1. Update on Building a New Trauma Registry
August 22 and 23, 2012

2. What we will cover today:
Mandatory Data Elements
Reporting patient first and last name
Additional Training Sessions
Updated Project Timeline

3. Legacy File Extract to Upload to DSHS
All data files that are sent to The Registry must be in ASCII tab-delimited format.  A tab must follow every field except the last field of each record.  Even if there is no data recorded for a particular field, or the field is optional, a tab must still be placed in that field’s position. 
The Main Fields section contains the minimum standard data set that everyone is required to send to The Registry.  A file sent in the Main Format must contain all of the fields in the Main Fields section of the appropriate data set.

4. EMS Mandatory Data Elements

5. EMS Mandatory Data Elements
1. Firm Number
Data Field Number: 2
Data Field Name: FIRMNO
Priority: Required
Field Length: 6
Field Type: Numeric
Value Range: –
Definition: The six digit numeric code assigned to YOUR EMS provider.
Data Values:
Firm numbers are assigned by the Texas Department of Health EMS/Trauma Registry. The list of Firm Numbers can be found on the injury website and in Appendix A.
– = Texas EMS providers

6. EMS Continued 2. Run Report ID Data Field Number: 1
Data Field Name: RRID
Priority: Required
Field Length: 10
Field Type: Character
Value Range: None
Definition: Unique number/characters assigned by the registry software program or registrar.
Data Values:
One unique entry per patient per incident

7. EMS Continued 3. Date of Call Data Field Number: 4
Data Field Name: CALLDATE
Priority: Required
Field Length: 10
Field Type: Date
Value Range: [1990 – current year, 9999] [01 – 12, 99][01 – 31, 99]
Definition: The date on which the call was made.
Data Values:
Format: YYYY/MM/DD
YYYY = Year; 9999 = Unknown
MM = Month; leading zero required; 99 = Unknown
DD = Day; leading zero required; 99 = Unknown

8. EMS Continued 4. Patient’s Last Name Data Field Number: 26
Data Field Name: LNAME
Priority: Required for RESPTYPE = 4 – 10
Field Length: 20
Field Type: Character
Value Range: None
Definition: The patient’s legal last name. If last name is unknown, enter a single 9.
Data Values:
Any characters used to identify the last name
9 = Unknown
Note: Doe as in “John Doe”, or any other pseudonym, is NOT an acceptable value for Unknown.
Must list at least the first four letters of the last name.

9. EMS Continued 5. Patient’s First Name Data Field Number: 27
Data Field Name: FNAME
Priority: Required for RESPTYPE =
Field Length: 20
Field Type: Character
Value Range: None
Definition: The patient’s legal first name. If first name is unknown, enter a single 9.
Data Values:
Any letters used to identify the first name
9 = Unknown
Note: John as in “John Doe”, or any other pseudonym, is NOT an acceptable value for Unknown.
Must list at least the first four letters of the first name.

10. EMS Continued 6. Date of Birth Data Field Number: 29
Data Field Name: DOB
Priority: Required for RESPTYPE =
Field Length: 10
Field Type: Date
Value Range: [1880 – current year, 9999][01 – 12, 99][01 – 31, 99]
Definition: Patient’s date of birth. If values are unknown, enter 9’s. Estimate birth year, if necessary.
Data Values:
Format: YYYY/MM/DD
YYYY = Year; 9999 = Unknown
MM = Month; leading zero required; 99 = Unknown or birth year is estimated
DD = Day; leading zero required; 99 = Unknown or birth year is estimated

11. EMS Continued 7. Sex Data Field Number: 36 Data Field Name: SEX
Priority: Required for RESPTYPE =
Field Length: 1
Field Type: Numeric
Value Range: 1 – 2, 9
Definition: The patient’s gender at injury date. If the patient is in the middle of a gender change, use the original gender.
Data Values:
1 = Male
2 = Female
9 = Unknown

12. EMS Continued 8. County of Patient’s Residence Data Field Number: 35
Data Field Name: RESCNTY
Priority: Required for RESPTYPE =
Field Length: 3
Field Type: Numeric
Value Range: 001 – 254, 801 – 899, 999
Definition: The county of the patient’s home; physical address, not mailing address.
Data Values:
County numbers are assigned by the Texas Department of Health EMS/Trauma Registry. The list of County Numbers can be found on the injury website and in Appendix C.
= TDH county codes
= TDH out-of-state codes
999 = Unknown

13. EMS Continued 9. Patient Destination Data Field Number: 95
Data Field Name: DESTIN
Priority: Required for RESPTYPE = 6 - 8
Field Length: 2
Field Type: Numeric
Value Range: 01 – 19, 88, 99
Definition: The type of place where the patient was delivered.

14. Hospital Mandatory Data Elements

15. Hospital Mandatory Data Elements
1. TRAUMA REGISTRY NUMBER
Data Field Number: 1
Data Field Name: TRNO
Required/Optional: Required
Max. Length of Field: 7
Type of Field: Numerical
Value Range:
DEFN Sequential unique number assigned by the registry software program or registrar.

