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University of Utah (NEMSIS) DUA
Page 1 of 15
NEMSIS DATA USE AGREEMENT
This Data Use Agreement (hereinafter, the “Agreement”) is entered into this _____ day of
_____________________, 2016 between the National EMS Information System Technical Assistance
Center (hereinafter, “NEMSIS” or “Data Recipient”) in the Department of Pediatrics at the University
of Utah School of Medicine, acting as an agent of NHTSA (Office of EMS) under contract number
DTNH2215C00030, and the _____State or Territory EMS Office____ (“Covered Entity”) for purposes
of compliance with the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), the
Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, and the
Paperwork Reduction Act OMB Control Number: 2127-0717.
RECITALS
A Whereas, Data Recipient performs certain operations including the collection of EMS incident
data in order to populate a National Emergency Medical Services (EMS) Database; and
B. Whereas, Covered Entity is engaged in activities including the collection of EMS activation,
response, and care data; and
C. Whereas, Covered Entity agrees to disclose a Limited Data Set (as defined in Appendix A) to
Data Recipient for use by Data Recipient in performing the Activities (as defined below); and
D. Whereas, Data Recipient agrees to limit its use of the Limited Data Set and protect the Limited
Data Set according to the terms and conditions of this Agreement, and all applicable
requirements of HIPAA, HITECH, and the Privacy Rule (as defined below), as amended from
time to time.
THEREFORE, in consideration of the mutual promises set forth herein and other good and
valuable consideration, the sufficiency of which is hereby acknowledged, the parties agree as follows:
ARTICLE 1
DEFINITIONS
“Agreement” means this document.
“Contractors” means agents, contractors and subcontractors.
“Data Recipient” means NEMSIS and its authorized employees acting within the scope of their duties.
“Deidentified Health Information” means any information not identified as “Protected Health
Information” from the Electronic Protected Health Information and shall include any information
that cannot be associated with any individual in a manner that could identify the individual.
“Effective Date” means the date on which the last party executes this Agreement.
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“Electronic Protected Health Information” means the term “electronic health information” in 45 CFR §
160.103, limited to information created, received, maintained or transmitted by Covered Entity to
Data Recipient.
“EMS” means Emergency Medical Services.
“HIPAA” means the Health Information Portability and Accountability Act of 1996.
“HITECH” means the Health Information Technology for Economic and Clinical Health Act of 2009
“Individual” means the person who is the subject of information collected, used, or disclosed by the
Covered Entity.
“Limited Data Set” means the data related to the NEMSIS data set in Appendix A.
“National Emergency Medical Services Database” means the collection of pre-hospital data collected
and maintained by NEMSIS.
“NEMSIS” means the National EMS Information System.
“NEMSIS TAC” means the National Emergency Medical Services Information Center – Technical
Assistance Center.
“Pre-hospital data system” means the information from an EMS incident and patient care data created
by EMSPs and then submitted to Data Recipient.
“Privacy Rule” means the Standards for Privacy of Individual Identifiable Health Information at 45
CFR parts 160, 162 and 164 subparts A and E.
“Protected Health Information” has the meaning given that term in HIPAA.
“Required by Law” mean the term “required by law” in 45 CFR § 164.501.
“Secretary” means the Secretary of the Department of Health and Human Services or his/her designee.
ARTICLE 2
DISCLOSURE OF LIMITED DATA SET TO DATA RECIPIENT
2.1 Scope of Limited Data Set. For purposes of this Agreement, the Limited Data Set shall
consist of the health information from the NEMSIS data subset described in Appendix A of Covered
Entity’s prehospital data system.
2.2 Disclosure of Limited Data Set. Covered Entity agrees to disclose the Limited Data Set to
Data Recipient solely for use in connection with Data Recipient’s responsibility to populate a National
EMS Database with data from states and territories from around the United States and related activities
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and Data Recipient agrees that it shall not use the Limited Data Set for any other purpose. Data
Recipient further agrees that Data Recipient shall limit access to and the use of the Limited Data Set to
the following individuals or classes of individuals who need the Limited Data Set in performing the
Activities: See Appendix B for a List of Individuals and classes of Individuals.
