Electronic Health Records and External Cause of Injury Data: Opportunities for Injury Surveillance and Other Uses

Recent changes in health information technology and Meaningful Use of electronic health records (EHRs), as part of the Affordable Care Act in the United States, provide new opportunities for the use of external cause of injury data.  Also, implementation of ICD-10-CM, in place of ICD-9-CM, for morbidity coding in the United States on October 1, 2014 will provide much more detailed coding of external cause of injury (mechanism, intent, place of occurrence, and activity).   Widespread adoption of EHRs in hospital and outpatient settings potentially will bring about more timely external cause-coded data for use in (1) monitoring trends in nonfatal injury rates and characterizing injured patients at the national, state, and local levels, (2) identifying/tracking injured patients with clinical referrals for cause-specific follow-up preventive care services (e.g., elderly fall risk reduction plan of care), (3) defining injury-related clinical quality measures (e.g., proportion of patients attempting suicide who were referred for follow-up psychology evaluation/other care), and (4) measuring health care utilization and cost of injury in a local health care setting. The injury field should be aware of these opportunities and emphasize the important role of high quality external cause-coded data for injury surveillance, epidemiologic research, prevention program planning and evaluation, and tracking quality of care measures for injured patients.  This presentation will provide a forum for discussion of these opportunities and how the injury field might demonstrate the need and usefulness of collecting high quality external cause-coded data through EHRs in hospital inpatient, emergency department, and other outpatient data systems.