Update on Building a New Trauma Registry

Update on Building a New Trauma RegistryAugust 22 and 23, 2012What we will cover today:Mandatory Data ElementsReporting patient first and last nameAdditional Training SessionsUpdated Project Timeline

2Legacy File Extract to Upload to DSHSAll data files that are sent to The Registry must be in ASCII tab-delimited format. A tab must follow every field except the last field of each record. Even if there is no data recorded for a particular field, or the field is optional, a tab must still be placed in that fields position. The Main Fields section contains the minimum standard data set that everyone is required to send to The Registry. A file sent in the Main Format must contain all of the fields in the Main Fields section of the appropriate data set.

3EMS Mandatory Data Elements4EMS Mandatory Data Elements1. Firm NumberData Field Number:2Data Field Name:FIRMNOPriority:RequiredField Length:6Field Type:NumericValue Range:001001 799999Definition:The six digit numeric code assigned to YOUR EMS provider.Data Values:Firm numbers are assigned by the Texas Department of Health EMS/Trauma Registry. The list of Firm Numbers can be found on the injury website and in Appendix A.

001001 799999 = Texas EMS providers

5EMS Continued2. Run Report IDData Field Number: 1Data Field Name: RRIDPriority: RequiredField Length: 10Field Type: CharacterValue Range: NoneDefinition: Unique number/characters assigned by the registry software program or registrar.Data Values:One unique entry per patient per incident

6EMS Continued3. Date of CallData Field Number:4Data Field Name:CALLDATEPriority:RequiredField Length:10Field Type:DateValue Range:[1990 current year, 9999] [01 12, 99][01 31, 99]Definition:The date on which the call was made.Data Values:Format: YYYY/MM/DDYYYY = Year; 9999 = UnknownMM = Month; leading zero required; 99 = UnknownDD = Day; leading zero required; 99 = Unknown

7EMS Continued4. Patients Last NameData Field Number:26Data Field Name:LNAMEPriority:Required for RESPTYPE = 4 10Field Length:20Field Type:CharacterValue Range:NoneDefinition:The patients legal last name. If last name is unknown, enter a single 9.Data Values:Any characters used to identify the last name9 = Unknown

Note: Doe as in John Doe, or any other pseudonym, is NOT an acceptable value for Unknown.Must list at least the first four letters of the last name.

8EMS Continued5. Patients First NameData Field Number:27Data Field Name:FNAMEPriority:Required for RESPTYPE = 4 - 10Field Length:20Field Type:CharacterValue Range:NoneDefinition:The patients legal first name. If first name is unknown, enter a single 9.Data Values:Any letters used to identify the first name9 = Unknown

Note: John as in John Doe, or any other pseudonym, is NOT an acceptable value for Unknown.Must list at least the first four letters of the first name.

9EMS Continued6. Date of BirthData Field Number:29Data Field Name:DOBPriority:Required for RESPTYPE = 4 - 10Field Length:10Field Type:DateValue Range:[1880 current year, 9999][01 12, 99][01 31, 99]Definition:Patients date of birth. If values are unknown, enter 9s. Estimate birth year, if necessary.Data Values:Format: YYYY/MM/DDYYYY = Year; 9999 = UnknownMM = Month; leading zero required; 99 = Unknown or birth year is estimatedDD = Day; leading zero required; 99 = Unknown or birth year is estimated

10EMS Continued7. SexData Field Number:36Data Field Name:SEXPriority:Required for RESPTYPE = 4 - 10Field Length:1Field Type:NumericValue Range:1 2, 9Definition:The patients gender at injury date. If the patient is in the middle of a gender change, use the original gender.Data Values:1 = Male2 = Female9 = Unknown

11EMS Continued8. County of Patients ResidenceData Field Number:35Data Field Name:RESCNTYPriority:Required for RESPTYPE = 4 - 10Field Length:3Field Type:NumericValue Range:001 254, 801 899, 999Definition:The county of the patients home; physical address, not mailing address.Data Values:County numbers are assigned by the Texas Department of Health EMS/Trauma Registry. The list of County Numbers can be found on the injury website and in Appendix C.

001 - 254 = TDH county codes801 - 899 = TDH out-of-state codes999 = Unknown

12EMS Continued9. Patient DestinationData Field Number:95Data Field Name:DESTINPriority:Required for RESPTYPE = 6 - 8Field Length:2Field Type:NumericValue Range:01 19, 88, 99Definition:The type of place where the patient was delivered.

13Hospital Mandatory Data Elements14Hospital Mandatory Data Elements1. TRAUMA REGISTRY NUMBER Data Field Number: 1Data Field Name:TRNORequired/Optional: RequiredMax. Length of Field: 7Type of Field: NumericalValue Range: 1 - 9999999DEFNSequential unique number assigned by the registry software program or registrar.

