in Public Health Services and Systems Research 3(2).

Pascale, Richard, Jerry Sternin, and Monique Sternin, 2010. The Power of Positive Deviance: How Unlikely Innovators Solve the World’s Toughest Problems. Harvard Business Press, United States of America.

Topmiller, Michael, 2016a. “Do Regions with More Preventive Care Have Lower Spending and Fewer Hospitalizations?”  HealthLandscape Geospatial Research Brief #1. 
Accessed at

Topmiller, Michael, 2016b. “Where are “Hot Spots” of Medicare Spending and Preventable Hospitalizations and “Cold Spots” for Preventive Care?”  HealthLandscape Geospatial Research Brief #2. 

Accessed at