NEMSIS Compliance and National Database Implementation

1. NEMSIS Compliance National Database Implementation National EMS Reports

2. What is NEMSIS Compliance? Use of the NHTSA Version 2.2.1 Dataset Use of the XML Standard

3. Why NEMSIS Compliance? • Makes sure the standard is followed • Gives some certainty that the data is consistent from location to location • Value to EMS Agencies and States investing in data systems • Guarantees that data collected locally can be aggregated at the state and national level.

4. Example Data Element: E06_11: Gender Data Element Definition: • The patients gender Data Element Variable and Code: 650 – Male 655 – Female -10 – Not Known

5. NEMSIS Compliance Levels • Gold • All NHTSA Version 2.2.1 Data Elements available for use • Demographic • EMS • Can generate an XML file containing actual data to specifications • Silver • Minimally the National Data Elements as defined • Test additional data elements as provided • Can generate an XML file containing actual data to specifications

6. How we test • Software Developer registers to enter the NEMSIS Compliance testing process • Sample XML is provided to the NEMSIS TAC for initial validation • Test Cases provided to be entered into the software resulting in the generation of an XML file • NEMSIS TAC evaluates the file based on the data dictionary, XML Standard, and data content.

7. Possible Outcomes • Pass • Posted on the www.NEMSIS.org website as compliant • Software Company • Product • Version • Platform • Fail • Provide feedback • Work to resolve issues • Retest during a later testing cycle

8. NEMSIS Compliance Testing Results

9. Gold ACS-Firehouse ImageTrend Med-Media ScanHealth Silver Healthware Solutions Intermedix NEMSIS Compliant SoftwareJuly 31, 2006

10. Common Errors • XML Schema Location • Times • Zip Codes • Header Information • Abbreviations • FIPS Codes • Null Values

11. XML Schema Location • XML files require this to identify the XSD used for authentication. • Should reflect the XSD location on the www.NEMSIS.org website.

12. Times • Times are expressed in UTC (Coordinated Universal Time), with a special UTC designator ("Z"). • Times are expressed in local time, together with a time zone offset in hours and minutes. • A time zone offset of "+hh:mm" indicates that the date/time uses a local time zone which is "hh" hours and "mm" minutes ahead of UTC. • A time zone offset of "-hh:mm" indicates that the date/time uses a local time zone which is "hh" hours and "mm" minutes behind UTC.

13. Zip Code • Zip Code fields have the City name instead of the Zip Code

14. XML Header Issues • Software Company, Product, and Version are required for each XML file.

15. Abbreviations and Rounding • Medications, Procedures, and other text value fields should not have abbreviations (with the exception of the Narrative). • Epinephrine cannot be Epi • Codes and Numbers should not be rounded. • GIS Coordinates • Also be careful with negatives and positives • 99.600 (ICD-9) not 99.6

16. FIPS Codes • County • 5 digit FIPS (2 for state and 3 for county) • City • Should be a FIPS Code (Not Zip Code) • State • 2 digit FIPS (37 instead of NC) • Country • Should be a FIPS Code

17. Null Values • Null Values are standardized throughout the dataset • “0” or “N/A” are not null values • Correct Null Values include • -5 = Not Available • -10 = Not Known • -15 = Not Reporting • -20 = Not Recorded • -25 = Not Applicable • Null Values for Numeric Fields or Date/Times are frequently “blank” per the data dictionary.

18. National EMS Database Goal: A database maintained and regularly updated at the national level containing data on every EMS event occurring within the United States.

19. National EMS Database Implementation 2006 • 5 States 2007 • 10 Additional States

20. What's in it? • NHTSA Version 2.2.1 Data Elements which are designated as “National” • Approximately 68 • Aggregated data designed to describe EMS from a: • Service Delivery • Personnel Performance • Clinical Care

21. Policy Funding Operational Reimbursement Research Education Initial Continuing Resource Needs Personnel Equipment Preparedness How will it be used?

22. Where and When? • Where will it be housed? • National Highway Traffic Safety Administration • National Center for Statistical Analysis • When will it be available? • January, 2007

23. How do I get reports? • Phase I • PDF reports will be generated an posted at www.NEMSIS.org • Quarterly, beginning January, 2007 • Phase II • NCSA will provide a web-based interactive reporting system • NEMSIS TAC will provide reports allowing states to benchmark themselves with other states • Beginning, 2008 or 2009

24. National EMS Reports

25. What is EMS? • Service Delivery • 911 • Response • Equipment • 24/7/365 • Rain, Sleet, Snow or Hail

26. EMS Professionals • Emergency Medical Dispatchers • First Responders • EMT-Basic • EMT-Intermediates • EMT Paramedics • Medical Directors

27. Clinical Care • History • Examination • Treatment • Monitoring • Outcomes

28. The ABC’s of Data Usage • Arrival • System Response Times • Other Service Delivery Parameters • Bean Counting • Patient Types • Success Rates • Care • Protocol Compliance • Interventions • Outcomes (mechanism vs. injury patterns)

29. What is important?

30. EMS System Response Times

31. EMS Response Times and Trauma