Leveraging Health Information Technology to Improve Trauma Resuscitation

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PROJECT SUMMARY/ ABSTRACT Despite rapid transport to appropriate facilities, many trauma patients needlessly die in the first hour of care. Trauma is the leading cause of death for Americans under the age of 46 and greatest cause of potential life years lost before the age of 75, exceeding that of either cancer or heart disease. Up to 20% of traumatic deaths may be preventable. It is estimated that miscommunication (that leads to errors, trauma team confusion and suboptimal care), is the leading attributable cause of death during the first phase of care. In part, this miscommunication stems from the complex and chaotic nature of the trauma resuscitation environment. While that is inherent in the cases that trauma teams address, there are facets of the environment that could be changed to improve communication and the quality of patient data captured. Presently, many trauma centers in the U. S. rely on to record data during trauma resuscitation. Since nurse scribes are charged with data inputs, human error further contributes to data inaccuracies or omissions that may impact the quality of managing a trauma case. Data capture with paper is also difficult due to the sheer volume of information transmitted, the fragmented nature of the information presented on various displays, and the fact that information does not flow concurrently to the treatment team. Unfortunately, current electronic health records (EHRs) do not support rapid input of data, and in fact, are known to slow many processes. Furthermore, none of the current methods used take into account front line staff workflow nor provide situational awareness. To address these problems, we have developed a prototype electronic platform coupled to a situation awareness monitor that integrates seamlessly into current resuscitation workflows. We have already conducted usability testing with trauma staff in earlier work, where we established wireless connectivity of all system components, demonstrated user acceptance of the interface designs for rapid data input by scribe nurses and validated integrity of data outputs from the situational awareness monitor (SAM). The goal of this Phase II project is to integrate this standalone product into a commonly used electronic health record platform to optimize security, data sharing and easier adoption of the platform. We will rigorously test the system for proper integration, assimilation into nursing workflow and usability. Testing will be conducted using simulated trauma resuscitations and real traumas. This device has the potential to greatly improve resuscitation effectiveness and patient safety through efficient, more complete and accurate data capture. Our technology will positively impact patient outcomes through improved situation awareness and faster intervention. Upon successful completion of this Phase II Grant we will be ready to pursue our sales plan and work towards broader integration across a popular EHR platform.