ARTICLE 3
OBLIGATIONS OF DATA RECIPIENT
3.1. Use of Limited Data Set. Data Recipient shall not use or disclose the Limited Data Set
except as permitted under the terms of this Agreement or as required by law.
3.2 Safeguards Against Misuse of Information. Data Recipient shall use appropriate safeguards
to prevent use or disclosure of the Limited Data Set other than as permitted under this Agreement.
3.3 Reporting of Disclosures of Protected Health Information. Data Recipient shall notify
Covered Entity in writing of any use or disclosure of the Limited Data Set in violation of this
Agreement by Data Recipient, its officers, directors, employees, contractors or agents, or by any third
party, within one day of Data Recipient having knowledge of any such violation.
3.4 Use of Limited Data Set by Third Parties. Data Recipient shall ensure that its agents,
contractors and subcontractors (collectively “Contractors”) to whom it provides any portion of the
Limited Data Set shall comply with all restrictions and conditions that apply to Data Recipient with
respect to the use of the Limited Data Set and that no Contractor shall use or disclose such information
except as permitted under the terms of this Agreement or as required by law. Data Recipient further
agrees that it shall obtain and maintain, throughout the term of this Agreement, an agreement with each
Contractor that has or will have access to the Limited Data Set by or through Data Recipient, under
which such Contractor agrees to be bound by the same restrictions, terms and conditions that apply to
Data Recipient pursuant to this Agreement.
3.5 Identity of Individuals. Data Recipient agrees not to use the Limited Data Set in such a way
as to identify any individual and further agrees not to contact any individual who may be a subject
within the Limited Data Set.
3.6 Minimum Necessary Information. Data Recipient represents that Data Recipient’s request
that Covered Entity disclose Protected Health Information to Data Recipient is limited in scope to the
minimum Protected Health Information necessary to accomplish Data Recipient’s purpose in
connection with the Activities.
3.7 Notice of Request for Data. Data Recipient agrees to notify Covered Entity within five
business days of Data Recipient’s receipt of any request or subpoena for Protected Health Information
relating to this Agreement. Such notice shall be in writing and may be sent by fax or email provided
that any such notice shall also be sent to Covered Entity by personal delivery, certified mail, return
receipt requested, or by nationally recognized overnight carrier to the following:
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Covered Entity Name
Department
Address
City, State, Zip Code
Phone Number
Fax Number
Email
.
To the extent that Covered Entity decides to assume responsibility for challenging the validity of such
request, Data Recipient shall cooperate fully with Covered Entity in any such challenge.
ARTICLE 4
OWNERSHIP OF INFORMATION
Data Recipient acknowledges that, as between Data Recipient and Covered Entity, all Protected
Health Information received or developed by Data Recipient in connection with this Agreement shall
be and remain the sole property of Covered Entity, including any and all derivatives thereof developed
by Data Recipient in performing its obligations under this Agreement.
ARTICLE 5
TERM AND TERMINATION
5.1 Term. The term of this Agreement shall commence as of the effective date set forth herein
and shall terminate when all of the Protected Health Information provided by Covered Entity to Data
Recipient, or created or received by Data Recipient on behalf of Covered Entity, is destroyed or
returned to Covered Entity, or, if it is not feasible to return or destroy Protected Health Information,
protections are extended to such information, in accordance with the termination provisions in this
section.
5.2 Termination for Cause. Upon Covered Entity’s knowledge of a material breach by Data
Recipient, Covered Entity shall:
(a) Provide Data Recipient with written notice of the breach and an opportunity to cure the
breach within 30 calendar days of receipt of such notice. Data Recipient shall immediately
take steps to mitigate the breach and shall cure the breach within the 30 day notice period.
If Data Recipient fails to mitigate and cure the breach within the notice period, Covered
Entity may immediately terminate this Agreement; or
(b) Immediately terminate this Agreement (without opportunity to cure) if Covered Entity
determines, in Covered Entity’s sole discretion, that Data Recipient has breached a material
term of this Agreement; and/or
(c) Covered Entity shall report the violation to the Secretary.
