Attached is one map out of the six that I have created (see below). Please note that this is not the final version as it needs to be reviewed by my advisor before presenting it to my supervisor and the association.
The map displays how often home health care (HHC) treated their patients of heart failure symptoms (%). It compares geographically areas that have overall higher or lower treatment than others. Rhode Island seems to have the highest treatment rate than Massachusetts, Southern New Hampshire, and Connecticut. Rhode Island is a small state and has only two VNA agencies which is probably why it had a high score. Southern New Hampshire does not have a single VNA agency and is therefore shared by MA VNAs. Surprisingly, major cities (i.e. Boston, Worcester, Hartford, & Providence) scored lower than rural areas. Of course, this may have to do with higher population density and the fact that there are more VNAs overlapping each other as well. Even more surprisingly, the central area of MA (Fitchburg – Gardner area) scored the lowest of all. Generally, this indicates that the HHC agencies may need to invest more financially and services at those particular regions. It may also indicate that HHC patients are not healthy enough for HHC treatment and must be submitted to the hospital to utilize the facilities for advance treatment. The second map, how often HHC patients were admitted to hospitals displays similar trends to the first map. Fitchburg – Gardner area has high admittance rate partly because of less efficiency treating heart failure symptoms of the patient.
Here are other maps (not displayed) that I have created or are on their way:
1) How Often Patients Received Urgent Home Health Care Without Being Sent To The Hospital (Created)
2) How Often Do HHC Patients Have To Be Admitted To Hospitals (Created)
3) Population Risk Assessment #1: Ratio of Often Admittance To Hospitals vs. Frequency of HHC Patients of Heart Failure Symptoms (Created)
4) Population Risk Assessment #2: Ratio of Often Admittance To Hospital vs. Patients Receiving Immediate HHC Treatment Without Admittance To Hospital (Created)
5) Population Risk Assessment #3: Ratio of Congestive Heart Failure Discharge Rate vs. Frequency Treating Heart Failure Symptoms of HHC Patient (Created)
6) Cost vs. Overall HHC Quality Analysis (Underway)
These maps have to be reviewed prior to display publicly.
One aspect in employment that matters most is the benefits. It is important to have a working environment that you would enjoy most. It is not required for me to report daily at the VNANE headquarters in Marlborough. In fact, my supervisor prefers me to do most of my work remotely; I have the GIS software, raw data, and internet. Once every two or three weeks, I set up a meeting with my database manager/supervisor, at the headquarters in Marlborough, and through an extensive meeting we discuss the current results, analysis and future plans. Another excellent benefit is the flexibility my supervisor provides. In other words, there is no set up schedule; I can work early in the morning or late at night; thus I could travel overseas (Greece) for vacation and visiting my grandparents / relatives for four weeks. Of course I still do work while abroad and report updates to my supervisor via email. I also communicate with my lead professor at Clark and together we set up goals and timelines.
Currently, I am working on the specification document and have concluded that results will be 6 maps. Three maps will display the quality of home health care based on survey questions from patients and records per zip code/town. The survey questions are:
1) How often do patients have to be admitted to hospitals?
2) How often patients received urgent home health care, unplanned care in the hospital emergency room – without being admitted to the hospital?
3) How often the home health team treated heart failure (weakening of the heart) patients’ symptoms?
These are almost done in the process and results will be posted in the near future. The 4th and 5th map will display comparison of congestive heart failure discharge rate versus one of the three survey questions (still in the process to find any similar trends or patterns spatially) and population risk assessment respectively. The 6th map has not been assessed yet but it will be based on cost of home health care versus visits per patient.
Hello again everyone!
As I mentioned earlier, the project is about mapping population factors, risks, costs, and quality of Home Health Care throughout New England. VNANE has its headquarters in Marlborough, roughly 25 minutes from Clark. I usually conduct it remotely either at Clark (for Microsoft Access), home (ArcGIS), or overseas. Once every couple of weeks I meet with my supervisor discussing about my work and results. What I was glad to hear during my first meeting with my supervisor is the organization and how they usually precede their projects. Their proceedings consisted of pre-scoping, scoping, specification, rough draft results, revision, final results, and presentation.
The pre-scoping phase mainly emphasizes in finding data that is available to the public and speculating the use of it. Initially, this was the most challenging part because GIS and statistical-intensive research can only be conducted when there is appropriate data available, otherwise you would have to revise the objective of the project. Excellent home health care that I have found is through Medicare and CMS (Center for Medicare & Medicaid Services). The data included each VNA and other home health care agency office location, twenty satisfaction questions from patients (in %), and ownership type. The tedious part was to specifically choose specific agencies that VNANE is interested in and manually insert service area by zip code for each agency in excel prior to GIS spatial analysis.
The scoping phase is the real brainstorming process. For this project, the scoping phase defines the objective of the project, why is the organization conducting it, and what would be the potential product (in this case maps). If your supervisor/organization does a similar process as VNANE, always ask if they have example documents or to specify. This helps you think more critically and write more clearly in a professional style. For me it has help me brainstorm efficiently. Currently, I am in the specification process, where I have to really specify what maps I will be creating, what they represent & its significance, and how will it be done step by step. The CEO and supervisor are still figuring out what is the specific objective and outcome of the project. This is my new challenge and will involve trial-and-error.
VNANE or Visiting Nurse Association of New England provides health care services (i.e. skilled nursing, therapy, health aides) to homebound patients in order to prevent the high necessity of institutional services. Most patients preferred to be treated at their homes because it is the most comfortable environment. Unfortunately, home health care is under studied and difficult to understand than institutions. VNANE’s mission is to ensure and provide better care, better health, and lower costs to home health care patients.
Project Goals And Expectations
Overall, the primary objective is to map population factors and home health care provider costs, quality, and outcomes. Furthermore is to research and build appropriate population and home health care provider databases, create maps to inform state policy makers, facilitate new delivery systems understand the risk/needs of their patient populations, and to assess performances of home health care providers.