PS 4-50 TRAUMA CENTER BASED ELECTRONIC INJURY SURVEILLANCE: IMPLICATIONS FOR PRECISION PUBLIC HEALTH

Wednesday, October 26, 2016
Bayshore Ballroom ABC, Lobby Level (Westin Bayshore Vancouver)
Poster Board # PS 4-50

Larissa Roux, MD MPH PhD1, S. Morad Hameed, MD MPH2, Nadine Schuurman, PhD3, Damon Ramsey, MD4, RT Spence, MD, MPH5, Andrew John Nicol, MBChB, PhD6, Alan Hubbard, PhD7, Mitchell Jay Cohen, MD, FACS8, Rachel Callcut, MD, MSPH9 and Richard Matzopoulous, BBusSci, MPhil (Epidemiology), PhD (Public Health)6, (1)T6 Health Systems, Vancouver, BC, Canada, (2)T6 Health Systems, Chestnut Hill, MA, (3)Simon Fraser University, Burnaby, BC, Canada, (4)InputHealth, Vancouver, BC, Canada, (5)University of Cape Town Health Sciences Faculty, Cape Town, South Africa, (6)University of Cape Town, Cape Town, South Africa, (7)University of California at Berkeley, Berkeley, CA, (8)University of Colorado Department of Surgery, Denver, CO, (9)UCSF, San Francisco, CA

Purpose: Injury is a global public health issue that accounts for over 5 million deaths a year, and inestimable loss of human potential. Injury surveillance, and the collection of data to inform injury prevention and trauma care, is widely recognized as a key first step in the control of the global injury pandemic. Unfortunately, in low resource environments, injury surveillance has not been feasible on a large scale, and even where injury data are collected, there is often a gap between data accrual and data driven improvements in injury control. This study reports on the implications of a mobile, electronic user interface for trauma center clinical documentation (that also wirelessly populates an electronic trauma registry in real time with standardized data) for population based public health efforts in a large metropolitan area in South Africa.

Methods:  The electronic Trauma Health Record (eTHR) is an iPad based clinical documentation tool that wirelessly and instantaneously populates an electronic trauma registry. eTHR was implemented at a large South African trauma center on March 1, 2014, and has populated a registry with over 20,000 trauma patients, converting a data scarce trauma system, to one where analytics and data visualization strategies can tailor public health interventions aimed at injury control. ArcGIS software was used, along with eTHR registry location data to document the spatial distribution of injury, and to map the flow of trauma patients between levels of care within a geographic trauma system.

Results: Injury rates were highest in specific geographic regions (Figure). Mapping of injury referral patterns revealed the presence of an inclusive trauma system, with all hospitals participating in trauma care, and a net flow of severely injured trauma patients to the regional level 1 trauma center.

Conclusions: Documentation of injury details by trauma center based clinicians, has the potential to inform population based public health efforts, particularly when an electronic platform can populate a registry with complete and standardized data in real time. Insights about both injury prevention among high-risk populations, and access to trauma center care are readily achievable with minimal expenditure on database maintenance or data collection. Injury prevention and trauma center access initiatives can, for the first time, can be planned with more precision, to study and address population based vulnerability.

 

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