USING OPEN SOURCE TO CREATE A GEOGRAPHICAL

INFORMATION SYSTEM FOR BLOOD DONATIONS

Juliano de Souza Gaspar, João Rolando Azevedo, Jorge Leal, Fábio Hedayioglu

University of Porto, Porto, Portugal

Ricardo João Cruz Correia

CINTESIS – Centre for Research in Health Technologies and Information Systems

Biostatistics and Medical Informatics Department, Faculty of Medicine University of Porto, Porto, Portugal

Keywords: Open source, Geographic information systems, Blood donors, Database management systems.

Abstract: The increasing development of Free/Libre Open Source Software (FLOSS) paradigm has brought a

reduction in the cost of software development and increased its speed, resulting in quality improvement and

constant evolution. Examples of applications that greatly enhance this area are geographic information

systems (GIS). They permit the allocation of raw data or processed information in a map, allowing

contextualization of the information itself and knowledge extrapolation. The transfusion medicine is an

excellent area of health in which one can use a GIS to display the geographic distribution of blood donors

on the map. A FLOSS GIS is feasible in this context thus reducing the high governmental costs in Health

Care Area. The information can be easily displayed without copyrights and other complications. For these

reasons, we decided to develop a platform that allows the display of information relative to the blood

donations. Our goals focused on: researching the state of the art off current status; data manipulation and

processing of the donor’s database; and modelling and developing a program that could show a varied

option of queries that can be done to the database. We used some statistic approach to the data as well as

software implementation. After its completion, it was possible to calculate the distribution of blood donors

and cross reference this with the places of collect. The distribution of the donors by group or area was made

visible for interpretation purposes. Ultimately, the feasibility of such systems is proved and the changes in

blood donation management can represent an important improvement towards good care.

1 INTRODUCTION

1.1 FLOSS in Health Care

The development paradigm using FLOSS has a

significant role in several areas of the market,

however, his use in health care is still limited

(Karopka, 2009). Some of the reasons for this

scenario in the health field are (Karopka, 2009; Rua,

2009; Baj, 2009): a lack of involvement of infield

specialists (doctors, nurses, laboratory technicians,

physiotherapists, etc.), a lack of appropriate training

and knowledge of health professionals about the

importance and benefits of these projects. Also, in

health area, the requirements of security and

reliability are extremely high. With FLOSS, not

always these requirements have clear and defined

rules that ensure health managers they can be

fulfilled.

Despite having to face and overcome these

challenges, FLOSS development has certain features

that allow its viability within the health area. For

example, a FLOSS that is designed and maintained

by the Internet for virtual communities, in which

continuous tests are made, leads to greater reliability

and availability of updates. This allows the health

authority to have access to technologies faster than

in the case of proprietary software (Baj, 2009).

Another advantage is that FLOSS provides more

opportunities for customization and enhancements.

They were able to manipulate the code and

customize it, for example, adapting it to a specific

unit within the entity. These manipulations were not

499

de Souza Gaspar J., Leal J., Rolando Azevedo J., Hedayioglu F. and João Cruz-Correia R. (2010).

USING OPEN SOURCE TO CREATE A GEOGRAPHICAL INFORMATION SYSTEM FOR BLOOD DONATIONS.

In Proceedings of the Third International Conference on Health Informatics, pages 499-504

DOI: 10.5220/0002765904990504

 SciTePress

possible through proprietary technologies (Baj,

2009).

Some of the motivations that drive government

initiatives in this regard are (Fernandes, 2004): ( a )

reduction with initial software and updates; ( b )

increased control and access to intellectual property;

( c ) reduction of trust in organizations of proprietary

software development; ( d ) use of software in the

public sector as public property; ( e ) adaptability

and modularity allowed by open source software to

the needs of each government area or sector of the

same institution.

1.2 Transfusion Medicine

Transfusion Medicine practice has as fundamental

purpose the attainment, availability and accessibility

of blood and its components. They must attain a

desired level of quality, safety and effectiveness.

Still actually, worldwide blood donation is

insufficient to the existing needs (Nilsson Sojka,

2007). The medical investigation and the

technological breakthrough in this sector had a big

boom thus allowing an improvement in this area. In

other hand, the development of a health care

structure, and the differentiation and sophistication

of medical techniques led to an increase on blood

demands. Simultaneously, people are ageing and as

a consequence there is a reduction of people elective

to be donors (from 18 to 65 years) and an increase of

number of people who actually needs blood

components as they grow older.

Other problem, specify from IPS (Instituto

Português do Sangue), is the elevated costs inherent

the definition of places for mobile blood collect

places that present a low rate of donations. These

costs vary from human resources (physicians,

technicians, nurses, drivers, etc.) to equipment,

among others.

1.3 Geographic Information Systems

Geography takes a fundamental role in almost all

decision we made. The choice of places, the

appointing of market segments, the planning of

distribution networks, response to emergencies

scenarios, the redrawing of countries frontiers, all

those problems address geographic issues.

