Following Hurricane Helene, Professor Saif Khairat and his team mobilized quickly, creating a map to spotlight communities hardest hit and most difficult to access
By Courtney Mitchell
When Hurricane Helene hit Western North Carolina in late September, it caused historic flooding that quickly washed out roads and bridges and damaged parts of the main interstate highways leading in and out. Within hours, much of that part of the state was impassible, and residents were left without power, water and cellular access.
Saif Khairat, PhD, MPH, a professor and Beerstecher-Blackwell Distinguished Term Scholar at the UNC School of Nursing, immediately knew data housed at UNC could play an important role in helping relief workers know more about who needed help and where.
His team at the National Institutes of Health (NIH)-funded Center for Virtual Care Value and Excellence (ViVE) had a treasure trove of information on every zip code in the state as they analyze who has access to health care and who does not. The group collects data on socioeconomic factors such as insurance, employment, ethnicity, internet, economic disparities, access to transportation and more to help others figure out how to provide care and broaden access to digital health services.
“We have been working for a number of years on a way to understand the level of access to health care that communities have,” he said. “We look at variables such as how many people in a community have access to a vehicle, which is a proxy of their ability to reach their doctor. How far are they from the closest highway? Who has an Internet Service Provider? We’ve been looking at socioeconomic factors that make up these communities to be able to understand the demographics of our neighborhoods.”
Within days of the event, Khairat and his team had aggregated publicly available data from the North Carolina Department of Transportation with UNC’s own data to create a map that could help identify areas of need. Shown below, the darker blue areas of the map show the most vulnerable zip codes, in terms of the many factors that can make health care access more difficult. They overlayed the NCDOT data into the map to mark areas where bridges and roads have been destroyed or blocked, helping to identify which areas may be challenging to navigate and individuals may be difficult to reach.
“Overall, you can show who is really struggling to get healthcare on the western side of the state. These are communities where people may be stuck, and we might not be able to get them out or get into them,” he said. “The usefulness of this tool is it allows us to do two things: understand the characteristics of these communities from a socioeconomic and health access standpoint, and it allow us to tailor our interventions to the needs of these communities.”
Khairat said they shared the tool widely with policymakers, health care leaders and providers to help them better understand how to provide care, as many of the communities already have access barriers. His hope is that the information can be used to identify areas where individuals have internet and can have a virtual care visit, or the ability to have a telephone visit.
“We can have eyes on the rapid changes and be able to make recommendations based on data. It’s a data-driven tool that tailors how we deliver health care.”
Saif Khairat, UNC School of Nursing Professor
Last year, the University was awarded a $3.73 million grant from the NIH’s National Center for Advancing Translational Sciences for a five-year project to establish ViVE, which is led by Khairat. An informatics expert, Khairat has spent years researching and collecting information on telemedicine and telehealth in health services and health data usability and visualization.
“Our analysis shows that there are a substantial number of North Carolinians who live in zip codes or regions that do not have easy access to health care. If we can’t get to them, and they can’t come to us, how can we take care of them? There are geographics barriers and digital barriers, like access to computers. Some may not have a smart phone or a data plan. Over time, we’ve been adding those layers of data points.”
Efforts to collect this kind of information started in 2018, and while the data housed at UNC continues to grow, it’s not enough, Khairat said. In times of crisis, access to real-time accurate data can lead to timelier, tailored interventions.
Khairat said it was eye-opening see how the information they’ve been collecting might be used in an emergency and how quickly. The original goal of the data has been to help providers make choices for how their clinics deliver care or to policy makers to invest in infrastructure such as hot spots that might aid in the delivery of virtual care. In an emergency, the tool could be quickly used for others to have a broader look at what the destruction across western North Carolina might mean for care delivery and disaster recovery.
Moving forward, Khairat said they are working on a user-friendly website and intentionally designing a way to deliver data in a crisis that can be scaled in ways that are useful to not only policymakers and health care administrators, but also to general populations as they make their own decisions. Data-sharing partnerships with statewide organizations could make a big difference in how populations are served.
“We have the technology to be able to aggregate thousands and millions of data points, and we can do it in a way that is intuitive and easy to digest. But what we’re lacking access to real time accurate data. What we did with the DOT shows that when data is public for us to be able to use, we can have the ability to collect real-time data and make it available for others to use.
“We hope we don’t have anything similar to Helene in the future, but if we do, we’re going to be prepared.”
