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Update on Building a New Trauma Registry

Update on Building a New Trauma Registry. August 22 and 23, 2012. What we will cover today:. Mandatory Data Elements Reporting patient first and last name Additional Training Sessions Updated Project Timeline. Legacy File Extract to Upload to DSHS.

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Update on Building a New Trauma Registry

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  1. Update on Building a New Trauma Registry August 22 and 23, 2012

  2. What we will cover today: • Mandatory Data Elements • Reporting patient first and last name • Additional Training Sessions • Updated Project Timeline

  3. Legacy File Extract to Upload to DSHS • All 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 field’s 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.

  4. EMS Mandatory Data Elements

  5. EMS Mandatory Data Elements • 1. Firm Number • Data Field Number: 2 • Data Field Name: FIRMNO • Priority: Required • Field Length: 6 • Field Type: Numeric • Value Range: 001001 – 799999 • Definition: 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

  6. EMS Continued • 2. Run Report ID • Data Field Number: 1 • Data Field Name: RRID • Priority: Required • Field Length: 10 • Field Type: Character • Value Range: None • Definition: Unique number/characters assigned by the registry software program or registrar. • Data Values: • One unique entry per patient per incident

  7. EMS Continued • 3. Date of Call • Data Field Number: 4 • Data Field Name: CALLDATE • Priority: Required • Field Length: 10 • Field Type: Date • Value 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/DD • YYYY = Year; 9999 = Unknown • MM = Month; leading zero required; 99 = Unknown • DD = Day; leading zero required; 99 = Unknown

  8. EMS Continued • 4. Patient’s Last Name • Data Field Number: 26 • Data Field Name: LNAME • Priority: Required for RESPTYPE = 4 – 10 • Field Length: 20 • Field Type: Character • Value Range: None • Definition: The patient’s legal last name. If last name is unknown, enter a single 9. • Data Values: • Any characters used to identify the last name • 9 = 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.

  9. EMS Continued • 5. Patient’s First Name • Data Field Number: 27 • Data Field Name: FNAME • Priority: Required for RESPTYPE = 4 - 10 • Field Length: 20 • Field Type: Character • Value Range: None • Definition: The patient’s legal first name. If first name is unknown, enter a single 9. • Data Values: • Any letters used to identify the first name • 9 = 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.

  10. EMS Continued • 6. Date of Birth • Data Field Number: 29 • Data Field Name: DOB • Priority: Required for RESPTYPE = 4 - 10 • Field Length: 10 • Field Type: Date • Value Range: [1880 – current year, 9999][01 – 12, 99][01 – 31, 99] • Definition: Patient’s date of birth. If values are unknown, enter 9’s. Estimate birth year, if necessary. • Data Values: • Format: YYYY/MM/DD • YYYY = Year; 9999 = Unknown • MM = Month; leading zero required; 99 = Unknown or birth year is estimated • DD = Day; leading zero required; 99 = Unknown or birth year is estimated

  11. EMS Continued • 7. Sex • Data Field Number: 36 • Data Field Name: SEX • Priority: Required for RESPTYPE = 4 - 10 • Field Length: 1 • Field Type: Numeric • Value Range: 1 – 2, 9 • Definition: The patient’s gender at injury date. If the patient is in the middle of a gender change, use the original gender. • Data Values: • 1 = Male • 2 = Female • 9 = Unknown

  12. EMS Continued • 8. County of Patient’s Residence • Data Field Number: 35 • Data Field Name: RESCNTY • Priority: Required for RESPTYPE = 4 - 10 • Field Length: 3 • Field Type: Numeric • Value Range: 001 – 254, 801 – 899, 999 • Definition: The county of the patient’s 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 codes • 801 - 899 = TDH out-of-state codes • 999 = Unknown

  13. EMS Continued • 9. Patient Destination • Data Field Number: 95 • Data Field Name: DESTIN • Priority: Required for RESPTYPE = 6 - 8 • Field Length: 2 • Field Type: Numeric • Value Range: 01 – 19, 88, 99 • Definition: The type of place where the patient was delivered.

  14. Hospital Mandatory Data Elements

  15. Hospital Mandatory Data Elements • 1. TRAUMA REGISTRY NUMBER • Data Field Number: 1 • Data Field Name: TRNO • Required/Optional: Required • Max. Length of Field: 7 • Type of Field: Numerical • Value Range: 1 - 9999999 • DEFN Sequential unique number assigned by the registry software program or registrar.

  16. Hospital Continued • 2. FACILITY NUMBER • Data Field Number: 6 • Data Field Name: FACILNO • Required/Optional: Required • Max. Length of Field: 7 • Type of Field: Numeric • Value Range: 0010001 - 2559999 • DEFN The seven digit numeric code assigned to YOUR hospital. • Values Facility numbers are assigned by the Texas Department of Health. The list of facility numbers can be found in Appendix A.

  17. Hospital Continued • 3. PATIENT’S LAST NAME • Data Field Number: 2 • Data Field Name: LNAME • Required/Optional: OptionalChanged to Required • Max. Length of Field: 20 • Type of Field: Character • Value Range: None • DEFN The patient’s legal last name.

  18. Hospital Continued • 4. PATIENT’S FIRST NAME • Data Field Number: 3 • Data Field Name: FNAME • Required/Optional: OptionalChanged to Required • Max. Length of Field: 20 • Type of Field: Character • Value Range: None • DEFN The patient’s legal first name.

