NEMSIS Compliance

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• NEMSIS Compliance
• National Database Implementation
• National EMS Reports

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What is NEMSIS Compliance?

• Use of the NHTSA Version 2.2.1 Dataset
• Use of the XML Standard

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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.

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Example

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

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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

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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.

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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

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NEMSIS Compliance Testing Results
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NEMSIS Compliant SoftwareJuly 31, 2006

• Gold
• ACS-Firehouse
• ImageTrend
• Med-Media
• ScanHealth

• Silver
• Healthware Solutions
• Intermedix

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Common Errors

• XML Schema Location
• Times
• Zip Codes
• Header Information
• Abbreviations
• FIPS Codes
• Null Values

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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.

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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 "hhmm" 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 "-hhmm" indicates that the
  date/time uses a local time zone which is "hh"
  hours and "mm" minutes behind UTC.

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Zip Code

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

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XML Header Issues

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

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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

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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

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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.

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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.

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National EMS Database Implementation

• 2006
• 5 States
• 2007
• 10 Additional States

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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

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How will it be used?

• Policy
• Funding
• Operational
• Reimbursement
• Research
• Education
• Initial
• Continuing

• Resource Needs
• Personnel
• Equipment
• Preparedness

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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

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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

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National EMS Reports
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What is EMS?

• Service Delivery
• 911
• Response
• Equipment
• 24/7/365
• Rain, Sleet, Snow or Hail

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EMS Professionals

• Emergency Medical Dispatchers
• First Responders
• EMT-Basic
• EMT-Intermediates
• EMT Paramedics
• Medical Directors

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Clinical Care

• History
• Examination
• Treatment
• Monitoring
• Outcomes

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The ABCs 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)

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What is important?
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EMS System Response Times
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EMS Response Times and Trauma