142nd APHA Annual Meeting and Exposition

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307423
Health Informatics Information Technology and Development of an Innovative Global Trauma Registry

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 3:30 PM - 3:50 PM

Michel Aboutanos, MD MPH FACS , Division of Trauma, Critical Care & Emergency Surgery, Department of Surgery, Virginia Commonwealth University Medical Center, Richmond, VA
Sudha Jayaraman, MD MSc , Division of Trauma, Critical Care & Emergency Surgery, Department of Surgery, Virginia Commonwealth University Medical Center, Richmond, VA
Lina Mata, MD , Division of Trauma, Critical Care & Emergency Surgery, Department of Surgery, Virginia Commonwealth University Medical Center, Richmond, VA
Edgar Rodas, MD , Hospital Vicente Corral Moscoso and Hospital Universitario Del Rio, Ecuador
Francisco Mora, MD , Cinterandes Foundation Mobile Surgical Program, Cuenca, Ecuador
Carlos Ordoņez, MD , Hospital Universitario del Valle and Fundacion Valle de Lili, Cali, Colombia
Carlos Morales, MD , Hospital San Vicente de Paul, Medellin, Colombia
Martha Quioddettis, MD , Hospital Santo Tomas, Panama City, Panama
Michael Duong , Department of Surgery, Virginia Commonwealth University Medical Center, Richmond, VA
Rao Ivatury, MD FACS , Virginia Commonwealth University Medical Center, Richmond, VA
Background

The global burden of injury disproportionately affects low and middle income countries although there is little data on injury in these settings. Through innovative health informatics and delivery systems, LMICs can more accurately determine the burden of injury, identify gaps in care and develop interventions to improve emergency care and quality.

Objective

Design, develop and test the feasibility of implementing an innovative electronic trauma registry, with capacity to link hospital systems at local, regional, national, and international levels.

Methods

A multi-disciplinary team: a medical director, program coordinator, statistician and information technology staff designed an electronic registry with a quality control system containing 250 data elements for comprehensive injury surveillance from prehospital phase through discharge from hospital, based on ICD-10 coding and injury severity scores (AIS, ISS, RTS and OIS). Pre-specified basic reports and advanced customizable reporting were set up to allow analysis. The registry was created in multiple languages, with capacity to link across hospitals and is accessible online via computers or mobile devices or through software installation where there is no internet.

Results

The registry and a standardized emergency department form were implemented across nine hospitals in three countries: Ecuador, Colombia and Panama, as a pilot program. Implementation included a week-long session on basic epidemiology and injury surveillance, monitoring and evaluation, and quality improvement, for clinicians, hospital administrators and data entry personnel. Since implementation, a total of 28,698 injured patients have been entered into the registry across the nine sites: 6911 in Ecuador at five hospitals; 20,795 in Colombia across three hospitals; and 992 in Santo Tomas Hospital in Panama. Site-specific analysis is under way.

Discussion

Better data on the need and quality of injury care in resource-constrained settings is essential. Investment in innovative and modifiable health informatics technology will provide more reliable information and allow more effective planning and resource-allocation.

Learning Areas:

Administration, management, leadership
Communication and informatics
Epidemiology
Public health administration or related administration
Public health or related public policy
Public health or related research

Learning Objectives:
Explain key components of design of a global trauma registry

Keyword(s): International Health, Data Collection and Surveillance

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I helped write up the project.
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.