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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 W A M T O R N D S D ID Marianas Islands W Y N V Guam M N U T C A C O American Samoa A Z MI W I IA N E I L K S NM W V KY NC TN A R SC MS TX O H IN M O OK ME V T N H NY CMAR T I PA N DJ E District of VA Columbia A L GA L A AK FL Puerto Rico KEY: HI U.S. Virgin Islands Active Data System No Active Data System Did Not Respond to Survey 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 • • • • • • • • www.nemsis.org Reference Documents Communication and Public Education Maintain Dataset and XSD Development Tools Direct Technical Assistance National Database Development Other www.NEMSIS.org 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 Gold • Must have the National elements • Must be able to offer all of the elements found in the NHTSA dataset • Any additional elements must comply with the standard • Must create the right XML/XSD files • 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 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 Questions? 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 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 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 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 Patient Care Report Software Patient Care Report Agency A’s Software Patient Care Report 911 Center Agency B’s Software Patient Care Report Agency C’s Software Value of Combined NEMSIS & NTR Translation Table NTR NTDB “Validator” “Validator” NEMSIS Outcomes 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 EMS System Prevention Emergency Department Rehabilitation Hospital www.nemsis.org Available Resources Michael Schnyder Michael Ely (801) 585-1631 (801) 585-9761