ITDX Inside

What is ITDX? A free data standard that provides 100% harmonization with ACS clinical requirements. For 2019, ITDX is included in all Windows and web-based trauma registry products of leading hospital trauma registry vendors Clinical Data Management (CDM), Digital Innovation (DI), and Lancet Technology.

Benefits to Hospitals – The ITDX allows registrars to maintain current data entry practices for fields such as Height and Weight, Physical ED and Hospital Discharge Date/Time, Complications, and Comorbidities. Registrars need only complete a small number of additional “helper fields” that are carefully designed to provide a 100% lossless conversion for ACS TQIP® and NTDB data submission. This is the best of all words—efficient data entry practices designed to meet national and state compliance initiatives.

Benefits to Regions and Health Systems – The ITDX establishes a “common language” for regional trauma care systems and health care systems that can be supported by all member facilities, going above and beyond national data standard definitions and providing efficient and well-designed clinical and technical data definitions for a higher degree of analysis, system-wide performance improvement, and resource utilization/performance.

Benefits to States – Because the ITDX is already inside the majority of trauma registry applications that upload data to state systems, a state’s adoption of ITDX eliminates multiple mapping and implementation steps for the state, saving both time and money. The integration of ITDX as the foundation for a state data dictionary ensures the state will remain 100% harmonized with ACS clinical definitions without creating a dependency on ACS technical standards. Moreover, the ITDX provides extensions so state databases can retain longitudinal data consistency across years and avoid masking data points.

The ITDX Data Standard is based on an innovative approach that builds upon and extends beyond the meaning and functionality of standard data definitions. Utilizing a tiered methodology, depicted by the colored key in the above diagram, ITDX is comprised of multiple layers that serve different purposes.

1. Yellow ring – At the core of ITDX is the priority to always remain 100% harmonized with NTDS clinical requirements, referred to as NTDS Aligned Fields.
2. Lime green ring – ITDX also provides a mechanism to maintain certain data points for which definitions have changed or been modified over time, allowing for the ability to retain all prior and new definitions. These are referred to as ITDX NTDS Continuity Fields. This is critical for consistency in data collection, reporting, and analysis and provides a higher degree of backwards compatibility. A primary example of this is maintaining flexibility to collect both ED and Hospital Discharge Dates and Times as they apply to the order discharge date/time and physical discharge date/time fields.
3. Teal ring – ITDX NTDS Harmonization Extensions are “helper fields” that provide information to ITDX to remain 100% harmonized with the NTDS year-specific clinical requirements. These extensions allow data to be collected regardless of timeliness (ex. Vital Signs) but provide the information required to ensure proper conversion to the NTDS data definitions.
4. Blue ring – ITDX Industry Wide Extensions are standard field additions that allow for consistency of definitions on a national basis across multiple state and health system databases. While these data points are outside the scope of national compliance, they provide important infrastructure to drive future initiatives that support local performance improvement, systems evaluation, and PI collaboratives.

ITDX is advancing the technical foundation for the trauma industry through this layered model, providing a pathway to efficiently implement state, regional, and system data collection solutions. ITDX will always remain 100% harmonized with NTDS requirements, but can easily grow beyond due to the flexibility of the ITDX standard. This, by far, is the most exciting influence that ITDX has to offer.