The ability on campuses to compile information about athletics injuries with a few computer keystrokes -- and dramatically improve an already unsurpassed source of national injury data in the process -- is generating excitement as the NCAA Injury Surveillance System (ISS) gears up for a full-fledged online debut later this year.

The ISS, which has relied since its establishment 22 years ago on the willingness of athletic trainers to submit paper forms reporting injuries in various NCAA-sponsored sports, will fully convert in August into a Web-based data-collection system that can compile far more data than ever before. At the same time, it will provide member institutions with a low-cost means of tracking medical information and analyzing injury trends on campus.

"I'm excited about it coming out, because I think it's going to be a great benefit to athletic trainers across the country," said Ron Courson, director of sports medicine at the University of Georgia and chair of the National Athletic Trainers' Association's College and University Athletic Trainers' Committee.

"Just from a time-saving standpoint, I think it will be beneficial. And if you're trying to do your own internal statistics at the end of the year, looking at what types of injuries you had in a certain sport, you can kick that out."

Those words please Randy Dick, NCAA associate director for the Injury Surveillance System, because that's exactly what he and other national office staff members hoped to achieve when they began work three years ago to put the ISS online.

"Recognizing the volunteer nature of ISS data collection, the system must be efficient, applicable, and minimize duplication of effort in order to create an incentive to participate," Dick said.

"In an ideal scenario, we'd like this system to become the medical and legal record for each school, so when they enter the information in the database, it's the information they need in their day-to-day work at that particular school."

And by investing in a computer and high-speed Internet access -- tools that many schools already have -- any NCAA member can participate in compilation of crucial data that guides the Association's Committee on Competitive Safeguards and Medical Aspects of Sports and sports rules committees in decisions affecting student-athlete health and safety, and provides medical researchers with unparalleled information about sports injuries.

"These things all build on themselves," Dick said. "If more schools believe it's a cost-effective, efficient and useful system, then the organization benefits, because we get more data. When we get more data, the rules committees will have even better data upon which to base decisions, schools will have better data for divisional and national comparisons, and researchers have better data for prevention studies. It just snowballs."

Paper barriers

More than 300 schools annually have provided injury data to the NCAA in recent years, using paper forms.

By necessity, the Injury Surveillance System staff has imposed limits on the number of schools reporting statistics for a particular sport, and even on the number of sports (currently 16) in which data are compiled, because of the time it takes for staff to enter that data into a computer for compilation and analysis. Courson said Georgia was permitted this year to provide data only for football, basketball and soccer.

Nationally, about 15 percent of schools sponsoring a sport monitored by the ISS provide data in that sport, which is enough to generate a representative sample -- "and that's all we could handle," Dick said.

Oftentimes, that was all that participating schools could handle.

Deb Runkle, athletic trainer and senior woman administrator at the University of Dubuque, who previously served on the staff of a Division II institution, said she discontinued reporting football injury data at her previous school because too much effort was required to collect and record the information.

"The paperwork was just too much," she said, recalling that she had to comb through individual student-athletes' records to compile the information, then place the data on the forms and send them to the national office. "It was too time-consuming."

But Runkle anticipates Dubuque, a Division III institution that currently does not have its own injury-tracking system, will participate in the Web-based system. In fact, she and athletic trainers at other Iowa Intercollegiate Athletic Conference institutions are discussing the possibility of collectively compiling data for entry into the ISS.

"Even if the conference doesn't do it, I think we'll do it, because the forms are easier, the recordkeeping is easier, and we can use that recordkeeping for our injury system," she said.

And there is an attractive bonus -- athletic trainers need only a computer and Internet access to use the system free of charge.

"In an era of budget cuts, there are things an athletic training department would rather spend its money on than an injury-tracking system," Runkle said.

The cost savings likely will be appealing on campuses, and Dick said the national office is saving money, too.

Those savings began three years ago, when the NCAA information services staff advised Dick that it could create a Web-based system in-house, rather than seeking outside programming assistance. Staff members Brad Alderson, Jeff Campbell and Ginger LaBelle-Brown succeeded first in converting paper reporting forms for three sports into Web-based forms, then this year created an entirely new data-collection format that compiles information through linked questions and can produce a variety of reports that Courson and other athletic trainers have requested.