Geographic characteristics such as topography and

geographic dispersion of population are fundamental

factors in fair resources distribution (Leitner, 2002).

GIS crosses regular data and their geographic

position with the purpose of building maps. This

technology allows us to visualize data with different

degrees of complexity in a map. This gives us a

useful way of reveling spatial and temporal relations

between data.

Combining data and applying some analytical

rules, it is possible to create a pattern in order to help

answer the question previously made. The GIS

primary goals in healthcare are (Maged, 2004)

inform and educate health professionals and

population, support decision making in many levels,

prevent results before making any compromises,

select priorities in lower resources environments,

change bad practices and routines and continuously

monitor and watch changes implementations.

Investigators, Public Health professionals, policy

makers and others can use GIS to better understand

geographic relation that affect health results, risks,

disease transmission, health care access and other

public health concerns. They’re being used more and

more often to deal with problems in a local, regional,

national or international overlay (CDC, 2009).

Despite the evident benefits of GIS use, its

dissemination and utilization it’s not yet a

generalized reality. Some possible explanation for

this to happen can be (Rob, 2003): the lack of

consideration towards user needs, elevated cost of

existing applications and the need to learn the way

they function and operate.

At requirement level, we verify an almost total

need of community involvement since the very

beginning. Meaning, users and developers must

work directly together in the project. Only in this

way can projects be realistic, reasonable and

sustainable (Weiner, 2002).

The use of Geographic Information Systems in

the field of Transfusion Medicine can use the data

from donors, more precisely place of residence and

blood type, presenting them in a situation so that

there is an important tool for analysis and support

for resource management more efficient and

facilitates the accomplishment of its objectives are to

operationalize the collection and distribution of

donations. Contextualizing geographically frequency

of donations, facilitates the planning of campaigning

and the collection of blood donation to the needs of

reserves replacement of components at the moment.

1.4 Motivation

The initial motivation to the realization of this

project departed from the fact that the participants

were involved in the health Care area, specifically in

the collect and distribution processes and also being

currently in the Master in Health Informatics study

cycles of the Medicine faculty of Porto University.

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One of the IPS necessities is to improve the

planning and management of blood collect places

utilizing donors’ geographic analysis without

increasing costs.

2 OBJECTIVES

2.1 General Objective

To create an open source Geographic Information

System that would allow the graphic representation

of the information concerning blood donations.

The Specific Objectives are (a) to facilitate the

analysis, in a geographic context, of the blood

campaign coordination process, (b) to support the

professionals in planning and distributing resources

for mobile collect posts, (c) to help the professionals

define places and dates of mobile collect posts,

according to the need to refill blood components

stoking by blood type, (d) check that can develop

open source software for health and their respective

advantages and (e) to describe the systems creation

process, exploring the motivation, difficulties and

potentialities founded.

3 METHODS

This work can be classified as an applied and

technological (Jung, 2009) research, because its goal

is the development of an application allowing the

graphic representation of blood donations.

Although this work has a statistical approach, it

incorporates qualitative standards. The two

methodologies are used to help carrying the whole

process.

This work followed the following methodology:

 Research of Servers of the Maps for a GIS,

functionalities and resources;

 Initial data analysis, treatment and statistical

analysis of the data given by the Portuguese,

Blood Institute;

 Building a prototype, design and create the

database, design and implement the prototype;

 Evaluation meetings with the project team in

order to improve the system;

3.1 Architecture

3.1.1 Requisites Analysis

Taking in account the overall characteristic of this

proposal, the requisites where analyzed and defined

by a multidisciplinary team composed of: a clinical

analysis technician, a nurse and a computing

engineer. For the application, the following

requisites where defined are (a) to show the blood

donation in the map, (b) allow that donation to be

filtered by: Date, District, Council, Lab results,

Collect places, Blood group, Rh factor, Gender,

Age, (c) show the mobile collect posts and (d)

develop the application using open source

technology.

3.1.2 Languages and Development Tools

The development tool uses the programming

language PHP 5.0 and MySQL database. The server

maps to present the results defined by the software

was the Google Maps version 2.0. However

JavaScript and HTML functions will also be used;

In order to fulfill a good usability CSS and

JavaScript JQuery v.1.3.2 framework styles will also

be used. Another resource used is AJAX, which

allows greater interaction with the User.

3.1.3 Diagrams

When open, the software executes a query to the

database, to fill the respective fields of the filters, as

showed in figure 1.

Figure 1: Diagram Initializing Data Filters.

Consultation of blood donations, according to the

selected filter, is displayed in the software by

following iterations showed in figure 2.

USING OPEN SOURCE TO CREATE A GEOGRAPHICAL INFORMATION SYSTEM FOR BLOOD DONATIONS

501

Figure 2: Diagram: View Blood Donations.

The main activities diagram was elaborated

grouping activities by actors, as showed in figure 3.

Figure 3: Activities diagram.

3.2 Implementation

In the diagram in figure 4, one can see the list of

GeoDádivas system files and also the interaction

between them.

