1. NEMSIS Compliance National Database Implementation National EMS Reports

2. What is NEMSIS Compliance? 1.Use of the NHTSA Version 2.2.1 Dataset 2.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 compliantwww.NEMSIS.org Software Company Product Version Platform Fail –Provide feedback –Work to resolve issues –Retest during a later testing cycle

8. NEMSIS Compliance Testing Results DateTestedGoldSilver June, 2006842 August, 20069?? October, 2006 January, 2007

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

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. www.NEMSIS.org

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

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 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? Measurable Important Process

30. DemographicLarge/HighMedium/LowSmallExtra-Small County Area10:5609:1808:0606:29 County Population08:3008:3707:1808:47 Median Age08:1308:41 Education Level08:4508:18 Socio-Economic Level 10:4608:07 Race: White%07:5810:05 Race: Black%09:3908:19 Race: Hispanic%08:3308:35 Fatal Injury Rate09:0808:05 Cardio Death Rate09:2108:12 EMS System Response Times

31. Top 5 and Bottom 5 EMS Systems by Average EMS Response Time EMS System Average EMS Response Time (mm:ss) Injury Fatality Rate (deaths/100,000 Pop) County 15:3569 County 26:0071 County 36:0172 County 46:2745 County 56:3072 Top 10 Average6:1165.8 County 9613:4796 County 9714:0387 County 9814:5951 County 9915:39100 County 10016:1997 Bottom 10 Average14:5786.2 EMS Response Times and Trauma