Background

Hospital Participation

It is important that all selected NEISS hospitals participate to maintain the statistical validity of the data. Hospitals are chosen randomly from particular demographic groups based on size, location, etc., forming a stratified random sample. If a selected hospital chooses not to participate another hospital must be chosen to replace it. In those cases the randomness, and hence the statistical validity of the system, is compromised. Active participation in NEISS from the selected hospitals assists CPSC in deriving valid national estimates from the sample data.

CPSC Responsibilities

To facilitate hospital participation in NEISS, CPSC pays for or provides:

• Training,
• Computers,
• Pay for each case
• On-going assistance

CPSC provides NEISS hospitals some additional benefits for participating such as access to:

• Reports, including hospital specific reports from the NEISS data
• The CPSC Clearinghouse for national data and information
• Product safety/hazard educational materials

Hospital Responsibilities

The hospital's main responsibility is to provide the staff to act as NEISS coordinators. Staff can be any hospital personnel who have access to the system. Hospitals typically use:

• EMT Staff
• Nurses
• Administrative Support
• Medical Records Technicians
• Billing and Accounting Office

Alternatives to using hospital staff can be described to the hospital if the need arises.

Topic List

The Process

The data collection process begins when a patient is admitted to the emergency department (ED) of a NEISS hospital. An ED staff member elicits critical information as to how the injury occurred and enters that information in the patient's medical record.

Each day, a NEISS hospital coordinator reviews all ED records for the prior day, selecting those that meet the (current) criteria for inclusion in NEISS. The NEISS coordinator abstracts pertinent data from each selected ED record and transcribes it in coded form to a NEISS coding sheet using rules described in the NEISS Coding Manual.

Identifying the consumer product(s) related to the injury is crucial for CPSC. The NEISS coordinator assigns a product code from an alphabetical listing of hundreds of products and recreational activities, being as specific as practical. For example, if a lawn mower were involved in an injury, the coordinator would use a different product code for a walk-behind mower than for a riding mower.

The victim's age, gender, injury diagnosis, body parts affected and incident locale are among other data variables coded. A brief narrative description of the incident is also included.

Once the abstract and coding are completed, the NEISS coordinator enters the data for the day's NEISS injury cases into a personal computer provided by CPSC.

Following completion of data entry at the hospital, a PC in the CPSC Washington office polls each NEISS hospital and collects the newly entered data over telephone lines. Acceptable cases are automatically incorporated into the Commission's permanent NEISS database. The data are available immediately for further review to CPSC staff.

The CPSC analytical process begins on the same morning the data are collected. Staff in the Directorate for Epidemiology read each case, not only checking items for quality control, but also screening each case for a potential, emerging hazard.

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Privacy and Confidentiality

On December 28, 2000 the Health Insurance Portability and Accountability Act (HIPAA) was published by the Department of Health and Human Services in the Federal Register. Now that HIPAA became effective on April 14, 2003, some health and medical officials have asked how HIPAA will affect their ability to furnish emergency department information to the commission for the National Electronic Injury Surveillance System. The answer is that it does not affect how they report their data because there is a specific exemption in section 45 CFR 164.512(b)(1), "Permit disclosures," that applies to NEISS. It says, relevant to part:

" A covered entity may disclose protected health information for the public health activities and purposes described in this paragraph to: (i) A public health authority that is authorized by law to collect or receive such information for the purpose of preventing or controlling diseases, injury or disability, including but not limited to, the reporting of disease, injury, vital events such as birth or death, and the conduct of public health surveillance, public health investigations and public health interventions...."

The commission is authorized by section 5(a)(1) of the Consumer Product Safety Act, 15 U.S.C 2054(a)(1), to maintain an Injury Information Clearinghouse to "collect, investigate, analyze, and disseminate injury data, and information, relating to the causes and prevention of death, injury, and illness associated with consumer products"...(Emphasis supplied).

Therefore, participating hospitals are exempt from HIPAA requirements for the purpose of reporting to CPSC through the NEISS.

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