By Suzanne Hoholik
The Columbus Dispatch
COLUMBUS, Ohio — The state’s trauma registry is understaffed, underfunded and not meeting expectations that it would be used to save lives and improve outcomes of people critically injured in car crashes, fires and shootings.
Budget cuts have reduced the number of state employees working on the 11-year-old registry from three to two, while the number of records in the database has grown from 24,000 a year to 40,000.
All workers can do is collect patient data and fill the 250 public-records requests received over the past three years. State officials say there is no money to hire people to analyze the data.
“When the legislation was written ... they simply didn’t imagine the work entailed in getting the data back out and using it appropriately,” said Tim Erskine, state trauma coordinator.
But no one at the state Emergency Medical Services division has told lawmakers that the registry needs more money.
“That’s concerning because my understanding was (the registry) was set up to take this data and study what things indeed happened, and try to deter those trauma accidents in the future,” said state Rep. John Patrick Carney, vice chairman of the House health committee.
The Columbus Democrat said he’s willing to talk to state and trauma committee officials about finding funding for the registry.
Dr. F. Barry Knotts, a Toledo trauma surgeon and a member of the state trauma committee, said the two registry workers also have to upgrade the registry to meet national standards and remove duplicate patient data.
But those workers also manage the EMS report database, which gets 1 million records a year, and the trauma-rehabilitation database, which receives 1,000 records a year.
Erskine said the state EMS division plans to hire a statistician and that he needs at least two people dedicated to managing the trauma registry and generating useful reports.
“If they really only have two people working on those three data sets, that’s not enough,” said Dr. Michael Cudnik, an assistant professor of emergency medicine at Ohio State University who has used the trauma data in studies. “They should have one person for each of those data sets.”
State officials also want to link the three databases to follow a trauma patient from treatment by paramedics in the field to a hospital and through rehabilitation.
Researchers could study, among other things, whether critically injured patients were taken to trauma centers, which are better staffed and equipped to treat them.
“Nationally, we know that 5 percent to 10 percent (of patients) are injured severely enough to end up in a trauma center,” said Dr. Howard Werman, a member of the committee and medical director of MedFlight of Ohio. “We don’t even know that in Ohio.”
He’d also like to know the outcomes of patients treated in trauma centers, how many people didn’t need trauma care but got it, and how often trauma patients are flown to hospitals.
“The trauma registry is not where we need it to be in terms of us using it to its full potential,” he said.
This isn’t the first time Ohio has had trouble running health databases.
Ohio lawmakers created a birth-defect registry in 2000, but funding issues stalled reports until 2007.
The state’s cancer registry, created in 1992, also faced a lack of funds that kept agency workers from compiling, analyzing and releasing data for more than eight years.
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