16. Hospital Continued 2. FACILITY NUMBER Data Field Number: 6
Data Field Name: FACILNO
Required/Optional: Required
Max. Length of Field: 7
Type of Field: Numeric
Value Range:
DEFN The seven digit numeric code assigned to YOUR hospital.
Values Facility numbers are assigned by the Texas Department of Health. The list of facility numbers can be found in Appendix A.

17. Hospital Continued 3. PATIENT’S LAST NAME Data Field Number: 2
Data Field Name: LNAME
Required/Optional: Optional Changed to Required
Max. Length of Field: 20
Type of Field: Character
Value Range: None
DEFN The patient’s legal last name.

18. Hospital Continued 4. PATIENT’S FIRST NAME Data Field Number: 3
Data Field Name: FNAME
Required/Optional: Optional Changed to Required
Max. Length of Field: 20
Type of Field: Character
Value Range: None
DEFN The patient’s legal first name.

19. Hospital Continued 5. SEX Data Field Number: 9 Data Field Name: SEX
Required/Optional: Required
Max. Length of Field: 1
Type of Field: Numeric
Value Range: 1-2
DEFN The patient's gender at injury date. If patient is in middle of gender change, use original gender.
Values 1 = Male 2 = Female

20. Hospital Continued 6. DATE OF BIRTH Data Field Number: 10, 11, 12
Data Field Name: MMOB, DDOB, YYOB
Required/Optional: Required
Max. Length of Field: 2, 2, 4
Type of Field: Numeric
Value Range: [01-12], [0-31], [1880 – present year]
DEFN The patient’s date of birth. Estimate, if necessary.
Values Month of Birth (MMOB)
01 = January = July
02 = February = August
03 = March = September
04 = April = October
05 = May = November
06 = June = December
Day of Birth (DDOB)
0 – 31
Year of Birth (YYOB)
Use four-digit year of birth. For example, if the patient was born in 1980, the value would be 1980.

21. Hospital Continued 7. COUNTY OF RESIDENCE Data Field Number: 20
Data Field Name: RESCNTY
Required/Optional: Required
Max. Length of Field: 3
Type of Field:
Numeric Value Range: , , 899, 999
DEFN The county in which the patient resides.
Values Each county in Texas is assigned a number 1 through A county code is also assigned for each state and some countries. Use 999 for unknown county. See Appendix C for county code list. See Appendix D for Texas city-county list.

22. Hospital Continued 8. DATE OF ARRIVAL Data Field Number: 22, 23, 24
Data Field Name: MMARHOSP, DDARHOSP, YYARHOSP
Required/Optional: Required
Max. Length of Field: 2, 2, 4
Type of Field: Numeric
Value Range: [01-12], [01-31], [2000 – present year]
DEFN The date in which the injured patient arrived at your hospital. Report information even if patient was a direct admission.
Values Month of Arrival (MMARHOSP)
01 = January = July
02 = February = August
03 = March = September
04 = April = October
05 = May = November
06 = June = December
Day of Arrival (DDARHOSP) 0 – 31
Year of Arrival (YYARHOSP)
Use four-digit year of arrival. For example, if the patient arrived at your hospital in 2000, the value would be 2000.

23. Hospital Continued 9. PATIENT DISCHARGED TO Data Field Number: 41
Data Field Name: DISTIN
Required/Optional: Required
Max. Length of Field: 1
Type of Field: Numeric
Value Range: 1-9
DEFN The place to which the patient was released when discharged from YOUR hospital.
Values 1 = Home Patient’s own home or significant other’s home. Can include apartment, boarding
house, farm house, home premises, house (residential), non-institutional place of
residence, or retirement community.
2 = Acute care facility
3 = Rehabilitation facility Transferred to a licensed rehabilitation facility
4 = Nursing home / SNF / ICF Skilled nursing facility or intermediate care facility. (Includes transfer to a SNF for rehabilitation purposes).
5 = Residential facility children's home, dormitory, hospice, jail, old people's home, orphanage, prison, reform school, shelter, protective services, psychiatric hospital, foster care
6 = Left AMA/ Eloped (Left prior to medical discharge)
7 = Other
8 = Morgue/funeral home
9 = Unknown destination

24. Hospital Continued 10. PATIENT DISCHARGED TO FACILITY NUMBER
(If Distin = 2 or Distin = 3)
Data Field Number: 48
Data Field Name: DISFAC
Required/Optional: Required – Conditional*
Max. Length of Field: 7
Type of Field: Numeric
Value Range: , ,
DEFN The seven digit numeric code assigned to the facility to which your hospital transferred the patient.
Values Facility numbers are assigned by the Texas Department of Health. The list of facility numbers can be found in Appendix A.
*This field is conditional. Complete only if patient was discharged to another acute care facility or a rehabilitation facility (i.e., if field #41 Patient Discharged To is equal to 2 – acute care facility or 3 – rehabilitation facility). Leave blank if patient was not discharged to another acute care facility or rehabilitation facility. Note: Some rehabilitation facilities do not have an assigned facility number at this time.

