DSHS, Environmental & Injury Epidemiology and Toxicology Using EMS/Trauma Registry Data: What Questions Are You Trying to Answer? Thank you for the opportunity to provide information to the committee regarding available data and how our stakeholders may gain access to the data. As you know, DSHS is working with the Trauma Systems Committee State EMS-Trauma Registry Workgroup to identify reports the stakeholders would like to have available through the Texas EMS/Trauma Registry. Today, we will be discussing how stakeholders may obtain a data file to perform analysis outside of the EMS/Trauma Registry. Trauma Fundamental purpose of data collection is to use the information – used to target interventions, identify areas of system improvement, evaluate interventions and system improvements Statutory stated purpose of EMS/Trauma Registry is ‘(to improve trauma services)’ This presentation is designed to demonstrate examples of reports that can be made available in the new EMS/T Registry system and encourage participants to change the perspective when requesting information/suggesting reports, ie rather than ‘I want xxx’, thinking in terms of ‘I want to know xxx’ John Hellsten, PhD Kristi Metzger, PhD DSHS, Environmental & Injury Epidemiology and Toxicology

What we will cover today: Access to Texas EMS/Trauma Registry Data Confidential patient data Public Use Data File Most recent data available How to obtain data

Access to Confidential Patient Data DSHS will provide an electronic data file to stakeholders who have authorized access to receive the data. This data file contains confidential patient data. Individual entity data All entities for which you are the medical director All entities for which a RAC has a BAA Many Medical Directors may have access already through their own data systems to the entity’s data for which they are the Medical Director. Some RACs have regional registries and have access to data in their registry. An individual entity may also have their own software and therefore have access to their own data. However, if an entity, Medical Director, RAC or any other authorized user of the account needs access to the data for which they are authorized to access, then they may request an electronic file of this data from DSHS.

How to Request a Confidential Data File Please send an email to: injury.web@dshs.state.tx.us Please include: Your name and phone number The names of the entities for which you have authorized access and for which you request a data file The year of data you are requesting DSHS will send the data in an encrypted email DSHS will verify that you are authorized to have access to the data and upon verification will prepare a data file and send it via encrypted email.

Public Use Data File Statewide data file Does not contain protected health information (PHI): There are 18 PHI identified funder HIPAA. Here is the list of PHI that is collected by the Texas EMS/Trauma Registry 1. Names; 2. All geographical subdivisions smaller than a State, including street address, city, county, precinct, zip code, and their equivalent geocodes, except for the initial three digits of a zip code, if according to the current publicly available data from the Bureau of the Census: (1) The geographic unit formed by combining all zip codes with the same three initial digits contains more than 20,000 people; and (2) The initial three digits of a zip code for all such geographic units containing 20,000 or fewer people is changed to 000. 3. All elements of dates (except year) for dates directly related to an individual, including birth date, admission date, discharge date, date of death; and all ages over 89 and all elements of dates (including year) indicative of such age, except that such ages and elements may be aggregated into a single category of age 90 or older; 7. Social Security numbers; 8. Medical record numbers; 18. Any other unique identifying number, characteristic, or code (note this does not mean the unique code assigned by the investigator to code the data)

What is available in the PUDF? http://www.dshs.state.tx.us/injury/data/ PUDF_EMS.doc PUDF_Hospital.doc

EMS Data Collected by TR EMS data include: Call type (medical, trauma, medical & trauma, etc) Run type (911, emergency transfer, mutual aid, etc.) Date, time (dispatch, arrival, departure) Patient demographics Vital signs Cause and type of injury Procedures Suspected illnesses

Hospital Data Collected by TR Hospital data include: Patient demographics Glasgow Coma Scale at admission Revised trauma score at admission Diagnosis, cause of injury, and severity scores Pre-hospital data, transport and transfer status Patient hospital charges

Most recent data available 2011 is the most recent data available. DSHS will create the PUDF for 2012 records in August 2013. DSHS will link EMS to Hospital records starting with 2013 data. The linked data file will be prepared in August of 2014.

Manager, DSHS Epidemiology Studies & Initiatives Branch Questions? Tammy Sajak Manager, DSHS Epidemiology Studies & Initiatives Branch tammy.sajak@dshs.texas.gov 512.458.7220