Trauma Database Improves Remote Access with New Web Interface

Clinical Data Management facilitates data entry with Revelation's OpenInsight for Web

Clinical Data Management (CDM) is a company headquartered in Colorado that provides clinical information database software, enabling medical institutions to report and compile data on patient care. Established in 1986 by Skip and Beverly Tinnell, Registered Nurses, CDM has made a commitment to improving the quality of patient care by providing state-of-the-art, user-friendly products, and as a result, its software is used by over 350  government agencies, hospitals and clinics nationwide and also  internationally.

CDM's flagship product, TraumaBase, is a trauma care registry used by healthcare providers to input data for collection by corporations and government agencies as well as for the evaluation of care by the medical teams themselves. Details such as a trauma patient's initial vital signs, how fast treatment is begun, and other aspects of a patient's care from the point of arrival at a medical facility are all recorded in the TraumaBase database.

A longtime user of Revelation Software, dating back to Revelation G and continuing through OpenInsight, CDM was pleased with both the quality of the products and the service from Revelation. However, CDM had come to realize it needed to provide a web interface for data entry to better support its customers and also stay current with evolving technology requirements.

That need was answered when Revelation launched the OpenInsight for Web (O4W) Development Toolkit, a web development toolkit that makes it possible for OpenInsight developers with limited or no HTML, XML or JavaScript experience to develop feature-rich web pages.

Modern Approach

Now with eTraumaBase, CDM's new web-enabled version of TraumaBase, remote clinics and facilities such as those in rural or mountain regions that have access to the web but only minimal support from IT professionals can input their data easily online. These clinics may only be open during part of the year, such as the ski season, or may only see one or two trauma patients each week and do all of their data entry at the end of the quarter. In fact, such a facility might not even be expert in trauma care, but could provide the first trained medical care when, say, someone falls off a ladder, and the X-ray finds there is a skull fracture. Making it easier for them to participate in reporting the details of trauma care enriches the data pool, enabling government agencies and the facilities themselves to better ascertain whether best practices are being followed and where improvements can be made.

While such facilities were able to do this data entry before O4W made eTraumaBase possible, it could be complicated, says Jody Summers, director of technical services  and software engineer at CDM. Large Level 1 and 2 Trauma Centers (nationally designated hospitals capable of treating the most severely injured patients) typically have a local installation of the software and are able to submit flat files into the database that they create on their own, but rural and low-volume facilities have IT environments that are not stable or well supported. "People might get a new computer and not realize that they have disposed of a computer with a database that they touched maybe only once a quarter, but then that machine is gone," he explains.  "Having this O4W-based solution has brought stability to these users."

The introduction of O4W could not have come at a better time, says Summers.  The states, agencies and companies that purchase CDM's registry and make it available to care facilities were asking for a web interface but it had to be provided in a cost-effective and efficient manner, says Summers.

Summers called Revelation in late 2009 and said that, in order to facilitate web access, his company would have to make a sizable financial commitment to hire a web developer who knew nothing about the Revelation software on which the company was based unless Revelation could offer an alternative.

The ability to dynamically update choice options is a big benefit.

"And that's when they said yes, we have this O4W we have been working on and it is about to be released," recalls Summers.  A developer from Revelation came out to Colorado for 3 or 4 days and CDM was able to quickly turn from the direction they were headed in - which was heavy on web development - and move towards O4W. "The reason it stood out was that it was web development that Revelation programmers could do.  Our long-time programmer who goes all the way back to Rev G and AREV and who had very little web development training was able to grasp it and program with it and make changes that function."


Beyond facilitating data entry, there are additional advantages that eTraumaBase offers. Inevitably, each year, states make changes to the information they want, requiring new fields to be added, or they make coding changes for procedures that need to be input into the system. Now, those changes are automatically updated in the eTraumaBase system by CDM without users requiring any technical support.

The ability to easily update choice options is a big benefit as is the ability to set up yes or no fields, say Summers. "It is actually set up dynamically within our system so we have one lookup table."

For example, if a state wants to start tracking a certain injury associated with a new type of vehicle such as a motorized scooter, with O4W, CDM can go to one place to change the choices. "And, because O4W is dynamic we don't have to touch the web side. Those choices appear as soon as the next person refreshes the screen," says Summers.  "With O4W, we update the screen and everybody gets it; everybody is standardized."

Beyond the U.S., eTraumaBase has also been used by trauma care doctors, nurses and medical students traveling to places as far flung as Nigeria, Qatar and Bhutan. And, CDM is piloting a program in which larger U.S. facilities with more advanced IT support, also submit their flat files through O4W so there is one centralized location for data collection. Up until now, those hospitals were sending in files using a secured FTP site, and then CDM handle them from there.

Staying Current with Technology

And, in addition to helping CDM reach remote clinics with its trauma registry, the availability of eTraumaBase has also helped CDM retain the clients it has. "The nature of the industry is that you have to keep growing and adopting new technologies." Not providing web-based data entry, for example, was an issue when CDM had to submit an RFP or an RFQ and found it necessary to explain how, despite its lack of a web interface, its software was still beneficial. "Everybody is moving to a web and cloud mentality and if they don't hear the right buzz words, they wonder if you are not keeping up," he observes.

Looking back at its adoption of O4W, which CDM implemented in the first quarter of 2010, Summers says the only surprise has been how fast it has taken off and how many more bells and whistles have been added.  "The project initially started out with us needing just a very simple data entry screen so someone could plug in data and hit ‘save' and then maybe run a couple of reports." But the more it has gone on, the more requests the company has had for features such as additional auto-populate fields and specialized trauma coding built into the software in a user-friendly way. "And we have been able to make it all happen - because it is all Revelation-based and we have a great Revelation programmer who knows Revelation so well."