1. Connecticut Concussion Tracker (CT)2
October 9, 2014
Joanne Conover, Ph.D., Associate Professor
Department of Physiology and Neurobiology
University of Connecticut
75 N. Eagleville Road, U-3156
Storrs, CT
Steven A. Demurjian, Ph.D., Professor
Computer Science & Engineering Department
371 Fairfield Road, U-4155
Storrs, CT
Thomas P. Agresta, M.D., M.B.I, Professor
Department of Family Medicine – Medical Informatics
University of Connecticut Health Center
263 Farmington Avenue
Farmington, CT
© Copyright 2014, 2015, J. Conover, S. Demurjian, and T. Agresta, University of Connecticut.

2. Objectives of (CT)2
Suite of Applications for Concussion Tracking in support of new CT Law HB5113
Mobile and Web Versions
Single system for all CT Schools
Nurses, Trainers, Coaches, Principals, etc.
Provide Additional Policy/Regulatory Capability
Data Collection: Causes, Symptoms, Follow-up, Return to Class/Participation
Track Students from K to 12
Establish Longitudinal Repository
Advanced Reporting Capabilities for both Schools and State
Deleted: Central Location for Storage Hosted at UConn
OpenEMR – Electronic Medical Record
Free & Open Source
Certified by Office of National Coordinator for Health IT

3. Initial Screens *

4. Selecting State/City/Town/Region/District/School

5. List of All Students/User and Summary

6. Remaining Summary Screens

7. Basic Student Info and Cause of Injury

8. Basic Student Info and Cause of Injury*

9. Symptoms within 48 hrs *

10. Following up with Student*

11. Returning to Learn and/or Play

12. Reporting Capabilities
Ability to examine data by variety of factors
Age
Gender
Symptoms
Duration
Sport
Football, Soccer, Basketball, Hockey, etc.
Days lost
Region/School
Longitudinal Analysis
Tracking trends over time
Under Current Development by M. Morton, CSE4701 Intro to Databases, Honors Project
Graphs:
Breaking out total concussions by sports (would look different if you did it by gender).
See concussion rates change over time, for example, football concussions might be decreasing while concussion rates in soccer may be on the rise.

13. Sample Reports You see trends such as:
More concussions occurring in school during middle school years, and the most sports related concussions occurring in HS.
Younger players have more concussions in games, but older players have more concussions in practices. Total number of sports concussions peaks at age Why?

14. Sample Reports You see trends such as:
More concussions occurring in school during middle school years, and the most sports related concussions occurring in HS.
Younger players have more concussions in games, but older players have more concussions in practices. Total number of sports concussions peaks at age Why?

15. Sample Reports You see trends such as:
More concussions occurring in school during middle school years, and the most sports related concussions occurring in HS.
Younger players have more concussions in games, but older players have more concussions in practices. Total number of sports concussions peaks at age Why?

16. Next Steps for (CT)2 Establishing (CT)2 Team
Involved UConn/UCHC Personnel
Department of Education Representatives
Identify Schools to Participate in Early Stages
Requirements Gathering for Security Access
Survey schools - who enters or accesses data
Design security/role based access
User Centric-Design and Implementation Session
Reports, user interface, content modifications
Deploy Test Version by Dec. 1, 2014 to gather input
Objectives:
Put into Hands of Potential Users
Admin, Nurses, Coaches, ADs, etc.
Adjust UI and Process

17. Current (CT)2 Team Physiology and Neurobiology
Dr. J. Conover/Ms. R. Acabchuk (PhD student)
Computer Science & Engineering
Dr. S. Demurjian, Ms. X. Shao (PhD student), Joshua Diffenderfer (MS Student), M. Morton (Ugrad)
Kinesiology
Dr. Lindsay Distefano
Nursing and Public Engagement
Dr. Carol Polifroni
School Nurse
Ms. L. Demurjian, RN, MBA, Nurse
Medical Doctor & Medical Informatics
Dr. Tom Agresta, MD, MBI

18. Interactions with Uconn Athletic Training
Identify Collaborators from UConn AT
Potential Usage of (CT)2 by UConn AT
Taking the App into the Field
User Interface and Usability Testing
Sharing the App with Members at Schools
Nurses, Coaches, Trainers, etc.
Suggestions for Changes/Enhancements
What are Other Potential Collaborations?

19. Next Steps for (CT)2 Deploy Wider-Scale Pilot Version
Develop Pilot rollout and evaluation strategy
Pilot Version Very soon
Android application
Secure Data Exchange and Encryption in Database
UI Design, Performance, and Load Testing
Wide Range of Schools – Urban, Suburban, Rural, Public, Private, etc.
Identify Stakeholders and Obtain Feedback
Plan Later Increments
Statewide Deployment in Fall 2017 (Very Optimistic)
Add iOS version
Add Canned and Ad-hoc Reporting
Add additional data capture screens to facilitate more robust reports (total participation in each sport, out of school sports participation – other as requested)

20. Connecticut Concussion Tracker Vision

21. Other Relevant Issues for (CT)2
Data Retrieval
Security Requirements
Role-Based Authentication/Access Control
Identity Management 
Data Storage Requirements 

22. Data Retrieval 
Enabling schools to self-evaluate and identify areas for improvement
De-identified incident level data available for canned and ad hoc reports by authorized school users.
De-identified aggregate & comparative reports available for canned and ad hoc reports by authorized school & state users.
Who has access to what type of reports would be determined in concert with Department of Education during project period

23. Security Requirements for (CT)2
Encryption: All Communication (mobile app or web version)
FERPA Compliance: Insure Concussion Records are Available to Parents/Students
HIPAA Compliance: Electronic Medical Records to establish a Backend Repository
Mobile App
No Data left on Phone
Encrypted Transmission
Web App
https
No Cookies
Backend Storage
All HIPAA Fields Encrypted
Take Advantage of EMR
Secured Report Environment

24. Role-Based Authentication/Access Control
Assigning and Maintaining User Privileges:
Who will have access to various features such as view data, update/delete record and close incident?
Who will create, assign & manage Admin accounts?
Who will assign and maintain user roles?
Plans for turnover.
Generic Security Levels:
Security Administrator
Simple User
Advanced User
Identifying Potential Users: Principal, Nurse, Athletic Trainer, Coaches, Administrators, Athletic Director

25. Identity Management Student ID Maintenance
Consider requirement of tracking multiple incidents for individual students longitudinally
If so, student identification be tracked across schools
Long term goals
Track diabetes, asthma, allergies, other health issues
Integration with student health record for complete healthcare record
Is the goal to statistically analyze data or to also manage student health?
Is it an incident tracking system only? If so, non-clinical. If clinical, then ICD-10 codes for EMR.
SSN is best for tracking person. Else, use probabilistic matching software.

26. Data Storage Requirements
Review/finalize App specifications, security, system admin, student ID management, data storage
Items to be determined
Intellectual property: work UConn Tech Trans
Potential expansion – other states or CT colleges
Server location options:
Initial development and staging at UConn
Potential hosting of production at UConn (hosting expense for HIPAA compliance, etc.)
Transfer production to State servers
Support staff
Software maintenance
Yearly updates/improvements