Initial (1997-99) Project Codes NH

CODES is the acronym for Crash Outcome Data Evaluation System. New Hampshire is one of 23 states to be awarded CODES funding by the National Highway Traffic Safety Administration (NHTSA). CODES uses statistically-based techniques to link crash data with medical information, such as hospital discharge, emergency medical services and hospital emergency department data.

The system helps states by linking data so that it is available to them to identify specific crash, vehicle and behavior characteristics that lead to increased risk of injury severity and high health care costs in their states. Applications for this information then can be developed to support state-specific decision-making.

The NH CODES Project was unique from its inception because it focused on using project data to meet the day-to-day evaluation and planning needs of local communities and state agencies. This approach reflects New Hampshire’s common sense, pragmatic personality. All of the special studies and presentations developed by the NH CODES Project were in direct response to specific requests from local communities and agencies.

In addition to the special studies, we used 1995 and 1996 linked data to generate a variety of reports examining various crash factors and their relationships to injury severity, inpatient charges, and length of stay in the hospital. This project was a continual learning experience for all of the participating agencies and especially for those of us responsible for managing the grant.

Where Do We Go from Here?

Institutionalization Plan for the NH CODES Project (March 1999)

Current Participants:

Dartmouth-Hitchcock Medical Center - Injury Prevention Center
Federal Highway Administration
Healthsource (HMO)
National Highway Traffic Safety Administration
NH Bureau of Emergency Communications
NH Bureau of Emergency Medical Services
NH Bureau of Substance Abuse
NH Chief Medical Examiner’s Office
NH Department of Health & Human Services - Health Data Services
NH Department of Health & Human Services - Injury Prevention Program NH NH Department of Safety
NH Department of Transportation
NH Executive Council
NH Governors Highway Safety Agency
New Hampshire Hospital Association
NH Police Standards and Training Council
University of New Hampshire - Department of Civil Engineering

Initiatives Developed through the Initial NH CODES Project:

• Development of specialized CODES data processing software.
• Crash-to-EMS and hospital data linkages.
• Ongoing evaluation of existing and proposed databases for all participating agencies.
• Ongoing multi agency collaboration to improve existing data collection systems apply technological advances to the development and implementation of information management systems for the 21st century.
• Timely responses to continuing requests, for custom data summaries and from police departments, hospitals, EMS squads, and local town government to assist in planning to meet local, regional, and statewide emergency services needs.
• Established standards for responding electronically to requests for data studies and PowerPoint presentations, thereby eliminating paper and/or diskette usage and significantly reducing response times.
• Ongoing provision of data and consultation services to CODES agencies and others engaged in crash or EMS-related research.
• Maintenance of NH CODES Governing Board, to promote and maintain effective inter agency collaboration and communication.
• Statewide and national marketing of the CODES concept and the value of data linkages (through conference participation and research presentations).
• Production of 1999 Project Report as an interactive CD-ROM instead of the 1081 pages that would have been required for a printed version.

Expanding CODES in New Hampshire

Our initial 1999 report only scratched the surface of what the New Hampshire CODES Project is capable. The project is succeeding because it has been willing to adapt to meet the changing needs of New Hampshire’s agencies and communities. We are now faced with an ever-growing list of opportunities to use our linked data and incorporate additional technologies and databases into the project. This second phase of the CODES project will address three major areas: E-911 and Geographic Information Systems (GIS), integration with the statewide Trauma System, and linkage to Division of Motor Vehicles databases to more accurately assess the impact of specific groups of drivers.

Geographic Information Systems (GIS) and global positioning satellite systems (GPS) are already widely used by law enforcement and the transportation industry to track vehicle movements and pinpoint locations. We hope to secure sufficient personnel and technological resources to enable us to use GIS as an assessment and planning tool for emergency medical and trauma services throughout the state. Ultimately, we will be able to identify every EMS event with GPS coordinates that will automatically update our GIS database. Linking to the E-911 database will give us exact incident times. By thus improving the specificity of our time and location data, we hope to significantly improve our data linkages. Currently we estimate that it will take at least five years to develop and implement such a system.

The Trauma Medical Review Committee is extremely interested in using our databases to evaluate the effectiveness of our state’s current trauma system, and to use these findings to guide future planning. By using linked data, the committee will be able to evaluate the effectiveness of various interventions for specific groups of trauma patients. Linked data will enable the committee to study groups of patients (by injury type, severity, etc.) from the injury-causing event all of the way through discharge from rehabilitation. We will finally have a complete and accurate picture of how our state’s trauma system manages patient care.

By linking CODES files to various Division of Motor Vehicle databases, we will be able to accurately assess the impact of certain groups of drivers. This information will have a number of valuable applications. First, by learning more about our high-risk drivers, we will be able to develop more effective driver education and public information campaigns. More detailed information about crash frequencies, locations, and contributing factors can serve as valuable aids to enforcement planning. Linking to motor vehicle conviction records will also enable us to better evaluate the effectiveness of legal interventions and driver re-training programs. All of this will enable us to objectively assess our system wide effectiveness and efficiency. Certainly, as traffic flows continue to increase throughout the state, it will become even more important for the Department of Safety and our EMS system to have the most complete and accurate data readily available to respond to requests from the public, other agencies, and state and local government.

Links to Other CODES Projects and Related Resources:

Safe Communities
National Transportation Data Archive
National Highway Safety Administration
Insurance Institute of Highway Safety Crash Tests
Department of Urban Planning - University of Hawaii