Building on solid foundations: Spatial data architecture for GIS surveillance in public health programs

Background: The US Centers for Disease Control and Prevention (CDC) is working collaboratively with the National Association of Chronic Disease Directors (NACDD) and the University of Michigan to enhance the capacity of state and local health departments (HDs) to leverage the benefits of Geographic Information Systems (GIS) for chronic disease surveillance. Our training program provides HDs with GIS skills and tools to integrate spatial data into daily operations for the surveillance and prevention of chronic diseases. Objective: Twenty-six HDs have completed our project-based GIS training program. The ability of these HDs to incorporate GIS into their programs was enhanced when HD information technology infrastructure (ITI) was integrated with spatial data architecture. We will share the key ITI considerations that serve as a foundation for building spatial data architectures and support sustained GIS capacity. Methods: We describe HD ITI a priori and a posteriori, focusing on systems, resources, and policies. We evaluate project outcomes for each of the HDs within the context of ITI changes. Results: We find that most HDs meet minimal hardware and software system requirements for GIS applications. We describe enterprise level resources and policies that play an important role in determining the level of functionality for a group of users performing GIS computing tasks and integrating data across multiple platforms and users. We compare outcomes across state and local programs, highlighting ITI changes that improved efficiency and facilitated GIS utilization. Discussion: Spatial data architecture is built on an integrated foundation of hardware, software, data, and policies at both the individual desktop and enterprise levels. Based upon our experience with 26 HDs from across the US, several key ITI policies and practices enhance the ability of HD staff to implement spatial data architectures accessible by multiple users to access common tools, increasing the likelihood of sustained GIS capacity.