Geographic Information Systems as Data Sharing Infrastructure for Clinical Data Warehouses.

Introduction: The sharing of patient location data is heavily regulated by laws that protect patient privacy and by institutional review boards that are designed to protect the rights and wellbeing of human subjects. Patient location data has incredible value for research due to environmental social determinants of health that heavily influence patient outcomes. The misalignment of sensitivity and utility creates a barrier for researchers that wish to understand the impact of neighborhood-level social determinants of health (SDOH) on health outcomes. Objectives: We describe data warehousing solutions for the safe and ethical enhancement of patient location data; these enhancements will enable easier data sharing. Methods: We deploy geographic information systems (GIS) as a complementary data warehousing service that imports patient addresses, processes the data, and returns results back to the warehouse for others to use and disseminate. Results: We processed 1.3 million patients and added facets about their location to our data warehouse, where they may later be requested for research. We further added de-identified information about the demographics of patient locations from the United States Census Bureau, which assists researchers in understanding the impact of location-driven SDOH. Conclusions: GIS support is a necessary component of a clinical data warehouse and sharing derived, de-identified data is both feasible and useful for research. Open-source software lowers the barrier of adoption and the cost associated with deriving these contextual data points.