NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National Data

The Money NHTSA –Office of EMS Division HRSA –EMS-C, Trauma, and EMS CDC

The Money Provided money to establish a NEMSIS Technical Assistance Center –$600k Year One –There is funding for Year Two $255k for States to submit to the NED NHTSA has established a funding source for states who are making a NEMSIS system –408 Highway Safety funds are being awarded

NEMSIS TAC The TAC picked up the work at the end of the Pilot phase of NEMSIS (Sept 2005) –University of Utah received the grant –Utah contracted with University of North Carolina to continue their efforts The Goal is to collect data from States and Territories to create the National EMS Database

Status: United States Source: NEMSIS TAC Capability Survey, 2006

NEMSIS TAC Simple goal, complicated objectives This means that the TAC will be offering assistance to: –States –Local EMS agencies –Software developers

NEMSIS TAC Resources Reference Documents Communication and Public Education Maintain Dataset and XSD Development Tools Direct Technical Assistance National Database Development Other

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.

Silver and Gold Compliance Silver Must have the National elements Any additional elements must comply with the standard Must create the right XML/XSD files Gold Must be able to offer all of the elements found in the NHTSA dataset Must create the right XML/XSD files

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

Software Compliancy On March 1, 2006, the TAC began testing software developers for compliance A total of 8 applications were received for 11 software applications There are two levels of compliance: –Gold –Silver

Compliance Twelve vendors successfully completed the process –Six Gold and Six Silver –Go to for the results The next round of testing is about to begin September 29, 2006 –We always have many interested parties with each round

Questions?

Availability of a Wiki Developed to aid in the process of documenting definitions (i.e., characteristics) associated with NHTSA 2.x data elements. Arrive on Scene Initial Responder Vehicle Ejection

Questions ?

Process for Helping States How can NEMSIS best assist states in becoming NHTSA 2.X compliant and participating in the NHTSA National EMS Dataset?

Experience has Taught Us States EMS Data Managers are: Very busy! Have limited resources Have priorities other than NEMSIS objectives May lack Department/EMS support Some lack some skills necessary to transport data using XML

The Tasks Are Many! Develop NEMSIS compliant data elements –Revise existing state data dictionary –Develop new state data dictionary Acquire NEMSIS compliant software Ensure data release requirements are satisfied Develop process for the export of data

Keeping the Ball in the Air! Portraying the value of the NEMSIS Keeping the project active (moving forward).

Process Seem Overwhelming?

Our Approach Last Year Talk to states considered “low hanging fruit” Call often and offer help Work through one contact to accomplish all required tasks Respond to questions and react to submitted sample data

Our Approach This Year Solve barriers experienced by EMS Data Managers: –Very Busy … Bring resources to you! –Limited Resources … Make funds available –Other priorities … Facilitate focused effort –Limited support … Provide education/motivation –Lack of XML experience …offer XML training

Bring resources to you! “What month would work for you?” “Can we come visit?” –What are your resources/barriers? May we review your documents? –EMS data dictionary –Process for release of EMS data Can we develop a strategic plan?

Example: Have a Data Dictionary? Map variables to NHTSA elements Ensure national variables are included Provide state report of mapping Suggest changes to ensure compliance Work with state to devise process for revision

Make Funds Available Money provided by NHTSA ($255,000) –Uses: –To aid states over the hurdle of submitting data to the National EMS Repository Additional programming Software modifications Needed consensus meetings

Provide Educational/Motivational Opportunities NEDARC –Conduct SWOT with focus on EMS data collection or NHTSA dataset Site visits –Value of NHTSA 2.X dataset and reporting –Review process for data release –Meet with local providers

Facilitate a Focused Effort Strategic Plan built around a one-month timeline: –Full dedication of the NEMSIS Team Designed to built momentum and relationships

Offer XML/XSD Training On site training with NEMSIS TAC staff –What is XML? –Valid XML documents –XML Attributes –XML Entities –Displaying XML documents –XML Namespaces

Value of Combined NEMSIS & NTR NTDB NEMSIS Translation Table Outcomes NTR “Validator”

Questions ?

National EMS Reporting 10 Reporting Domains –Data Quality Reports –Agency Reports –Elapsed Time Reports –Patient Characteristics Reports –Disposition Reports –Provider Reports –Cardiac Arrest Reports –Billing Reports –Delay Reports –Trauma Reports

Unexpected Opportunity! NCSA asks NEMSIS TAC to develop reporting format –Searchable OLAP Cube database –Traditional database for paper reporting

Describe the EMS Community EMS Agencies –Number –Level of service –Location –Size –Volume EMS Personnel –Numbers –Level (EMT, EMT-Intermediate, EMT-Paramedic –Location Patients –Number of events –Number of patients –Numbers based upon population and sevice area

Describe the EMS Events Number of total events Number and % of injuries Number and % of cardiac arrests Number and % of non-injuries Time of day Day of week

Describe the EMS Patient Situation By dispatch types and EMD use By CMS condition codes By reason for encounter By providers primary impression Protocols used

Describe the EMS System Response Average and 90% fractal times –Call center time –Chute and turn-out time –Dispatch time –Response –Scene –Transport –Total call time Delays –Dispatch –Response –Scene –Transport

Describe the EMS Patient Comparing “EMS Events” & “Patient Situation” –Comparison by age –Comparison by sex –Comparison by race/ethnicity

Describe the Health Insurance Compare by age, sex, race/ethnicity Compare by pediatric and adult Compare by event type Compare by patient situation Compare by disposition

Describe the Injured Patient Type event by demographics Frequency/mass casualty incidence Injury locations Cause of injury Drug and alcohol use Hospital outcomes

Describe the Cardiac Patient Events and incidence (adult vs. pediatric) Rates by population Hospital outcomes

Describe EMS Care Provided Protocols used Medications administered Procedures performed

Performance of EMS Personnel Procedure use by personnel over time Procedures performed by patient situation Procedure success rate

Describe Outcome of Patient Hospital Disposition –By event type –By patient situation –By injury

Questions ?

Where We Need to Be EMS is one piece of a health care puzzle 911 System

Available Resources Michael Ely (801) Michael Schnyder (801)