Transcript National EMS Information System

NEMSIS Compliance
National Database
Implementation
National EMS Reports
What is NEMSIS Compliance?
1. Use of the NHTSA Version
2.2.1 Dataset
2. Use of the XML Standard
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.
Example
Data Element:
E06_11: Gender
Data Element Definition:
• The patients gender
Data Element Variable and Code:
650 – Male
655 – Female
-10 – Not Known
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
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.
Possible Outcomes
• Pass
– Posted on the www.NEMSIS.org website as
compliant
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•
Software Company
Product
Version
Platform
• Fail
– Provide feedback
– Work to resolve issues
– Retest during a later testing cycle
NEMSIS Compliance Testing
Results
Date
Tested
Gold
Silver
June, 2006
8
4
2
August, 2006
9
?
?
October, 2006
January, 2007
NEMSIS Compliant Software
July 31, 2006
Gold
• ACS-Firehouse
• ImageTrend
• Med-Media
• ScanHealth
Silver
• Healthware Solutions
• Intermedix
Common Errors
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XML Schema Location
Times
Zip Codes
Header Information
Abbreviations
FIPS Codes
Null Values
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.
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.
Zip Code
• Zip Code fields have the City name
instead of the Zip Code
XML Header Issues
• Software Company, Product, and Version
are required for each XML file.
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
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
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.
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.
National EMS Database
Implementation
2006
• 5 States
2007
• 10 Additional States
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
How will it be used?
• Policy
• Funding
– Operational
– Reimbursement
– Research
• Education
– Initial
– Continuing
• Resource Needs
– Personnel
– Equipment
– Preparedness
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
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
National EMS Reports
What is EMS?
• Service Delivery
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911
Response
Equipment
24/7/365
Rain, Sleet, Snow or
Hail
EMS Professionals
• Emergency Medical
Dispatchers
• First Responders
• EMT-Basic
• EMT-Intermediates
• EMT Paramedics
• Medical Directors
Clinical Care
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History
Examination
Treatment
Monitoring
Outcomes
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)
What is important?
Measurable
Important
Process
EMS System Response Times
Demographic
Large/High
Medium/Low Small
Extra-Small
County Area
10:56
09:18
08:06
06:29
County Population
08:30
08:37
07:18
08:47
Median Age
08:13
08:41
Education Level
08:45
08:18
Socio-Economic
Level
10:46
08:07
Race: White%
07:58
10:05
Race: Black%
09:39
08:19
Race: Hispanic%
08:33
08:35
Fatal Injury Rate
09:08
08:05
Cardio Death Rate 09:21
08:12
EMS Response Times and Trauma
Top 5 and Bottom 5 EMS Systems by Average EMS Response Time
Average EMS
Response Time (mm:ss)
Injury Fatality Rate
(deaths/100,000 Pop)
County 1
5:35
69
County 2
6:00
71
County 3
6:01
72
County 4
6:27
45
County 5
6:30
72
Top 10 Average
6:11
65.8
County 96
13:47
96
County 97
14:03
87
County 98
14:59
51
County 99
15:39
100
County 100
16:19
97
Bottom 10 Average
14:57
86.2
EMS System