15Hospital Continued2. FACILITY NUMBER Data Field Number:6 Data Field Name: FACILNO Required/Optional: RequiredMax. Length of Field: 7Type of Field: NumericValue Range: 0010001 - 2559999DEFNThe seven digit numeric code assigned to YOUR hospital.ValuesFacility numbers are assigned by the Texas Department of Health. The list of facility numbers can be found in Appendix A.

16Hospital Continued3. PATIENTS LAST NAMEData Field Number: 2Data Field Name: LNAMERequired/Optional: Optional Changed to RequiredMax. Length of Field: 20Type of Field: CharacterValue Range: NoneDEFNThe patients legal last name.

17Hospital Continued4. PATIENTS FIRST NAMEData Field Number: 3Data Field Name: FNAMERequired/Optional: Optional Changed to RequiredMax. Length of Field: 20Type of Field: CharacterValue Range: NoneDEFNThe patients legal first name.

18Hospital Continued5. SEX Data Field Number: 9 Data Field Name: SEX Required/Optional: Required Max. Length of Field: 1 Type of Field: Numeric Value Range: 1-2DEFNThe patient's gender at injury date. If patient is in middle of gender change, use original gender.Values1 = Male 2 = Female

19Hospital Continued6. DATE OF BIRTH Data Field Number: 10, 11, 12 Data Field Name: MMOB, DDOB, YYOB Required/Optional: Required Max. Length of Field: 2, 2, 4Type of Field:NumericValue Range: [01-12], [0-31], [1880 present year]DEFNThe patients date of birth. Estimate, if necessary.ValuesMonth of Birth (MMOB)01 = January 07 = July02 = February 08 = August03 = March 09 = September04 = April 10 = October05 = May 11 = November06 = June 12 = December

Day of Birth (DDOB)0 31 Year of Birth (YYOB)Use four-digit year of birth. For example, if the patient was born in 1980, the value would be 1980.

20Hospital Continued7. COUNTY OF RESIDENCE Data Field Number:20 Data Field Name: RESCNTY Required/Optional:Required Max. Length of Field: 3 Type of Field: Numeric Value Range: 1-254, 801-858, 899, 999DEFNThe county in which the patient resides.ValuesEach county in Texas is assigned a number 1 through 254. A county code is also assigned for each state and some countries. Use 999 for unknown county. See Appendix C for county code list. See Appendix D for Texas city-county list.

21Hospital Continued8. DATE OF ARRIVAL Data Field Number: 22, 23, 24 Data Field Name: MMARHOSP, DDARHOSP, YYARHOSP Required/Optional:Required Max. Length of Field: 2, 2, 4Type of Field:Numeric Value Range: [01-12], [01-31], [2000 present year]DEFNThe date in which the injured patient arrived at your hospital. Report information even if patient was a direct admission.ValuesMonth of Arrival (MMARHOSP)01 = January 07 = July02 = February 08 = August03 = March 09 = September04 = April 10 = October05 = May 11 = November06 = June 12 = December Day of Arrival (DDARHOSP) 0 31 Year of Arrival (YYARHOSP)Use four-digit year of arrival. For example, if the patient arrived at your hospital in 2000, the value would be 2000.

22Hospital Continued 9. PATIENT DISCHARGED TO Data Field Number: 41Data Field Name: DISTINRequired/Optional: RequiredMax. Length of Field: 1Type of Field: NumericValue Range: 1-9DEFNThe place to which the patient was released when discharged from YOUR hospital.Values1 = Home Patients own home or significant others home. Can include apartment, boarding house, farm house, home premises, house (residential), non-institutional place of residence, or retirement community.

2 = Acute care facility

3 = Rehabilitation facility Transferred to a licensed rehabilitation facility

4 = Nursing home / SNF / ICF Skilled nursing facility or intermediate care facility. (Includes transfer to a SNF for rehabilitation purposes).

5 = Residential facility children's home, dormitory, hospice, jail, old people's home, orphanage, prison, reform school, shelter, protective services, psychiatric hospital, foster care

6 = Left AMA/ Eloped (Left prior to medical discharge)

7 = Other

8 = Morgue/funeral home

9 = Unknown destination

23Hospital Continued10. PATIENT DISCHARGED TO FACILITY NUMBER (If Distin = 2 or Distin = 3)Data Field Number: 48Data Field Name: DISFACRequired/Optional: Required Conditional*Max. Length of Field: 7Type of Field: NumericValue Range: 0010001-2549999, 8010000-8990000, 9999999 DEFNThe seven digit numeric code assigned to the facility to which your hospital transferred the patient. ValuesFacility numbers are assigned by the Texas Department of Health. The list of facility numbers can be found in Appendix A.

