University of South Alabama (USA), Surgical Critical Care and Trauma Services, United States

University of South Alabama uses Intergraph technology to research rural trauma care

The Challenge:

According to the Congressional Office of Technology assessment, the mortality rate among victims of rural vehicular accidents is twice as high as that among their urban counterparts. Dr. Richard P. Gonzalez, Director of Surgical Critical Care and Trauma Services for the University of South Alabama (USA), is spearheading research into rural vehicular trauma. The goal of the project is to develop a trauma plan for reducing rural mortality rates by using geographic information systems (GIS) in rural trauma systems to assess trends in trauma care.

The Project Objectives:

Establish methods to gather GIS data for analysis
Use GIS data to identify roadways that contribute to the occurrence of accidents or that present challenges in providing prompt and effective trauma care
Enable responders to determine the most efficient mode of patient transport
Enable responders to identify the appropriate medical facility, both in level of care and proximity to the accident site

The Solution:

To analyze roadway data, Dr. Gonzalez and his team recognized that location data would be required. However, the only location data available was gathered from police records in the form of link-nodes. Link-nodes are point identifiers located at most intersections and along various roadways and illustrated on paper maps that are issued by the Alabama Department of Transportation. These nodes are used to report and record motor vehicle crash (MVC) locations, indicating that the accident occurred between two specific points. While electronic forms of the maps exist, they do not contain X/Y coordinate information, and no relationship exists between the node point and the text box that labels it

Initially, the nodes were digitized using JPEG images of the paper maps. However, because of limitations in this process, GeoMedia Professional was chosen to integrate the newly created node files with TIGER/Line maps. This map platform is preferred because the maps are readily available at no cost, they enable users to view data by street according to street name, and they allow the team to compare their data with various census tracts within Alabama.

With GeoMedia, the team can illustrate any record that has been linked to the police crash data. Any combination of more than 250 attributes collected from the participating organizations can now be queried and displayed. Accidents can be viewed according to their location in relation to available medical resources, helping responders to select appropriate care. The team accesses data from reports related to rural vehicular accidents collected from the State of Alabama Department of Public Health, Division of Emergency Medical Services (EMS); State of Alabama Department of Public Safety; police accident records from the University of Alabama at Tuscaloosa, Computer Science Department; 16 hospitals; and SouthFlite Aeromedical Services at the University of South Alabama Medical Center.

The Findings:

The results of the research by Dr. Gonzalez and his team ultimately determined that mortality rates from rural motor vehicle crashes (MVCs) were greater than urban MVCs within seven counties of southwestern Alabama. A significant contributing factor to that mortality rate was the speed at which pre-hospital care was administered.

Future Plans:
From the above findings, Dr. Gonzalez and his team have developed a number of interventional studies aimed at reducing rural EMS response time and distance to the scene. These studies – Static Redeployment,

Moving Map Display, and Ambulance Real-time Deployment Testing – will run for a 12-month period. Afterward, the data will be analyzed to determine if the efforts have reduced response time and distance, and more importantly, if the efforts had any impact on mortality rates.

Right Hand Column