Compliance Transition Event

2019 marks an unprecedented event in trauma informatics history. This is the first time that substantial clinical revisions, technical revisions, and platform transitions will all occur at the same time. This trifecta is so significant that it has a name—the “Compliance Transition Event.” The 2019 transition entails the addition of appreciable clinical revisions that could have an associated impact on trauma registry software and processes. Fortunately, your trauma vendors have been planning for this and have you covered.

The ACS NTDS 2019 Data Dictionary was released on August 17, 2018. Changes are significant in breadth and depth and include clinical and technical changes. Highlights include:

  • Clinical
    • 55 new data elements
      • Co-Morbid Conditions – separate field for each
      • Hospital Events (Complications) – separate field for each
      • GCS 40 (EMS, ED, TQIP)
      • Antibiotic Type, Date, Time
  • Technical
    • Introduction of new national ACS technical platform
      • Submission Format
      • Validator

Please see the 2019 NTDS Data Dictionary for a full list of changes and revisions.



The following diagram illustrates the technical transition of the NTDS XML data format along two distinct paths. This transition is necessary due to the new ACS technical requirements and the incompatibility with existing trauma registry software. The top path preserves the historical NTDS format, now renamed to the ITDX format. This is needed to maintain the data model, legacy data and report and query functionality within local software. The second path illustrates the new technical implementation now required for ACS TQIP® and NTDB data submission. The ITDX is a continuation of the vendor XML formats that have been in place in the industry for the past decade with a very successful track record of implementation and ACS support by the vendors. Going forward, the ITDX standard will always remain 100% harmonized with NTDS clinical and technical requirements as they are released each year.


The continuation of the vendor supported ITDX format allows for a centralized single point of integration to the new NTDS technical requirements, as illustrated in the diagram below.


The Compliance Transition Event is more fully explained in the following video: