Mapping the ChristianaCare response to COVID-19:: Clinical insights from the Value Institute’s Geospatial Analytics Core

INTRODUCTION: COVID-19 exemplifies the spatial nature of infectious disease in both its mechanism of transmission and the community-level conditions that facilitate its spread. With a long history of use for infectious disease applications, maps and geographic information systems (GIS) have been widely used in recent months for surveillance and risk prediction mapping. The Value Institute’s Geospatial Analytics Core applied spatial methodologies to inform ChristianaCare’s pandemic response around telehealth, testing disparities, and test site prioritization. METHODS: Descriptive data related to disparities in telehealth utilization were mapped to identify areas in which intervention is needed to increase telehealth access. Cluster detection methodology was used to identify “hot” and “cold” spots for COVID-19 testing by place and race across New Castle County, DE. A composite risk score was created to prioritize communities for testing sites. All analyses took place in Delaware from March-June 2020, with particular emphasis on New Castle County. RESULTS: Parts of northeastern New Castle County and western Sussex County were highlighted for intervention to increase broadband internet access for telehealth utilization. “Cold” spots for COVID-19 testing were found in New Castle County, indicating neighborhoods in which testing levels were significantly lower than expected. Data for testing levels, disease positivity, and socioeconomic risk factors were used to identify communities in northeastern New Castle County that warranted new test sites to mitigate disease spread. PUBLIC HEALTH IMPLICATIONS: Geospatial methodologies can be used to combine electronic health record data and population-level spatial data for pandemic response efforts. This allows health systems to confidently identify areas of need while mitigating disparities in resource allocation.