Technical Strategies for Real-time Geocoding in Healthcare

The open data movement provides city, state and national data that can be useful in providing healthcare providers with contextual information about their patients. For example, data about social determinants of health or environmental exposures, the “envirome”, can help clinicians adapt their patient conversations. Enabling health care providers with real-time access to this information during a patient encounter is an important step toward “Smart Cities”. Often open data sources are keyed by geospatial parameters such as census tract. Integrating this contextual information into electronic health record workflows is an optimal strategy to bring envirome data to the point of care but requires careful consideration to comply with privacy regulations. We discuss three technical strategies for geocoding patient addresses and review the benefits and challenges of each. One novel strategy separates the IP address of the site requesting geocoded data from the transmission to a geocoding service, offering a unique mitigation to concerns about using cloud-based services.