Using the UDS Mapper for Rural Areas 1

We will start at 2 minutes after the hour

Slides from today’s webinar can be found on the UDS Mapper website in the Tutorials & Resources tab in the Tutorials section

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Go to Webinar Attendee Screen

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Today’s Slides

UDS Mapper webinars are recordedDownload the slides on the UDS Mapper website

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Today’s Agenda

State of rural health

UDS Mapper considerations for rural areas

About the UDS Mapper

Case study

Finding user support after the webinar

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What is the UDS Mapper?

An online mapping tool developed to provide access to maps, data, and analysis using Uniform Data System (UDS) and other relevant data to visualize service area information for Health Center Program (HCP) awardees and look-alikesCompares HCP awardee and look-alike data to community/population data and shows spatial relationships between the program, community attributes, and other resources

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Who Can Use the UDS Mapper?

The UDS Mapper is open to everyone, not just HCP awardees and look-alikes

To begin using the UDS Mapper all you have to do is register for a user name and password at www.udsmapper.org

More than one person from an organization can have a login for the UDS Mapper

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Register for a New Account

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Rural America

According to the Federal Office of Rural Health Policy1, after the 2010 census

• 84% of the area of the United States was rural• 18% of the population of the United States lived in rural areas

Rural areas are not homogenous• Rural areas differ from each other in many ways, including in their

racial/ethnic and socioeconomic composition and their proximity to urban areas2

1 https://www.hrsa.gov/rural-health/about-us/definition/index.html 2 https://aspe.hhs.gov/report/feasibility-using-electronic-health-

data-research-small-populations/data-issues-regarding-rural-health

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Rural Health Issues U.S. rural areas are suffering from a dramatic health care shortage

• The Harvard Global Health Institute reports an increase of “medical deserts” across rural America3

Medical deserts are regions where health care is limited or non-existent Between 2010 and 2015, there has been a six-fold increase in the rate of rural hospitals closures These situations present serious health care barriers and they yield poor health outcomes

3 https://globalhealth.harvard.edu/blog/medical-deserts-america-why-we-need-advocate-rural-healthcare

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Rural Healthcare Crisis Example

Among all 50 U.S. states, Mississippi has the lowest number of physicians

• In 2017, the state had only 169.8 active physicians per 100,000 residents4

The problem is particularly stark in Mississippi’s rural areas

• The Mississippi Department of Health indicates that in 2016, 21 of Mississippi’s 82 counties had four or fewer primary care physicians

• Two of those counties had no primary care physicians

4 AMA Physician Masterfile (December 31, 2016), Population estimates as of July 1, 2016 are from the U.S. Census Bureau (Release date: December 2016)

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Health Centers in Mississippi

At present, throughout the state, there are 21 health centers5

Health centers offer comprehensive primary healthcare, including pre-natal care

• The Mississippi Department of Health wants to expand the state’s primary and pre-natal care offerings

Today, we will demonstrate how you can use the UDS Mapper to explore rural Mississippians' access to maternal and infant care

5 The Mississippi Primary Health Care Association. http://www.mphca.com/community-health-centers/browse

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Data in the UDS Mapper

Uniform Data System (UDS) data• Patients by insurance type by ZIP Code table

– Aggregated to create Health Center Program (HCP) level analysis -what areas are served? Are they well-served?

– Individual data available in the Explore Service Area tool in By Patient Origin mode

• Other UDS data available for individual health centers in the Information Card deck

Population data• American Community Survey demographic data• Population health data from multiple sources

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Geography: ZIP Codes

A ZIP Code is a route-instructions to drive/walk and put mail in mail boxes on the street or on the building- even if that route crosses county or state lines

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ZCTA

ZCTAs are generalized areal representations of United States Postal Services (USPS) ZIP Code service areasZCTAs are more stable than ZIP Codes because they only change every 10 yearsZCTAs are built from Census Blocks so one can report demographic/Social Determinants of Health (SDOH) data at the ZCTA level

