Comparing Hospital Infection Rates via Interactive Map

The California Department of Public Health's interactive map displays more than 300 hospitals in the state with symbols representing surgical infection rates for about a dozen procedures.

by / January 24, 2013
Photo courtesy of Brasiliao/ Photo courtesy of Brasiliao/

Patients in U.S. hospitals experience about 290,000 surgical site infections annually. These infections are the second most common health-care associated infection in the country.

California’s Department of Public Health (CDPH) educates more than 36 million residents about health dangers like these, but it’s not an easy job. Anita Gore, deputy director of the department’s Office of Public Affairs, strategizes ways to inform citizens so they make intelligent health-care decisions. 

Unfortunately taxpayers don’t always understand the intricate health information that the department provides online. “It’s complicated information,” she said, referring to the data tables that present the information on the public health website.

Reading hyper-detailed Web pages is challenging. The department’s Healthcare Associated Infections program posts information about surgical site infections and blood-related infections, but the voluminous data may exhaust readers’ patience. Dozens of pages contain paragraph after paragraph describing sophisticated, hard-to-pronounce infection types, and there are long lists of links to reports and other health-related websites. 

“We have major pieces of data and charts and information on our website, but not necessarily user-friendly,” Gore said. “When we started releasing these reports to the public, we were criticized for them not being consumer helpful.”

The CDPH created the Healthcare Associated Infections interactive map to deliver infection information to consumers that’s less confusing. The map displays more than 300 California hospitals with symbols representing surgical infection rates for about a dozen procedures. Users click a symbol to generate a pop-up box disclosing the hospital’s stats for different surgeries. Data reveals whether the facility’s infection rates are lower, higher or equal to state or national averages. 

Gore and her colleagues designed the map to package data in ways that will have fewer Californians scratching their heads. “This is an attempt to take the information we were being given and make it usable for people,” she said.

Exploring Choices

The map offers general infection data about common operations, supplemented by more detailed information elsewhere on the CDPH website. For example, say Diane, a 30-something office assistant in Sacramento, learns she’s pregnant and wants to know more about infection rates for C-sections. 

Diane visits the interactive map to view C-section infection rates for local hospitals and weigh her options. A main menu sorts the data along multiple infection categories. One is for general surgical site infections (SSI), and the others involve bloodstream infections. The surgical site infection button has a dropdown menu with a “cesarean section” option, so Diane clicks that one to sort accordingly. 

The legend under the map says, “Rates of infection per hospital are compared with the U.S. national average for SSIs.” This is represented by four symbols: A green square means a hospital has lower-than-average infection rates, a purple circle means it’s equal to the average, an orange triangle means it’s higher, and a gray circle means no data’s available for a comparison.

Diane sees that most hospitals in Sacramento and nearby regions have purple circles, which means their C-section patients don’t get infected at higher-than-normal rates. However, she’s excited when she sees two hospitals with green squares, University of California Davis Medical Center in Sacramento and a Kaiser facility in the nearby suburb of Roseville. These hospitals’ C-section infection rates are lower than she expected, so one of those would make her feel much safer when she delivers her baby.  

But Diane won’t find detailed numbers on infection rates unless she visits other CDPH pages. Links beneath the map lead to Web pages featuring specific infection data. If she digs around, she’ll see that one of her choices, UC Davis Sacramento, performed 351 C-sections from April to December 2011 with only two infections. The other, Roseville’s Kaiser, performed 629 with no infections during the same period. In this case, the map was a great starting point for infection data, but the data’s real substance lies elsewhere.

“The map is an extra added value to make the information easily available and understandable to the consumer,” Gore said.

An Inside Look

Successive events led to the map’s creation. They began with a 2006 California law requiring the CDPH and general acute care hospitals to create programs to monitor diseases and prevent health-care-associated infections. This prompted state hospitals to provide the CDPH with infection data.

The CDPH unveiled the map’s first iteration in January 2012. The California Healthcare Foundation supplied $75,000 in grants for the project, and designers from Stamen Studios, a San Francisco-based design studio, worked with state staff to create the map and Web page. The most recent version debuted in August 2012 after a relatively quick implementation period that began in May.

Nabil Fares, the CDPH’s CIO, is proud of the teamwork between the state’s businesses units, his IT staff and the California Healthcare Foundation. “It’s really a model for collaboration among different stakeholders and different entities,” he said.

The map was developed in Flash and is embedded into the site using JavaScript to embed it on the site. The application, roughly 367 MB in size, is self-contained and doesn’t interact with the server. The Web page itself was developed in Microsoft SharePoint.

California law requires hospitals in the state to submit infection data to the CDPH quarterly. Hospital researchers deliver the CDPH infection data in multiple spreadsheet formats, including delimited and comma-separated values. CDPH personnel feed the data to the map in comma-separated values and populate it with infection data.  

The interactive map is a young application, but it’s already gaining attention. In summer 2012, the project garnered the CDPH a Best Public Sector App award in the People’s Choice Category at Government Technology’s GTC West conference.

But despite the accolade, it may be years before the CDPH assesses the map’s usefulness in reducing hospital infections and educating citizens. “Because of the newness of the application, it’s a little bit hard to predict,” Fares said.

For now, they will support their creation and wait to see what develops.

“It certainly is the goal as the reporting continues, that we will see steps taken to decrease the number of infections that occur related to hospital stays,” Gore said.

Photo courtesy of Brasiliao/

Hilton Collins

Hilton Collins is a former staff writer for Government Technology and Emergency Management magazines.

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