*This field is conditional. Complete only if patient was discharged to another acute care facility or a rehabilitation facility (i.e., if field #41 Patient Discharged To is equal to 2 acute care facility or 3 rehabilitation facility). Leave blank if patient was not discharged to another acute care facility or rehabilitation facility. Note: Some rehabilitation facilities do not have an assigned facility number at this time.

24Hospital Continued11. IS THIS A TRANSFER?Data Field Number: 106Data Field Name: TRANSFRequired/Optional: RequiredMax. Length of Field: 1Type of Field: NumericValue Range: 1-2DEFN Hospital transfer applies to patients who are transferred from an initial acute carefacility to your facility. A patient sent to your facility from a private doctors office, clinic, or stand-alone ambulatory surgery center is not a transfer.Values 1 = Yes 2 = No

25Hospital Continued12. FIRST HOSPITAL NUMBER (If Transf =1)Data Field Number: 107Data Field Name: HOSP1Required/Optional: Required Conditional*Max. Length of Field: 7Type of Field: NumericValue Range: 0010001-2549999, 8010000-8990000, 9999999DEFNThe seven digit numeric code assigned to the facility, which transferred the patient to your hospital.ValuesFacility numbers are assigned by the Texas Department of Health. The list of facility numbers can be found in Appendix A.

*This field is conditional. Complete only if the patient was transferred from another hospital to your hospital (i.e., if field #106 Is this a Transfer? is equal to 1- Yes). Leave blank if patient was not transferred from another hospital to your hospital.

26Mandatory Fields for new Trauma RegistryEMS: 9 elements all required in TRAC-ITHospital: 11 elements all EXCEPT patient first name and last name required in TRAC-IT27Name Data FieldsIn the file you have sent for the past several years, there are columns for the first name and the last nameVendors have either left them blank, inserted a tab, or inserted a spaceSome hospitals report patient names to DSHS alreadyMany EMS have not been reporting patient names even though it has been required for years, DSHS has never enforced it28Considerations for Reporting Patient NameDSHS conducted two webinars for vendors Aug. 20 and Aug. 23Vendors so far have conveyed to DSHS, the customer is able to change a setting on their software to populate the name fields with data and this will not require the vendor to re-create the file extract29Vendors/software that are able to report patient names without re-programmingCDM (Clinical Data Management)Digital Innovation CorporationDigitech Computer, Inc.EmergiconEmergidata (Rescue Medic)EmschartsESO SolutionsHouston Fire DepartmentImageTrendIntermedixLancet Technology, Inc. Municipal Computing ServicesTritech Software Systems (aka Ortivus or Sweet Computers)UMC Lubbock STATco (EMS data)Zoll Data Systems

30Considerations ContinuedIf an entity can not change a setting locally and needs their vendor to make a software change in order to populate the name fields, then DSHS will work with that entity and vendor to assist DSHS is currently exploring a work around for any entities who can not report patient names by Go LiveYour hospital designation or EMS license will not be negatively impacted if you are not able to report patient names at Go Live31Considerations ContinuedDSHS is extending Go Live by one week in order to create the work around solution to enable entities to continue to report even if they are not able to report names at Go LiveGo Live is now Sept. 17th, 201232How will names be used?Patient names will be used for:De-duplicationEMS and Hospital Record Linking33De-duplicationThe registry was developed to allow only the reporting facility to see their data (can allow RAC access or Billing company access)Records can be de-duplicated within each facilityFor a record to be considered a duplicate, both records must contain the same data for the date of the event, the DOB, County of Residence, etc. If one record has exactly the same data AND contains additional data elements not in the second record, then the record with the greatest amount of data will be saved and the other marked as a duplicate for deletion34De-duplicating ContinuedAccuracy in reporting the number of patients injured: It is important to not count the same person twice for the same injury when reporting on the number of persons injured Valid and complete data is needed to determine whether records are duplicates.Patient names are essential to detect duplicates35De-duplicating ContinuedA recent de-duplication of EMS records for the Houston MSA revealed 6% of records were duplicates. There are 2 million EMS records reported annually to DSHS6% of 2 million records would be an estimated 120,000 duplicate records

36Linking EMS and Hospital RecordsIt is important to link EMS to hospital records to study the factors associated with treatment given at the scene and during transport with the factors associated with the hospital treatment and the ultimate patient outcome.Linking EMS to Hospital records has been a goal articulated for a long time by the stakeholders for the trauma system in Texas37Questions or comments regarding reporting patient names38Additional Training SessionsAugust 27 -31: Two webinarsSept. 3-7: Two webinarsSept. 10-14: Two webinarsCovers both uploading of data files and the basics of web data entry39Updated Project TimelineUser Acceptance Testing Continues Through August 24August 27 - Sept 6: Pilot Testing August 27: Data Conversion Begins August 31: Entity accounts/users imported into new system September 17:New system Go Live

40Questions about training sessions or the project timelineThank you for attending the webinar today.41