25. Hospital Continued 11. IS THIS A TRANSFER? Data Field Number: 106
Data Field Name: TRANSF
Required/Optional: Required
Max. Length of Field: 1
Type of Field: Numeric
Value Range: 1-2
DEFN
Hospital transfer applies to patients who are transferred from an initial acute care
facility to your facility. A patient sent to your facility from a private doctor’s office, clinic, or stand-alone ambulatory surgery center is not a transfer.
Values 1 = Yes 2 = No

26. Hospital Continued 12. FIRST HOSPITAL NUMBER (If Transf =1)
Data Field Number: 107
Data Field Name: HOSP1
Required/Optional: Required – Conditional*
Max. Length of Field: 7
Type of Field: Numeric
Value Range: , ,
DEFN The seven digit numeric code assigned to the facility, which transferred the patient to your hospital.
Values Facility numbers are assigned by the Texas Department of Health. The list of facility numbers can be found in Appendix A.
*This field is conditional. Complete only if the patient was transferred from another hospital to your hospital (i.e., if field #106 Is this a Transfer? is equal to 1- Yes). Leave blank if patient was not transferred from another hospital to your hospital.

27. Mandatory Fields for new Trauma Registry
EMS: 9 elements all required in TRAC-IT
Hospital: 11 elements all EXCEPT patient first name and last name required in TRAC-IT

28. Name Data Fields
In the file you have sent for the past several years, there are columns for the first name and the last name
Vendors have either left them blank, inserted a tab, or inserted a space
Some hospitals report patient names to DSHS already
Many EMS have not been reporting patient names even though it has been required for years, DSHS has never enforced it

29. Considerations for Reporting Patient Name
DSHS conducted two webinars for vendors Aug. 20 and Aug. 23
Vendors so far have conveyed to DSHS, the customer is able to change a setting on their software to populate the name fields with data and this will not require the vendor to re-create the file extract

30. Vendors/software that are able to report patient names without re-programming
CDM (Clinical Data Management)
Digital Innovation Corporation
Digitech Computer, Inc.
Emergicon
Emergidata (Rescue Medic)
Emscharts
EMS Consultants
ESO Solutions
Houston Fire Department
ImageTrend
Intermedix
Lancet Technology, Inc. (Trauma One)
Municipal Computing Services
Tritech Software Systems (aka Ortivus or Sweet Computers)
UMC Lubbock
STATco (EMS data)
Zoll Data Systems

31. Considerations Continued
If an entity can not change a setting locally and needs their vendor to make a software change in order to populate the name fields, then DSHS will work with that entity and vendor to assist
DSHS is currently exploring a ‘work around’ for any entities who can not report patient names by ‘Go Live’
Your hospital designation or EMS license will not be negatively impacted if you are not able to report patient names at ‘Go Live’

32. Considerations Continued
DSHS is extending ‘Go Live’ by one week in order to create the ‘work around’ solution to enable entities to continue to report even if they are not able to report names at ‘Go Live’
‘Go Live’ is now Sept. 17th, 2012

33. How will names be used? Patient names will be used for: De-duplication
EMS and Hospital Record Linking

34. De-duplication
The registry was developed to allow only the reporting facility to see their data (can allow RAC access or Billing company access)
Records can be de-duplicated within each facility
For a record to be considered a duplicate, both records must contain the same data for the date of the event, the DOB, County of Residence, etc.
If one record has exactly the same data AND contains additional data elements not in the second record, then the record with the greatest amount of data will be saved and the other marked as a duplicate for deletion

35. De-duplicating Continued
Accuracy in reporting the number of patients injured: It is important to not count the same person twice for the same injury when reporting on the number of persons injured
Valid and complete data is needed to determine whether records are duplicates.
Patient names are essential to detect duplicates

36. De-duplicating Continued
A recent de-duplication of EMS records for the Houston MSA revealed 6% of records were duplicates.
There are 2 million EMS records reported annually to DSHS
6% of 2 million records would be an estimated 120,000 duplicate records

37. Linking EMS and Hospital Records
It is important to link EMS to hospital records to study the factors associated with treatment given at the scene and during transport with the factors associated with the hospital treatment and the ultimate patient outcome.
Linking EMS to Hospital records has been a goal articulated for a long time by the stakeholders for the trauma system in Texas

38. Questions or comments regarding reporting patient names

39. Additional Training Sessions
August : Two webinars
Sept. 3-7: Two webinars
Sept : Two webinars
Covers both uploading of data files and the basics of web data entry

40. Updated Project Timeline
User Acceptance Testing Continues Through August 24
August 27 - Sept 6: Pilot Testing
August 27: Data Conversion Begins
August 31: Entity accounts/users imported into new system
September 17: New system Go Live

41. Questions about training sessions or the project timeline
Thank you for attending the webinar today.