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5.3 Effect of Termination. Upon termination of this Agreement, Data Recipient shall, upon the
request of Covered Entity, either return or destroy all Protected Health Information received from
Covered Entity, or created or received by Data Recipient on behalf of Covered Entity, and thereafter
Data Recipient shall not retain any copies of such Protected Health Information. Notwithstanding the
foregoing, to the extent that Covered Entity agrees that it is not feasible to return or destroy such
Protected Health Information, the terms and provisions of this Agreement shall survive termination of
the Agreement and such Protected Health Information shall be used or disclosed solely for such
purpose or purposes that prevented the return or destruction of such Protected Health Information.
ARTICLE 6
INDEMNIFICATION
Covered Entity and Data Recipient shall each defend, indemnify and hold harmless the other
from and against any and all claims, losses, causes of action, judgments, damages and expenses
including, but not limited to attorney’s fees, to the extent caused by or arising out of any breach of this
Agreement or failure to perform the obligations hereunder, by the indemnifying party, its employees,
officers, volunteers or Contractors. The indemnity obligations set forth in this Article 6 shall survive
termination of this Agreement.
ARTICLE 7
INJUNCTIVE RELIEF
Data Recipient agrees that the remedies at law for any breach by it of the terms of this
Agreement may be inadequate and that monetary damages from any such breach may not be sufficient
or readily measured. Accordingly, in the event of any breach or threatened breach by Data Recipient of
any terms of this Agreement, Covered Entity shall be entitled to immediate injunctive relief. Covered
Entity’s right to injunctive relief shall be cumulative and nothing herein shall prohibit Covered Entity
from seeking all other available remedies.
ARTICLE 8
GENERAL PROVISIONS
8.1 Singular case means the plural and plural includes the singular.
8.2 Any alterations, modifications, or waivers of the provisions of this Agreement may be made
by a joint amendment directing the change and signed by both Covered Entity and Data Recipient.
8.3 Failure of Covered Entity to require strict performance of any term or condition of this
Agreement shall not be deemed to be a waiver of any subsequent breach or default of any term or
condition.
8.4 Effect. The terms and provisions of this Agreement shall supersede any other conflicting or
inconsistent agreements between Covered Entity and Data Recipient, including without limitation all
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exhibits and all documents incorporated herein by reference. Any limitation of liability or exclusion of
damages provisions in any other agreement shall not be applicable to this Agreement.
8.5 Amendment. Data Recipient and Covered Entity agree to amend this Agreement to the
extent and whenever necessary to allow either party to comply with the Privacy Rule, the Standards for
Electronic Transactions (45 CFR Parts 160 and 162) and the Security Standards (45 CFR Part 142)
(collectively, the “Standards”) promulgated or to be promulgated by the Secretary or other regulations
or statutes. Data Recipient agrees that it will fully comply with all such Standards and that it will agree
to amend this Agreement to incorporate any material changes required by the Standards.
8.6 Any legal notice or other communication required or permitted hereunder with Covered
Entity shall be in writing, and will be deemed given when delivered personally, sent by confirmed fax,
sent by commercial overnight courier (with written verification of receipt) or sent by registered or
certified mail, return receipt requested, postage prepaid. All communications shall be sent to the
attention of the persons listed on the signature page or their successor of this Agreement and at the
addresses or fax numbers set forth below unless other names, addresses or fax numbers are provided
by either or both parties, with copies of all such legal notices or other communications delivered in
accordance herewith to the following:
Covered Entity Name
Department
Address
City, State, Zip Code
Contact Person
Title
Phone
Email
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IN WITNESS WHEREOF, the parties have caused this Agreement to be executed by their
duly authorized representatives effective as of the day and year set forth herein.