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Considerations for Rural Areas 1

ZCTAs may be larger than your service areaUse your narrative

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Considerations for Rural Areas 2

ZCTA data may misrepresent need Use local

knowledge

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Walkthrough of the UDS Mapper

How to use the UDS Mapper tool to:

Examine a rural area in Mississippi that may have been affected by a recent hospital closure

Find data from nearby health centers to see levels of prenatal care provided to the community

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Don’t Forget to Type in Questions

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Keep control panel open by clicking View and unchecking Auto-Hide the Control Panel

Type questions into the question box (do not raise hand)

Using the UDS Mapper for Rural Area

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Search for Area of Interest

UDS Mapper works best at the local level

In the Explore Service Area tool Search Box, enter the location you want to view and select correct option from drop-down box

• Search list is organized by type of location

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Add Point Locations

We want to see where hospitals have closed in Mississippi Use the Map My Data tool to add many points at once

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Structure the Data File

Create a spreadsheet that has separate columns for Address, City, State, and ZIP Code

• These should be columns A, B, C, and D respectively

• Add other information in subsequent columns, if desired

If your workbook has multiple sheets, make sure the one with the addresses is the first (leftmost) one

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Upload File and Make Selections

Select which column of your dataset, if any, you would like to use to color the points on the map (Color code points based on) Choose up to three columns

from your dataset to include in the Information Card Provide a name for your file Then select Geocode

Addresses After the data are geocoded,

the file can be saved

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Added Data

Once all points have been added, the map will zoom and center at the closest zoom that shows all points

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Add Facilities That are Included in the UDS Mapper

In the Explore Health Related Facilities tool you can turn on other types of organizations

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Which Health Centers are Close to a Closed Hospital?

In the Explore Service Area tool, add Health Center Administrative locations

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Focus on Clarksdale, MS

Use the zoom tools to focus on your place of interest In this

example we will focus on Clarksdale, MS since there is a health center near a closed hospital

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Clinical Quality DataTurn on the Information Card Deck to access non-geographic, organization level UDS data Does this health

center see a high number of prenatal patients?

Are patients entering care early?

What are their birth outcomes?

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Select Health Center

Clicking on the administrative dot will open the Information Card Deck Select

Quality and scroll down to view data

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UDS Data on BPHC Website

Access the same data on the Bureau of Primary Health Care (BPHC) public facing web pages Data for all awardees and look-alikes

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Select Health Center

After selecting Awardee or Look-Alike Data:

• Select State

• Select Health Center

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Quality Data in UDS Mapper = Clinical Data on BPHC Website

Open the Clinical Data section to find trend data for the health center

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Three-Year Trend Data

Three years of data are available to see any impact from hospital closure This health

center saw a growth in the number of prenatal patients and patients who delivered since the hospital closure in 2016

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Population Indicators We can use the

Population Indicators tool to get more information about relevant population health outcomes

The national rate of low birth weight is 8%

Pink ZCTAs have that rate or higher

You can adjust the threshold the indicator is set to using the slider

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Benchmarks

If you are going to adjust the slider, select a threshold that is a published number State

benchmarks can be found in the Tutorials & Resources section of the website

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Find State-Level Benchmarks

There are three tables; scroll to find the right table The Mississippi low birth weight rate is 11.5

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Adjust Indicator to State Benchmark

Adjust the slider to the state benchmarkZCTAs that do not meet this threshold will no longer be pink

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Add Other Indicators You can add other

indicators to see how they overlap

Low income and low birth weight rate are high in the health center’s ZCTA

The health center is outperforming the area in terms of low birth weight rate and may be well situated to address the needs of the community

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Tutorials and Resources

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Thank You!

If you have additional questions or feedback after the conclusion of this webinar, please use the Contact Us form provided on the UDS Mapper Site:

https://www.udsmapper.org/contact-us.cfm