The map server chosen for this software was

Google Maps (map visualization free service

utilizing satellite images). Besides maps and satellite

images, it provides routes between pre-determinate

spots, zoom, dragging the map, among others

(Davis, 2006). The simplicity and open source

methodology are its biggest assets. The grabbing and

dragging possibility, increase or decrease zoom

without big delays in the web page are a few of the

simple tasks that favor it.

The functions javascripts labeledmarker.js and

markerclusterer.js and the Jquery library are also

used. All distributed by GNU licenses.

Figure 4: Diagram: Files Interaction.

3.3 Application Interface

The primary interface of the application has three

distinct parts, a header in the top of the page and two

columns, one of filters on the left and another of

results on the right as we can see in figure 5.

Figure 5: Main Application Window.

4 RESULTS

4.1 Data Analysis

The database used for the prototypes refers the blood

donations occurred in the northern region of

Portugal between the years 2000-2008. The initial

analysis revealed that the database possessed

approximately 634000 entries, and were used the

respective variables: date, donor, gender, birth date,

zip code, blood type, Rh factor, triage results, collect

results and lab results. After statistical analysis, we

can verify that the frequencies distribution is similar

to the Portuguese study of blood types (Duran, 2007)

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in which 46.6% of the population has type A, 3.4%

AB, 7.7% B and 42.3% O.

4.2 Clusters

Analyzing the first results, it was noted that no

conclusion can be drawn from first images showed.

Because there were many blood donors, a marker on

the map for each donor had a result as or more

confusing to interpret than looking directly at a table

data, figure 6.

Figure 6: View Blood Donations without Cluster.

From these results, it was defined the need for

developing clusters (aggregating relatively close

donors together, geographically).

4.3 View Blood Donations

In figures 7 and 8 we can see the difference in

existing donors with type A and AB on North

Portugal region. Being AB a more difficult type to

obtain, collect posts positioning can be easily

managed.

Figure 7: Blood group A donation.

4.4 Sapo Summerbits 2009

Software GeoDádivas was one of 10 winners of the

“Projecto Sapo Summerbits 2009” (Software Livre,

2009). This project is inspired by the Google

Summer of Code. In this initiative, scholarships are

awarded to students of Portuguese universities to

develop code to free software projects, existing or

new, that use GNU Licence (Sapo, 2009).

Figure 8: Blood group AB donation.

In figure 9, a most detailed visualization can be

made after a zoom in action.

Figure 9: Detail of Blood collect places in Porto city and

donors distribution.

4.5 Repositories

Repositories where GeoDádivas codes can be found,

as well as their licenses are:

Software Livre:

http://softwarelivre.sapo.pt/geodadivas

Source Force:

http://sourceforge.net/projects/geodadivas

The software is currently hosted in the

CINTESIS and can be used on an experimental basis

as it uses a database of tests:

http://geodadivas.gim.med.up.pt

5 DISCUSSION

After the completion of this work we can realize that

the GIS development is a complex system that needs

much research.

The fact that it was developed by a multi-

disciplinary team was essential towards its

realization. The view of (a) the professional that is

integrated in the entity where the system will be

implemented (Clinical analysis technician),

USING OPEN SOURCE TO CREATE A GEOGRAPHICAL INFORMATION SYSTEM FOR BLOOD DONATIONS

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combined with (b) the scientific analysis view from

other health care area and (c) the technologic

knowledge of the Informatics professional

constituted an important point in its execution.

As the treatment and data manipulation revealed

itself a difficult task, the software development

became more complex.

We can conclude that all the initial project of

data treatment (analysis, integrity verification,

validation, and comparison with other scientific

studies already done), although having consumed the

majority of time spent, was crucial to final work

quality.

The frequencies of the variables in our system

are consistent with national published studies. This

gives us an additional prove of data integrity quality.

Initial tests revealed that a GIS Open Source

system is feasible in this context. Also we could

realize that Google Maps API can support big

volume of data in each query and Web 2.0

technology and JQuery UI Framework were a good

choice in this experimental project phase, especially

in relation with the user-system interaction.

The cluster method partially solves the graphic

visualization problem, reducing the markers’

quantity relatively close between themselves.

However, after system conclusion, we could verify

that clusters could easily create an optic illusion of

blood donation, when less zoom was utilized.

For future work we suggest that other functions

can be added and existing ones can be improved,

namely:

 possible use of colorized polygons that

delimitate cities can be used in replacement of

the cluster solution because they can facilitate

the visual interpretation;

 more complex functions to establish relations

between different variables such as calculation

the distance between donor’s houses and

blood collection places;

 determine with higher precision the location

of blood collect places with lowest

frequencies that represent high resources

consumption;

 relate the population density with blood

donations in certain areas.

ACKNOWLEDGEMENTS

To Dr. Jorge Condeço, Head Chief of the

Informatics/Hemovigilance department of the

CRSP-IPS, IP (PBI, 2009), for all the help and

collaboration in obtaining the data and its treatment,

analysis and comprehension.

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