  19. Hospital Continued • 5. SEX • Data Field Number: 9 • Data Field Name: SEX • Required/Optional: Required • Max. Length of Field: 1 • Type of Field: Numeric • Value Range: 1-2 • DEFN The patient's gender at injury date. If patient is in middle of gender change, use original gender. • Values 1 = Male 2 = Female

  20. Hospital Continued • 6. DATE OF BIRTH • Data Field Number: 10, 11, 12 • Data Field Name: MMOB, DDOB, YYOB • Required/Optional: Required • Max. Length of Field: 2, 2, 4 • Type of Field: Numeric • Value Range: [01-12], [0-31], [1880 – present year] • DEFN The patient’s date of birth. Estimate, if necessary. • Values Month of Birth (MMOB) • 01 = January 07 = July • 02 = February 08 = August • 03 = March 09 = September • 04 = April 10 = October • 05 = May 11 = November • 06 = 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.

  21. Hospital Continued • 7. 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, 999 • DEFN The county in which the patient resides. • Values Each 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.

  22. Hospital Continued • 8. DATE OF ARRIVAL • Data Field Number: 22, 23, 24 • Data Field Name: MMARHOSP, DDARHOSP, YYARHOSP • Required/Optional: Required • Max. Length of Field: 2, 2, 4 • Type of Field: Numeric • Value Range: [01-12], [01-31], [2000 – present year] • DEFN The date in which the injured patient arrived at your hospital. Report information even if patient was a direct admission. • Values Month of Arrival (MMARHOSP) • 01 = January 07 = July • 02 = February 08 = August • 03 = March 09 = September • 04 = April 10 = October • 05 = May 11 = November • 06 = 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.

  23. Hospital Continued • 9. PATIENT DISCHARGED TO • Data Field Number: 41 • Data Field Name: DISTIN • Required/Optional: Required • Max. Length of Field: 1 • Type of Field: Numeric • Value Range: 1-9 • DEFN The place to which the patient was released when discharged from YOUR hospital. • Values 1 = Home Patient’s own home or significant other’s 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

  24. Hospital Continued • 10. PATIENT DISCHARGED TO FACILITY NUMBER • (If Distin = 2 or Distin = 3) • Data Field Number: 48 • Data Field Name: DISFAC • Required/Optional: Required – Conditional* • Max. Length of Field: 7 • Type of Field: Numeric • Value Range: 0010001-2549999, 8010000-8990000, 9999999 • DEFN The seven digit numeric code assigned to the facility to which your hospital transferred the patient. • Values Facility 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.

  25. Hospital Continued • 11. IS THIS A TRANSFER? • Data Field Number: 106 • Data Field Name: TRANSF • Required/Optional: Required • Max. Length of Field: 1 • Type of Field: Numeric • Value Range: 1-2 • DEFN • Hospital transfer applies to patients who are transferred from an initial acute care • facility to your facility. A patient sent to your facility from a private doctor’s office, clinic, or stand-alone ambulatory surgery center is not a transfer. • Values 1 = Yes 2 = No

  26. Hospital Continued • 12. FIRST HOSPITAL NUMBER (If Transf =1) • Data Field Number: 107 • Data Field Name: HOSP1 • Required/Optional: Required – Conditional* • Max. Length of Field: 7 • Type of Field: Numeric • Value Range: 0010001-2549999, 8010000-8990000, 9999999 • DEFN The seven digit numeric code assigned to the facility, which transferred the patient to your hospital. • Values Facility 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.

  27. Mandatory Fields for new Trauma Registry EMS: 9 elements all required in TRAC-IT Hospital: 11 elements all EXCEPT patient first name and last name required in TRAC-IT

  28. Name Data Fields • In the file you have sent for the past several years, there are columns for the first name and the last name • Vendors have either left them blank, inserted a tab, or inserted a space • Some hospitals report patient names to DSHS already • Many EMS have not been reporting patient names even though it has been required for years, DSHS has never enforced it

  29. Considerations for Reporting Patient Name • DSHS conducted two webinars for vendors Aug. 20 and Aug. 23 • Vendors 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 extract

  30. Vendors/software that are able to report patient names without re-programming • CDM (Clinical Data Management) • Digital Innovation Corporation • Digitech Computer, Inc. • Emergicon • Emergidata (Rescue Medic) • Emscharts • ESO Solutions • Houston Fire Department • ImageTrend • Intermedix • Lancet Technology, Inc. • Municipal Computing Services • TritechSoftware Systems (aka Ortivus or Sweet Computers) • UMC Lubbock • STATco (EMS data) • Zoll Data Systems

  31. Considerations Continued • If 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 Live’ • Your hospital designation or EMS license will not be negatively impacted if you are not able to report patient names at ‘Go Live’

  32. Considerations Continued • DSHS 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 Live’ • ‘Go Live’ is now Sept. 17th, 2012

  33. How will names be used? • Patient names will be used for: • De-duplication • EMS and Hospital Record Linking

  34. De-duplication • The 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 facility • For 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 deletion

  35. De-duplicating Continued • Accuracy 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 duplicates

  36. De-duplicating Continued • A 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 DSHS • 6% of 2 million records would be an estimated 120,000 duplicate records

  37. Linking EMS and Hospital Records • It 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 Texas

  38. Questions or comments regarding reporting patient names

  39. Additional Training Sessions • August 27 -31: Two webinars • Sept. 3-7: Two webinars • Sept. 10-14: Two webinars • Covers both uploading of data files and the basics of web data entry

  40. Updated Project Timeline • User Acceptance Testing Continues Through August 24 • August 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

  41. Questions about training sessions or the project timeline Thank you for attending the webinar today.

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