City of Bethlehem, Pennsylvania, Recognizes the Power of GIS Despite User Inexperience

The City of Bethlehem, home to 75,000 residents, is located in eastern Pennsylvania. Being a small city, it faces many challenges including a lack of resources; staff; and, at times, even a lack of modern technology. The city's health bureau encountered these issues daily, as it lacked the modern infrastructure to store data and related programs. Instead, staff entered their data and program information in different Excel sheets via paper and pen and, in some cases, received data and never got around to analyzing it.

City administrators sought answers to the following questions: How could the city improve its community's health when the city lacked the resources to do so efficiently? How could a staff of merely 22 people keep their city safe amid a global pandemic?

The solution was found in geographic information system (GIS) technology. The City of Bethlehem's health bureau staff recognized the power of location intelligence when COVID‑19 opened their eyes to the geographic approach. Data was useless unless it provided actionable solutions that could easily be implemented where they were needed most, and GIS provided these solutions. Despite their lack of understanding and experience in using GIS technology, the health bureau staff knew they had to incorporate location-driven solutions, or their efforts would remain unsystematic. 

It was March of 2020, and the city's COVID-19 guidance was changing every other day. New protocols had to be implemented and overseen, and on top of that, staff needed to track and report the positivity rates back to city stakeholders.

At the time, the city did not have a system that allowed staff to access real-time data, which was the expectation during the COVID‑19 pandemic. Positivity rates were increasing every day, and soon the city would have to report vaccine needs to the state. The health bureau required a system that not only stored data in one cohesive system but also allowed it to be easily shared with stakeholders.

The director of chronic disease programs, Sherri Penchishen, found all the health bureau's needs answered when she was introduced to GIS. She saw a tool that could provide access to real-time data and would modernize the city's IT infrastructure, improve efficiency, and reduce work duplication.

Despite the lack of GIS experience, the health bureau had almost immediate staff buy-in as the department recognized that GIS would change the way the organization operated and make it a superior health department overall.

The health bureau did not currently have anyone experienced in GIS; however, it had plenty of data. So, it leveraged the city's GIS manager, who helped create a COVID‑19 dashboard that displayed positive COVID‑19 cases throughout the city. Instead of tracking cases via Excel sheets, the health bureau was able to easily access this information via the dashboard and even share it with the mayor, who requested updates periodically. The mayor also recognized the importance of access to real-time data and directed that the COVID-19 dashboard be displayed on the city's public website.

This was monumental for the bureau, as it had never been able to leverage real-time data so easily. But as the bureau's GIS work gained momentum, the city's GIS manager left suddenly, and because bureau staff had relied on his support to manage their GIS, they were back at square one—unable to keep track of their programs in one cohesive workflow and unable to strategically analyze data they were collecting. By this point, the health bureau staff had embraced the power of location intelligence and the ability it gave them to visualize, analyze, and make data actionable, so they knew they could not go back to their previous workflows. They needed to become GIS users themselves to carry on the great work they had started.

In the wake of the vaccine rollout, the city knew it had to leverage location-driven solutions to efficiently get vaccines to the most vulnerable populations. Despite her lack of GIS experience, Penchishen went home and successfully created a survey using ArcGIS Survey123, a simple and intuitive form-centric data-gathering solution.

"I was actually very proud of myself, as I created a survey in English and Spanish, which would help us understand how many vaccines we needed to order from the state," Penchishen said. "I love what GIS has to offer. For the first time in my 27-year public health career, I actually had real-time data."

Upon creating the first survey, which easily collected and displayed real-time data, the health bureau started receiving vaccine survey requests from school districts, community organizations, and the county jail. Penchishen knew GIS was something the bureau needed to invest in.

"I saw the future with GIS. If we really use this right, we can really benefit from our data—all the time," Penchishen said.

So with its Cooperative Agreement for Emergency Response: Public Health Crisis Response and Enhancing Detection grants, the city health bureau purchased GIS software licenses, training, and tech support for the next two years up front so that it could continue to leverage the technology and expand it to improve additional workflows.

"It's been phenomenal for our organization," said Penchishen. "We're still certainly in the early stages and still learning, but very quickly we had staff buy-in. They saw that this could reduce some duplication; it could increase efficiencies. So, staff were eager to learn about how GIS could improve their programs. We also have seen just from the short time we've been using GIS that it's really changing the way our organization operates, and it's going to make us a better health department in the long run."

Still, in the middle of a global pandemic, the health bureau quickly started finding areas in its programs that could be improved. For example, upon connecting the survey results to dashboards, staff effortlessly detected populations that were getting vaccinated and which were not. Based on this information, the city's health bureau saw that only 6 percent of its Hispanic population were getting vaccinated. The City of Bethlehem has a 28.2 percent population of Hispanics, so staff knew then that they had to adjust and tailor their outreach efforts toward these communities.

Taking advantage of this information, the city's health bureau partnered with local Spanish-speaking radio stations and ran ads in Spanish that encouraged residents to make an appointment to get vaccinated. They also were able to run ads that were sent directly to phones that were set up in Spanish. In addition, they used GIS to establish mobile vaccine clinics that went into areas with a predominantly Hispanic population. The practice of location-driven solutions helped tailor the bureau's marketing campaigns, which then increased the percentage of Hispanic residents getting vaccinated from 6 percent to 10.2 percent.

Without GIS, the city's health bureau would not have been able to identify vulnerable populations, create a health equity plan, and expand its vaccine distribution.

After successfully embracing the geographic approach, the city health bureau has been looking for ways to leverage GIS to respond to other health crises. It has since launched a public site, created using ArcGIS Hub, which hosts data, projects, and community organizations that provide resources and insight into the local opioid crisis. This hub site was launched to support the Northampton County Opioid Task Force, as the county recently experienced an increase in opioid-related overdose deaths.

The use of GIS has allowed the health bureau to collect more accurate data across its communities, which empowers staff to stay informed of what is going on in their city and further enables them to provide the city leaders with actionable real-time data.

The City of Bethlehem's health bureau understood it needed to effectively streamline its programs. Once staff were exposed to GIS technology, they knew that a geographic approach was the answer. Not only were they able to improve services and save time and money on current projects by implementing GIS, but they are also now executing GIS into the city's workflows.

"The one thing that I love about GIS is, although I feel like it can be daunting and overwhelming, it's actually very learnable," said Penchishen. "And I think it's just going to make us a better organization overall."