Mark Hoffman, PhD, FNAI

Chief Research Information Officer, Children's Mercy Kansas City; Professor of Pediatrics, University of Missouri-Kansas City School of Medicine; Research Professor of Pediatrics, University of Kansas School of Medicine

Full Biography

There are a few things most people already know influence their health. Diet is important, of course. So is sleep, exercise and avoiding tobacco products. But what about your neighborhood?

A patient’s address can reveal a lot about the health risks, resources and contextual factors that impact medical outcomes. These “social determinants of health” are tied to where a patient lives, works, goes to school, plays and prays, and they’re critical pieces of information that determine what treatments may or may not be effective, playing a role in shared decision-making at the point of care.

The problem? Incorporating that data has historically been challenging.

“Most providers want to know: Where's this kid coming from? Does their address tell us something about their vulnerability or susceptibility?” said Natalie Kane, PhD, Senior Data Scientist at the Children’s Mercy Research Institute. “Researchers want to be able to incorporate patient addresses into their analyses —a process called geocoding —but often they aren't familiar with using the software you would typically use to geocode.”

Dr. Kane tackles a wide range of projects at CMRI but was especially interested in research to understand more about population health patterns.

In 2022, Molly Krager, MD, FAAP, Co-Director of Pediatric Resident Advocacy Education, approached Dr. Kane and Chief Research Information Officer Mark Hoffman, PhD, FNAI, to suggest building on a geocoding tool originally developed at Cincinnati Children’s Hospital Medical Center. Drs. Kane and Hoffman began working with Kevin Power, Director of Research Informatics Engineering, and Harpreet Singh Gill, MBA, Senior Manager of Research Software and Bioinformatics Engineering, to build a user-friendly tool that would geocode regular patient addresses, converting them into coordinates for mapping — something that could be leveraged for greater insights.

The result was GeoMarker, a HIPAA-compliant web application for geocoding that’s easy for even non-technical users and available from any browser. This accessibility, Gill said, is a game-changer.

“The technology existed, but the access to technology was a major hurdle for researchers,” he said. “So that was probably the core innovation.”

The “self-service” tool transforms a simple upload of addresses into the latitude/longitude a researcher needs to map points. It returns the census block group, which includes the census tract ID, both used by the U.S. Census Bureau to organize and present data for statistical analysis.

“That allows you to put a point on a map, which is a part of what's so valuable in health care,” Dr. Kane said. “Researchers are not frequently able to access address-level data, and when they do, there are all these barriers to using it. Now you can start to map things at different geographies, as well as other contextual information commonly used in analysis.”

Launched internally at Children’s Mercy in 2023, GeoMarker not only eliminates the need for specialized software or administrative permissions, but researchers can also link the app with other available census data, supercharging the results.

One innovation leads to another

Of course, just possessing the data produced by GeoMarker only gets you so far. Most researchers and clinicians need help visualizing the results — or “connecting the dots,” as Dr. Kane said — for more frequent and meaningful use of place-based health data.

Using grant funding from the Frontiers Clinical and Translational Science Institute at the University of Kansas, the team quickly developed a new software tool known as Spatial Cohort Analysis and Location Explorer (SCALE). Launched in 2024, the patent-pending, secure web app makes spatial analysis of health and related place-based data possible.

By using the geocoded data produced by GeoMarker, SCALE can create visualizations of patient cohorts and social determinants with side-by-side mapping, including information like the child opportunity index, race and ethnicity details, income data and more. The tool can also automatically generate a summary table of cohort data alongside publicly available data for those indicators, giving researchers a more accurate view into how well-represented the various demographic groups are in their own data sets. Users can toggle layers on and off, change colors on the map, export visuals, and more.

“It helps them drill down to see patterns that matter,” Dr. Kane said.

New tech is adopted by other organizations

The innovative tools are catching on, first internally with the Patient Progression Hub (which is using GeoMarker to geocode all patients and then examine social determinants for each), along with the Heart Center, Genomic Answers for Kids, the Child Diabetes Center and several other departments. Inna Lobeck, MD, FACS, FAAP, is surgical director of the Fetal Health Center and is planning to use the tool to map all patients with congenital anomalies. And Rose Gelineau-Morel, MD, Clinical Assistant Professor of Pediatrics at the UMKC School of Medicine, is leveraging both tools to look at the distribution of patients with dystonia.

“It's a great example of work that began in research being applied to the broader use of the organization,” Dr. Hoffman said.

Even beyond the campus, the tools are also already in use around the country: The University of Kansas is now using GeoMarker across the organization and finalizing the licensing agreement for SCALE. And Cincinnati Children’s — the inspiration for GeoMarker — recently installed the tool at their own facility, which Dr. Hoffman calls “a really nice twist.”

“They developed the core technology, we put a wrapper around it, and they liked that wrapper and wanted to install the enhancement,” he said.

The team sees the high interest as further evidence of the crucial need for the insights that can be generated from place-based analyses of electronic health record (EHR) data.

“That's our big-picture vision,” Dr. Kane said. “I hope we can move toward creating those actionable, place-based indicators tied to meaningful outcomes.”

Dr. Hoffman agreed and said the success is a true testament to the incredible collaboration among the internal teams.

“One of the exciting things is we can build applications that get used.”