221307 Public health registry development in the age of the electronic medical record: The case of injured veterans with embedded fragments

Wednesday, November 10, 2010 : 1:00 PM - 1:15 PM

Joanna M. Gaitens, PhD, RN , School of Medicine, University of Maryland, Baltimore, MD
Carrie Dorsey, MD, MPH , School of Medicine, University of Maryland, Baltimore, MD
Katherine Squibb, PhD , School of Medicine, University of Maryland, Baltimore, MD
Melissa McDiarmid, MD, MPH , School of Medicine, University of Maryland, Baltimore, MD
Soldiers serving in Iraq and Afghanistan have a unique risk of injury and occupational exposure related to blasts or explosions from improvised explosive devices (IEDs). Contact with IEDs results in traumatic injury and commonly involves wound contamination with toxic foreign material such as metal fragments, plastics, or organic matter, which can pose additional chronic health harm. Using a robust national electronic medical record as a data source, the Veterans Health Administration is building an Embedded Fragment Registry to identify cases and monitor the health of affected veterans. Currently, there are over 750,000 veterans who have served in Operation Enduring Freedom or Operation Iraqi Freedom. Pilot data suggest that 4% of these veterans meet the case definition of having a retained fragment resulting from injury. The Embedded Fragment Registry will also include injury and exposure questionnaire data, urine biomonitoring data, health outcomes, and fragment content results, when available. The information collected will be used to conduct population level surveillance and develop medical and surgical management guidelines for veterans with embedded fragments. This presentation will provide on overview of the registry development process, discuss the strengths and limitations of the case finding method, and discuss how the preliminary findings can inform wider public health audiences.

Learning Areas:
Clinical medicine applied in public health
Epidemiology
Occupational health and safety
Public health or related research

Learning Objectives:
At the end of this presentation, participants will be able to: Describe how an electronic medical record can be a data source for case finding. Discuss strengths and limitations of the approach employed in developing the registry and its relevance to other public health applications.

Keywords: Registry, Surveillance

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I am the Clinical Coordinator for the Toxic Embedded Fragment Surveillance Center and play a key role in the development of the Embedded fragment registry.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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