Child injury / risk ages birth to three - 100 California Hospitals

Health information in medical child abuse reports may be missing lost or misunderstood by investigators. Hospitals may have no record system to manage their reports. Case management and children suffer. The ICAN California Hospital Network provides a contrasting integrated model with liaison in 100+ hospitals statewide, connected in regional clusters sharing cases and resources. Networks connect 12 child burn hospitals and 32 PICU. Birth hospitals will be connected in 2012. Fatal hospital cases will be connected to child death review. Contacts in five states, NACHRI and CDC helped form an informal national working group. Hospitals are ranked for possible exposure to abuse by the size of service for injured children under age three. ICD9CM Codes for maltreatment have been studied but are not consistently applied. Child abuse reports could bring structure to this systems but, most hospitals lack a manageable record system. Automated child abuse reports and data systems can resolve this with 10 major medical centers and a 13 hospital chain are building models. Some would add child abuse data to medical records. Others use MS Excel or Access. A third model draws on both of these the Internet and a list of key data elements. Multiple data sets will be used to define this process along with plans for a national system. A previous parallel program created a dramatic increase in LA County child abuse reports. At least one major hospital has seen an increase in this program. The presentation will include system data and future plans.