AMORE Project: Using Big Data to Improve Cancer Care Accessibility in Urban Areas

Improving accessibility to radiotherapy services in Cali, Colombia: cross-sectional equity analyses using open data and big data travel times from 2020

Authors: Luis Gabriel Cuervo, Carmen Juliana Villamizar, Daniel Cuervo, Pablo Zapata, Maria B. Ospina, Sara Marcela Valencia, Alfredo Polo, Ángela Suárez, Maria O. Bula, J. Jaime Miranda, Gynna Millan, Diana Elizabeth Cuervo, Nancy J. Owens, Felipe Piquero, Janet Hatcher-Roberts, Gabriel Dario Paredes, María Fernanda Navarro, Ingrid Liliana Minotta, Carmen Palta, Eliana Martínez-Herrera, and Ciro Jaramillo

In many metropolitan areas, cancer patients often face long, costly journeys for ambulatory treatment, adding stress and financial strain to them and their families. Fragmented care and travel burdens can lead to catastrophic health expenses, underscoring the need for urban planning that prioritises accessible, high-quality, integral care.

Applicable solutions rely on collaboration among government sectors, service providers, organized civil society, scientists, and urban planners. By supporting the alignment of health and mobility policies, governments, communities, and service users can devise strategies that guarantee essential services are accessible. To achieve this, they must share objectives, communicate effectively, and measure their actions. They need a shared understanding and metrics to engage all parties with comprehensible data.

An international team of over 40 volunteers—including technical experts, policymakers, patient advocates, scientists, and service providers—collaborated with data scientists and a doctoral project from the Autonomous University of Barcelona to develop a web-based interactive platform. The platform integrates big data on travel times, accounting for traffic congestion levels, alongside public census and health services data to assess healthcare accessibility. Utilising smartphone-derived big data, the platform generates compelling heatmaps, accessible graphs, and straightforward statistics to highlight which communities are underserved, particularly during daytime and peak traffic periods. It reveals the connections between populations, traffic congestion, and accessibility.

The platform also suggests locations where new healthcare services would maximise accessibility and equity. It enables users to model various scenarios and assists decision-makers in evaluating solutions and their potential impact. While numerous factors determine the ideal placement of health services, this new data will enhance data-driven land use and health services planning. Perhaps due to the participation of interest holders and knowledge users, the project’s findings have been quickly adopted. They are now referenced in Cali’s 2024-2027 Development Plan, the scientific basis for the city’s evolving land-use plan, and a community policy brief on mobility.

The proof-of-concept doctoral study conducted in Cali, Colombia, where chronic traffic congestion limits access to health services, demonstrated its effectiveness. The study, which has attracted attention from civil servants, civic and entrepreneurial organisations like ProPacífico, urban observatories, and the City Cancer Challenge Foundation (C/Can), an international NGO, revealed that only a fraction of Cali’s residents could reach radiotherapy within 20 minutes by car for much of the day, let alone during peak congestion hours. Most patients, particularly those in vulnerable situations, face long, costly journeys. It also indicated that strategically situating sufficient new facilities in key areas of the city would significantly reduce the impact of traffic congestion, enhancing equity by increasing accessibility to levels like those experienced when traffic flows smoothly, thereby bringing the majority of residents within the twenty-minute threshold.

Radiotherapy travel times baseline vs prediction Cali Colombia.

The same methodology was applied to emergency and specialised care services, including haemodialysis and high-complexity emergency services utilised by cancer patients facing complications. The results reinforced the need for service expansion for these services for similar reasons. Notably, many underserved areas coincided, and the preliminary results of integrating the three studies suggest the necessity of placing services in neighbouring locations, particularly in Cali’s eastern Aguablanca district. This indicates potential solutions such as upgrading existing institutions, forming partnerships with providers, or adapting land use plans to establish institutions offering integrated services. Establishing high-capacity facilities in these areas could benefit half of Cali’s population.

This approach can be adapted to other cities, and so far, Cali is making good use of it. It can be applied to a range of services and modes of transport. The necessary data is readily available, and the methodology allows the data to convey its message. By integrating technology with urban and health service planning, communities can develop more accessible and equitable cancer care systems.

Testimonies from cancer and dialysis patients in Cali’s outlying neighbourhood facing mobility difficulties.