"What we put together was something that had a whole different look on the screen," Dick said. "There was a lot more specificity in the questions. Everything was branched, so depending on how you answered one question, other questions would show up. You weren't faced with answering questions that were irrelevant to a particular injury.

"We think it's a much more efficient system for the user, because they're only putting in information that's relevant to a particular injury."

Just putting those first three sports -- men's and women's soccer and field hockey -- online is saving $20,000 to $30,000 annually in printing and postage costs, and that figure will increase significantly as the other 13 sports currently included in the ISS, as well as a 17th sport (men's volleyball), are added in August.

Making jobs easier

Dick anticipates that all NCAA sports will be included in the ISS within the next two years, and he also hopes to add emerging sports.

"In the past, we've said, here's the list of sports, and we'll let you pick one or two a season, because of our data-entry limitations," he said. "There are no data-entry limitations now, so if a school wants to participate in all 17 sports, they can do that as long as it's a sport they sponsor."

The potential benefits to institutions that choose to participate broadly are significant -- thanks in large part to a cooperative effort between the ISS staff and the NATA College and University Athletic Trainers' Committee in developing the Web-based system.

"They've done a great job of putting it together," Courson said of the ISS staff. "Randy has traveled extensively across the country and gone to numerous athletic training meetings, trying to show what it is, get feedback in the developmental stage, and go back and make changes in accordance with that."

For example, athletic trainers told Dick they could use a system that will generate many of the reports that administrators and coaches request day-to-day.

"The coaches' report was an offshoot of that," Courson said about one of the system's features. "We said it would be nice if we could take this information and adapt it into a coaches' report, so that's one less thing we're typing out separately. (Dick) was very receptive of that. He said, give me several examples of what your daily coaches' reports look like, so we got several athletic trainers to give him examples of those."

Another new feature is an individualized calendar that schools can generate online, indicating daily injury categories, status and even day-to-day climatic indicators useful in monitoring heat-related injuries and illnesses.

"This gives the athletic trainer and the coach real, visual help in understanding injury data related to the pattern of practice," Dick said.

Courson said another useful function of the system is that it will provide athletic trainers with the ability to store and retrieve such items as insurance and emergency-contact information for individual student-athletes.

"It's going to simplify the athletic trainer's job," he said. "Instead of, as many do right now, typing out an injury report, and typing out an athlete's insurance information, and adding the emergency contact, once you've added that information into the system, you have all of that accessible."

And, perhaps most attractive, the system serves essentially as a "no-cost" injury-management and tracking system, Courson added.

"I think it has potential for every school. Where I think it has the most potential is at some of the smaller schools that don't have as big of a budget, and it may be cost-prohibitive to purchase an injury-management software system, because they can be very expensive," he said.

"If you have the equipment and Internet access, it gives you a no-cost system that really gives you a lot of capabilities for evaluating your injuries in your overall program."

Several institutions in the Mid-America Intercollegiate Athletics Association, a Division II conference, were looking for such a software system when Commissioner Ralph McFillen learned from Dick that the Web-based ISS could satisfy many of those schools' needs.

As a result, Dick will meet with athletic trainers from the conference's 10 schools in May to describe the system and answer questions. He is scheduled to participate in similar meetings with at least nine other conferences and various other groups during the next couple of months.

"Athletic trainers want that data," McFillen said. "They want to know what are the best methods to rehabilitate injuries, and what kinds of injuries other campuses are seeing. They're looking for anything they can find in the data that can help prevent injuries.

"I know that once (Dick) meets with our trainers, and they hear what he has to present and how they can pull information out, he'll get higher participation from our people, and I know the trainers will use that to benefit the kids on our campuses."

Dick suggested that conference health and safety and technology grants may be available in Divisions II and III for upgrading hardware and installing high-speed Internet connections.

Pillar of health and safety

The ISS may become a valuable resource to specific institutions, but it already is an important source of data for various NCAA committees as well as sports sciences researchers -- and that value only can increase as more schools submit more data.

"The database's possibilities are huge, from both a research standpoint and application to the NCAA," Dick said.

He believes that, even with the practical limitations of the past on sports that could be included, the ISS has become the biggest continuous collection of injury data in the world. He adds that major American sports medicine organizations recognize it as "the gold standard" both in terms of the information it contains and its accessibility for research.

But the system's primary use is by the NCAA committees charged with monitoring and protecting the health and safety of student-athletes.

