New Mexico Administrative Code
Title 7 - HEALTH
Chapter 27 - EMERGENCY MEDICAL SERVICES
Part 7 - TRAUMA CARE SYSTEM
Section 7.27.7.10 - TRAUMA SYSTEMS DATA COLLECTION

Universal Citation: 7 NM Admin Code 7.27.7.10

Current through Register Vol. 35, No. 18, September 24, 2024

A. Bureau Responsibilities: the bureau shall:

(1) establish a statewide trauma data registry to collect and analyze data on the incidence, severity, and causes of trauma, including traumatic brain and spinal cord injury for the purposes of:
(a) monitoring and providing information necessary to evaluate qualifying trauma patient care, outcome and cost,

(b) assessing compliance of pre-hospital providers, designated trauma centers, and other hospital/healthcare facilities with the standards of the state trauma system operation and designation,

(c) providing information necessary for resource planning and management,

(d) providing data for injury surveillance, analysis, and prevention programs, and

(e) providing a resource for research and education.

(2) establish criteria to identify patients to be included in the State trauma system data collection from:
(a) all EMS providers,

(b) hospital/healthcare facilities, both designated and non-designated,

(c) Office of Medical Investigator reports,

(d) other sources outside of the trauma system which may include, but not be limited to:
(i) death certificates,

(ii) Hospital Inpatient Discharge Data (HIDD), and

(iii) law enforcement agency records.

(3) establish, publish, and periodically review the required data elements to be submitted to provide information regarding injury, trauma care, and system operation, in the following categories:
(a) demographic,

(b) anatomic,

(c) physiologic,

(d) severity,

(e) epidemiologic,

(f) resource utilization,

(g) Process Improvement,

(h) outcome, and

(i) financial.

(4) require a case specific patient identifier common to all data sources used in the trauma registry;

(5) provide procedures and specifications for electronic and hard copy submission of data;

(6) develop a system for, and report mechanism on process improvement through:
(a) establishing protocols for quality control, consistent with the Bureau's most current data quality guidelines,

(b) completing studies to assess the completeness and accuracy of case identification and data collection, and

(c) assuring the completeness and accuracy of data submitted for each provider submitting data to the trauma registry.

(7) evaluate requests from appropriate ReTrAC for collection of voluntarily submitted additional data elements from agencies and facilities in that region.

B. Provider Responsibilities:

(1) all certificated ambulance services shall:
(a) provide pre-hospital run reports for inclusion of trauma patient data on:
(i) trauma victims dead at scene,

(ii) all patients meeting local/regional trauma triage criteria who are transported to a hospital or healthcare facility and,

(iii) all patients transported in accordance with inter-facility transfer policies to a higher level of care or for special resources.

(b) submit data by electronic transfer or, if authorized in writing, to the EMS database as required, on approved forms.

(c) the transporting service shall be responsible for submitting to the receiving hospital/healthcare facility data, described in Appendix A, sub paragraph B (1), on all trauma patients.

(2) designated trauma centers shall use the following patient criteria to identify trauma patients for submission of data as defined in Appendix D, Table 1 as follows:
(a) discharge diagnosis ICD-0-CM codes of 800.0-904.99, including 940.0 - 949.00 (burns) when associated with major trauma,

(b) meets local, regional or state trauma triage criteria,

(c) emergency admissions (less than twenty-four (24) hours after arrival) for traumatic injuries,

(d) transferred to another hospital for trauma evaluation and/or definitive care by a trauma service,

(e) trauma patients who are pronounced dead on arrival at a hospital/healthcare facility,

(f) all trauma patients who are pronounced dead after admission to a hospital/healthcare facility, and

(g) submit required trauma system trauma registry data as indicated in Appendix C, via electronic transfer or, if authorized, in writing by the Bureau on approved paper forms.

(3) the Office of Medical Investigator (OMI) shall submit data to the Systems Trauma Registry, and appropriate hospital facility trauma registry, on all patients with injury listed as an underlying cause or contributing factor to death on the death certificate.

C. Trauma Registry Reports:

(1) the Bureau shall report:
(a) annually on all patient data entered into the System Trauma Registry;

(b) on trends, patient care outcomes, and other data, for each trauma region and for the state, for the purpose of regional evaluation as required in the State and Regional PI Plan; and,

(c) periodically on financial trends and needs.

(2) the Bureau shall provide:
(a) periodic reports to all providers submitting data to the System Trauma Registry;

(b) provider-specific raw data to the provider that originally submitted the data, upon request;

(c) aggregate regional data semiannually to the appropriate ReTrAC, excluding any confidential or identifying data; and,

(d) aggregate state trauma system data for hospitals, public or private, agencies and other interested parties for prevention activities, epidemiologic/demographic studies, and education and research projects.

D. Access and Release of Systems Trauma Registry Information:

(1) data elements related to the identification of individual patient's, provider's, and hospital/healthcare facility's outcomes shall be confidential.

(2) persons with access to information collected under these regulations shall use the information for only those purposes stipulated.

(3) the Bureau may approve requests for data and other information from the Trauma Registry for special studies and analyses, consistent with requirements for confidentiality of patient and quality management records. The Bureau may require requestors to pay any or all of the reasonable costs associated with special preparation of such requests, which may be approved. In accordance with those provisions, confidential information shall not be disclosed, except:
(a) on request, to an approved regional process improvement program which is bound by the same confidentiality guidelines as the Bureau;

(b) on request, to a scientific research professional associated with a scientific research organization, providing:
(i) the research professional's written research proposal has been reviewed and approved by the Bureau with respect to the scientific merit and confidentiality safeguards;

(ii) the Bureau has given administrative approval for the proposal; and,

(c) data does not provide specific hospital/healthcare facility or patient identification.

Disclaimer: These regulations may not be the most recent version. New Mexico may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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