1. International Trauma System Development Program Experience in Trauma registry Lina V. Mata MD., Sudha Jayaraman MD., Luke Wolfe MS, Michael Duong, Melvin Denwiddie, Ishaq Sahhar, Kin Leung, Michel B. Aboutanos MD., MPH Acute Care Surgical Services, Virginia Commonwealth University COUNTRYHOSPITAL RECORDS ENTERED Ecuador HVCM4518 Hospital Macas355 Hospital Puyo499 Pio XII835 San Jose Taisha86 Colombia Hospital Universitario del Valle (2012-2013)9566 Fundación Valle de Lili (2012-2013)10713 Hospital San Vicente de Paul (2012-2014)1330 PanamaSanto Tomas (2012-2013)1035 TOTAL28937 HOSPITAL WEB BASED REGISTRY TRAINING PARTICIPANTS Hospital Universitario del Valle (2012-2013) 32 Fundación Valle de Lili (2012-2013) 13 Hospital San Vicente de Paúl (2012-2014) 10 Santo Tomás (2012-2013) 10 TOTAL 65 BACKGROUND Injury is a major cause of death and disability in low and middle income countries. Latin American region is faced with the challenges and pressures of health care inequities and scarcity of resources. There is an urgent need to provide both essential and cost effective trauma care, a major impediment to trauma system development is the lack of injury data. OBJECTIVES Development of information and communication infrastructure for implementation at every level of health care facilities in low and middle income countries, to assess injury patterns, identify areas for improvement and measure effectiveness of interventions for trauma system development. METHODS An accessible regional web-based trauma registry was created by ITSDP, characterized by: An electronic trauma database with a capacity for 20 languages (English, Spanish, Portuguese) Ability to link hospital systems at a local, regional and national level and serve as an international injury data bank. Accessible through a secure online website for settings with internet connection or software installation where internet connectivity is limited or unavailable. Colombia- In Cali, Colombia; two level I trauma centers were trained, during October 2011. In December 2012 the main trauma hospital in Medellin, Colombia also implemented the registry.. Panama- During February 2011, a smaller level I hospital in Panama City adapted the registry. Web-based registry training Training was conducted in a two day period to a total of 65 people, which included paramedics, statisticians, epidemiologist, trauma and critical care fellows, medical students, nurses and attending's at each locality. CONCLUSION An electronic trauma registry is feasible to implement in low and middle income countries if customized to their settings and incorporated with a training program. In the near future the trauma registry will allow an accurate estimation of the burden of injuries and will act as a source of data needed for public health surveillance and interventions. Government awareness will allow planning of trauma systems. A flexible injury surveillance tool can help institutions in resource- constrained settings identify opportunities for improvement and facilitate the development of context-specific interventions. 50 essential elements are available, expandable up to 250 elements, per record and includes the ICD-10 system and injury severity scores such as AIS, ISS, RTS and OIS. Integrated quality control analysis system Reports module with advanced graphics system for fixed or modifiable statistical reports. We implemented this system as a pilot program for clinicians, administrators and data entry personnel, with specific training program in basic injury surveillance, the use of a standardized emergency department form and a corresponding electronic trauma registry, periodic auditing and quality improvement. RESULTS The initial pilot phase will allow the implementation and training of 10 countries from Latin America. At the moment the registry has been implemented successfully in 9 hospitals of 3 countries in Latin America. Ecuador - 5 hospitals in Ecuador were the first to implement an earlier version (Access) of the registry from 2005 to 2010. Experience acquired led to the development of the registry's 5 th web-based version.