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An Evaluation of the Utah Injury Reporting System

An Evaluation of the Utah Injury Reporting System. By Bryan Gibson,DPT Neelam Zafar, MD, MHA. How this Project started. Catherine Staes approached Sam LeFevre for a real world problem which students in the Public Health Informatics class could use as a project

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An Evaluation of the Utah Injury Reporting System

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  1. An Evaluation of the Utah Injury Reporting System By Bryan Gibson,DPT Neelam Zafar, MD, MHA

  2. How this Project started • Catherine Staes approached Sam LeFevre for a real world problem which students in the Public Health Informatics class could use as a project • Students chose an Injury class, identified relevant surveillance systems, interviewed stakeholders and presented a paper describing the system • This is a summary of those papers which are related to injury classes included in the Utah Injury Reporting Rule

  3. The Utah Injury Reporting rule • The Utah Legislature passed the Utah Injury Reporting Rule (UIRR) in 1997 • The UIRR authorizes the Utah Department of Health (UDOH) to perform surveillance of twelve classes of injury • Cases are defined by death or hospitalization • Injuries must be reported to UDOH within 60 days • Case report content is specified but limited

  4. Injury Systems Evaluated

  5. Injury Systems Evaluated Cont.

  6. Conclusions/Reccomendations • Utahhospitals must meet redundant and overlapping reporting requirements • These reporting requirements create non-standard and redundant data silos • Public Health practitioners were not aware of all existing data sources available for surveillance

  7. Conclusions Cont. • Many systems use non standard data formats which then require manual data abstraction, entry, and re-entry. • Data collected under the authority of the Utah Injury Reporting Rule is not currently used. • The timeliness required by the Utah Injury Reporting Rule is not consistent with the public health response indicated (CO poisoning should be more timely, TBI could be reported less frequently).

  8. Recomendations • Re-evaluate need for Utah Injury Reporting Rule • Harmonize reporting requirements and create adequately explicit case definitions to enable automation • Enhance use of Utah Trauma Registry

  9. Traumatic Brain Injury Surveillance in Utah

  10. Background • Traumatic brain injury (TBI) is a leading cause of death and disability • Each year, 1.4 million persons sustain a TBI, 50,000 die. 5.3 million Americans live with permanent TBI-related disability¹ • The Utah Department of Health (UDOH) collects information about TBI-related injuries under several different reporting rules

  11. Objective Evaluate current TBI surveillance processes, identify gaps and inefficiencies, and align Utah Injury Reporting Rule with stakeholder needs.

  12. Methods • Identified potential data sources, described data flow, and interviewedkey stakeholders including epidemiologist, educators from Violence and Injury Prevention Program at UDOH, a trauma registrar from University Hospital, and researchers from Intermountain Injury Control Research center(IICRC).

  13. Methods • Compared current reporting case definition with definitions defined or implied by other potential data sources. • Compared current data elements used for TBI surveillance with data elements that are collected under different reporting rules

  14. Findings • We identified three major potential data sources for surveillance of TBI-related injuries, including mortality data and hospital discharge data storedat the UDOH, and trauma registry data stored at the Intermountain Injury Control Research Center under contract by UDOH. • Public health stakeholders interviewed were unaware of the Utah Trauma Registry under contract by UDOH

  15. Findings • CDC-funded TBI surveillance is a manual intensive process which results in the review of a 55% stratified sample and excludes non-hospitalized cases. We identified 44 data fields used. • Utah Trauma Registry captures data for admissions lasting at least 24 hours, deaths due to traumatic injury and EMS data for patients transferred from one hospital to another or by air ambulance. The Utah Trauma Registry includes all data fields required for TBI surveillance, additional data, from all Utah hospitals. At trauma level I and II hospitals a trauma registrar with direct access to the clinical Information system abstracts required information.

  16. Recommendation • We recommend exploring use of the Utah Trauma Registry for TBI surveillance in Utah • Eliminate requirement of reporting TBI as part of the Utah Injury Reporting Rule

  17. References: • 1. CDC. Traumatic Brain Injury in the United States: A Report to Congress. Atlanta (GA): Department of Health and Human Services, National Center for Injury Prevention and Control; 1999 • 2. Updated guidelines for evaluating public health surveillance systems. MMWR 2001; 50 (RR-13): 1-35.

  18. Acknowledgements • Catherine Staes, University of Utah • Sam Lefevre, UDOH • NLM (# LM007124 for CJS,NZ) • VA (VA special fellowship program, Office of Academic Affiliations for BG) • CDC Center of Excellence in Public Health Informatics (#1P01CD000284-01 for CJS). Utah Department of Health • Intermountain Injury Control and Research Center.

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