"We have made many important decisions based on this voluntary data -- the changes in spring football in 1997, ACL injuries, heat illnesses in football," Dick said. "I could go through a whole list of applications of the data.

"All of our rules committees look at it. There's a dependence by our committees for sports in which we collect data -- they all look at it. The competitive-safeguards committee looks at it. It's become a pillar of health and safety within the Association."

The enhanced system will permit broader and more detailed analysis of injuries in NCAA sports than ever before, as well as provide a better understanding of the impact that changes in rules and equipment have on occurrence of injury.

"In an ideal world, baseball bats would have been a wonderful thing to look at, but we didn't begin collecting data on baseball until after the aluminum bat was the only bat in use," Dick said. "It would have been nice to see, OK, you've got the wood bat and you've switched to the metal bat -- what happened?

"We can look at the differences, once the rules changes have been put in place, whether injuries increased, decreased, stayed the same, whatever. That's an important application, to understand the effectiveness of change."

Courson is enthusiastic about expanding the system to more sports, both across the Association and on campuses.

"As this comes online and is more refined, and we get more use by more schools, there is power in numbers," he said. "So I think as more schools use it for multiple sports, we'll start developing injury statistics, and down the road, treatment statistics."

Among other benefits, the increased data will better inform athletic trainers who wish to apply the NATA's Appropriate Medical Care for Intercollegiate Athletics (AMCIA) formula for determining appropriate levels of medical and training support for various sports in an institution's athletics program.

"When you have X number of trainers and Y number of activities, and recognizing that there are simultaneous, ongoing in-season and out-of-season activities, looking at the data will give information about where you can best place your medical-support resources," Dick said.

"Football obviously is a high-risk sport, and we have a good idea of the number of injuries," Courson said. "Track and field, on the other hand, or swimming and diving, are lower-risk sports in terms of the frequency and severity of injury, but they may have a high treatment correlation -- I may have 100 people on my track and field team, and although I don't have lot of significant injuries that require surgery or long down time, I may have a lot of chronic overuse injuries, like shin splints or muscle strains.

"I might treat 35 or 40 track and field athletes every day, and they may not miss a significant amount of time, but that information is really valuable for knowing how to staff your sports medicine facility, from a manpower standpoint."

Such information will be just as valuable in NCAA decision-making, Dick believes.

"There currently are sports committees that don't have access to this data for decision-making, because we're not collecting it for track, we're not collecting it for swimming, not collecting it for tennis," he said. "In a year or two, we'll be able to expand this to all of those sports, and give those committees the information to make informed decisions."

Making a difference

The NCAA's legal counsel, Elsa Cole, suggests a broader data-collection system will be invaluable in monitoring and considering policies from a legal perspective.

"Protection from legal liability in an area of sports safety can be enhanced from data that is scientifically and statistically sound and collected in all sports."

The new system's unprecedented capacity for providing NCAA committees with better data is clear, and it certainly will be a powerful tool on campuses for making decisions with budgetary implications.

Even more importantly, the system can provide information for use every day at a level where it can do the most immediate good -- keeping student-athletes safe and healthy.

"There's this whole audience (athletic trainers) that's on the leading edge of health and safety for student-athletes that can use this information, and have just as great an impact as any president or athletics director, because they understand what these data mean," Dick said.

"We can go to a coach," Runkle said, "and say we've had 10 knee injuries in the last two weeks; what are you doing in practice that's causing them? If we have 10 people coming in and saying, this is the drill where it's happening, we can print that out and say, hey, coach, this is what's going on -- do we need to look at the situation, make adjustments, or dispose of that drill or technique?" Runkle said.

"We can mentally do this, but if we don't have numbers, sometimes it doesn't show up."

Dick believes it primarily was athletic trainers' desire to protect student-athletes that motivated them to participate in the ISS even when data collection was demanding and laborious.

"What is the incentive for schools -- and in this case, the athletic trainers -- to do all this extra work? That's what's sort of amazing about the entire system, because on average we've had more than 300 schools that have participated or submitted data," he said. "I believe a major reason they are doing it is the fact they can see that this information makes a difference in the health and safety of student-athletes."

And now, that impact may be multiplied through wider participation and more complete data.

"It's a nice place to be, to have all this information that can be a benefit," Dick said.