The Trauma Register is an orthopaedic trauma registry instrument which relies on direct, senior-level, physician-specialist input of detailed, structured-data entry to multiply classify and describe diagnosis, treatment, complication and outcome of orthopaedic injury. It also records all visceral injuries, co-morbidities and non-traumatic orthopaedic diagnoses.
Recognizing the high cost and fatigue-failure rate of duplicated input required by stand-alone data systems, The Trauma Register relies heavily on the integration of the registry into practice management functions through input load-sharing data exchange with other information resources on the hospital network. Such a process is necessary to the enrichment and validation of data entry.
Developed in consultation with trauma specialists from Cornell University School of Medicine, the Mount Sinai School of Medicine, the Wayne State University School of Medicine, the Vanderbilt University School of Medicine and the Maryland Institute of Emergency Medical and Surgical Services (MIEMSS), the Trauma Register program has been formulated in accordance with guide-lines of the US Department of Health and Human Services Center For Disease Control Trauma Registry Coding Guide, the Gustilo/Orthopaedic Trauma Association Fracture Classification Manual, the AIS90 Abbreviated Injury Scale, the International Classification of Diseases (ICD-9), the AMA Current Procedural Terminology (CPT-4) Guides and the HCFA Relative Value Units (RVU) scales. It combines many well established classifications and outcome scoring scales from the medical literature.
To minimize interobserver variability, a special emphasis is placed on image archiving and knowledge coupling. Knowledge coupling (per Lawrence L. Weed, Springer-Verlag, 1991) involves the hyperlinkage of educational resources with data entry screens. According to artist Frank Stella "You see what you know." Just-in-time educational resources are immediately available to optimize the observations required by data entry routines as well as to provide prompts, alerts and soft decision support.
The original Trauma Register program was constructed with Macintosh Computer/HyperCard and FoxPro software linked by a system of FileFlex external commands. The current version of the Trauma Register program is based upon a cross platform, rapid prototyping, web-enabled Metacard multimedia front-end which communicates with a web-served PHP/MySQL database via standard TCP/IP sockets.