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Page 1: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.
Page 2: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

NEMSIS Update• Status of the Technical Assistance Center

• Compliance Information

• Data Element Wiki

• New Format to Receive State Data

• Reporting Using National Data

Page 3: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

The Money• NHTSA

– Office of EMS Division

• HRSA– EMS-C, Trauma, and EMS

• CDC

Page 4: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

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

Page 5: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

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

Page 6: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

Status: United States

AK

HI

AL

AZ A

R

CA

CO

CT

DE

FL

GA

ID

IL IN

IA

KS KY

LA

ME

MAMI

MN

MS

MO

MT

NE

NV

NH

NJ

NM

NY

NC

ND

OH

OK

OR

PA

RI

SC

SD

TN

TX

UT

VT

VA

WA

WV

WIW

Y

U.S. VirginIslands

Puerto Rico

Marianas Islands

Guam

American Samoa

District of Columbia

KEY:

Active Data System

No Active Data System

Did Not Respond to Survey Source: NEMSIS TACCapability Survey, 2006

Page 7: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

NEMSIS TAC• Simple goal, complicated objectives

• This means that the TAC will be offering assistance to:– States– Local EMS agencies– Software developers

Page 8: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

NEMSIS TAC Resources• www.nemsis.org

• Reference Documents

• Communication and Public Education

• Maintain Dataset and XSD

• Development Tools

• Direct Technical Assistance

• National Database Development

• Other

Page 9: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

www.NEMSIS.org

Page 10: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

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.

Page 11: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

Silver and Gold ComplianceSilver

• 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

Page 12: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

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

Page 13: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

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

Page 14: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

Compliance• Twelve vendors successfully completed

the process– Six Gold and Six Silver– Go to www.NEMSIS.org for the results

• The next round of testing is about to begin September 29, 2006 – We always have many interested parties

with each round

Page 15: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

Questions?

Page 16: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

Availability of a Wiki

http://155.100.188.41/NEMSISTACWIKI

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

Page 17: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

Questions ?

Page 18: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

Process for Helping States• How can NEMSIS best assist states in

becoming NHTSA 2.X compliant and participating in the NHTSA National EMS Dataset?

Page 19: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

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

Page 20: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

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

Page 21: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

Keeping the Ball in the Air!• Portraying the value of the NEMSIS

• Keeping the project active (moving forward).

Page 22: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

Process Seem Overwhelming?

Page 23: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

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

Page 24: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

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

Page 25: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

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?

Page 26: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

Example: Have a Data Dictionary?• Map variables to NHTSA 2.2.1 elements

• Ensure national variables are included

• Provide state report of mapping

• Suggest changes to ensure compliance

• Work with state to devise process for revision

Page 27: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

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

Page 28: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

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

Page 29: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

Facilitate a Focused Effort• Strategic Plan built around a one-month

timeline:– Full dedication of the NEMSIS Team

• Designed to built momentum and relationships

Page 30: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

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

Page 31: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

Patient Care Report Software

Agency C’s Software

911Center

Patient Care

Report

Agency A’s Software

Patient Care

Report

Patient Care

Report

Agency B’s Software

Page 32: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

Value of Combined NEMSIS & NTR

NTDBNTDB NEMSISNEMSIS

Translation Table

Outcomes

NTRNTR

“Validator”

“Validator”

Page 33: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

Questions ?

Page 34: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

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

Page 35: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

Unexpected Opportunity!• NCSA asks NEMSIS TAC to develop

reporting format– Searchable OLAP Cube database– Traditional database for paper reporting

Page 36: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.
Page 37: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

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

Page 38: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

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

Page 39: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

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

Page 40: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

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

Page 41: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

Describe the EMS Patient• Comparing “EMS Events” & “Patient Situation”

– Comparison by age– Comparison by sex– Comparison by race/ethnicity

Page 42: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

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

Page 43: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

Describe the Injured Patient

• Type event by demographics

• Frequency/mass casualty incidence

• Injury locations

• Cause of injury

• Drug and alcohol use

• Hospital outcomes

Page 44: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

Describe the Cardiac Patient

• Events and incidence (adult vs. pediatric)

• Rates by population

• Hospital outcomes

Page 45: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

Describe EMS Care Provided

• Protocols used

• Medications administered

• Procedures performed

Page 46: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

Performance of EMS Personnel• Procedure use by personnel over time

• Procedures performed by patient situation

• Procedure success rate

Page 47: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

Describe Outcome of Patient

• Hospital Disposition– By event type– By patient situation– By injury

Page 48: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

Questions ?

Page 49: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

Where We Need to Be

• EMS is one piece of a health care puzzle

EMSSystem

EmergencyDepartment

Hospital

Rehabilitation

Prevention

911System

Page 50: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

www.nemsis.org

Page 51: NEMSIS Update Status of the Technical Assistance Center Compliance Information Data Element Wiki New Format to Receive State Data Reporting Using National.

Available Resources

Michael Ely

(801) 585-9761

Michael Schnyder

(801) 585-1631


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