University of Utah School of Medicine
(“Data Recipient”)
By: _________________________________
Date: _______________________
(Signature)
Name: _______________________________
(Please Print)
Title: ________________________________
Covered Entity - Name
(“Covered Entity”)
By: _________________________________
(Signature)
Name: _______________________________
(Please Print)
Title: ________________________________
Date: _______________________
University of Utah (NEMSIS) DUA
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Appendix A – Limited DataSet
The NEMSIS Version 3 National EMS Elements
To Be Collected from the Covered Entity (State or Territory)
The NHTSA / NEMSIS Version 3 standard consists of two Datasets: the Demographic (EMS Agency
Information) (DEM DataSet) and EMS (ePCR/Event) (EMS DataSet). The national subsets of requisite
data [Limited Dataset] are the only elements that are sent from a State or Territory (Covered Entity) to
populate the NEMSIS Database at the NEMSIS Technical Assistance Center. The DEM DataSet
represents information regarding the EMS Agency. The EMS DataSet represents information regarding
the EMS activation / response. This may or may not include detailed incident, scene, patient,
assessment, and treatment information depending on the disposition of the incident and/or patient.
NHTSA / NEMSIS Version 3 – Requisite National Elements
- Demographic DataSet The NHTSA / NEMSIS Version 3 National Subset of data elements for the Demographic (EMS
Agency) submission is listed below. 35 elements comprise the Demographic Dataset (DEM DataSet).
The three elements with a grey background will be submitted with details by the State Data Collection
System to populate the NEMSIS Database. The 32 remaining elements are specific to the EMS
Agency based on its structure and the licensure granted by the State EMS Office or other licensing
authority.
Blue typeface indicates the elements will be removed from public reporting.
NHTSA / NEMSIS
V3 Element Number
NHTSA / NEMSIS
V3 Element Name
Elements Removed
from Public Reporting
DEMOGRAPHIC (EMS Agency) REPORT Information
dAgency Information
1
2
3
4
5
6
7
8
9
10
11
12
13
dAgency.01
dAgency.02
dAgency.04
dAgency.05
dAgency.06
dAgency.07
dAgency.08
dAgency.09
dAgency.11
dAgency.12
dAgency.13
dAgency.14
dAgency.15
EMS Agency Unique State ID
EMS Agency Number
EMS Agency State
EMS Agency Service Area States
EMS Agency Service Area County(ies)
EMS Agency Census Tracts
EMS Agency Service Area ZIP Codes
Primary Type of Service
Level of Service
Organization Status
Organizational Type
EMS Agency Organizational Tax Status
Statistical Calendar Year
Removed
Removed
Removed
Removed
Removed
Removed
Removed
Public Data
Public Data
Public Data
Public Data
Removed
Removed
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14
15
16
17
18
19
20
21
NHTSA / NEMSIS
V3 Element Number
dAgency.16
dAgency.17
dAgency.18
dAgency.19
dAgency.20
dAgency.21
dAgency.25
dAgency.26
NHTSA / NEMSIS
V3 Element Name
Total Primary Service Area Size
Total Service Area Population
911 EMS Call Center Volume per Year
EMS Dispatch Volume per Year
EMS Patient Transport Volume per Year
EMS Patient Contact Volume per Year
National Provider Identifier
Fire Department ID Number
Elements Removed
from Public Reporting
Removed
Removed
Removed
Removed
Removed
Removed
Removed
Removed
dConfiguration Information
- This group repeats to allow for EMS Agencies licensed in multiple states to document the
information specific to each state requirements.
22
23
24
25
26
dConfiguration.01
dConfiguration.02
dConfiguration.03
dConfiguration.04
dConfiguration.05
State Associated with the Certification/Licensure
Levels
State Certification/Licensure Levels
Procedures Permitted by the State
Medications Permitted by the State
Protocols Permitted by the State
Public Data
Public Data
Public Data
Public Data
Public Data
27 dConfiguration.06
28 dConfiguration.07
EMS Certification Levels Permitted to Perform
Each Procedure
EMS Agency Procedures
Removed
Removed
29
30
31
32
dConfiguration.08
dConfiguration.09
dConfiguration.10
dConfiguration.11
EMS Certification Level Permitted to Administer
Each Medication
EMS Agency Medications
EMS Agency Protocols
EMS Agency Specialty Service Capability
Removed
Removed
Removed
Removed
33 dConfiguration.13
34 dConfiguration.15
35 dConfiguration.16
Emergency Medical Dispatch (EMD) Provided to
EMS Agency Service Area
Patient Monitoring Capability(ies)
Crew Call Sign
Removed
Removed
Removed
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NHTSA / NEMSIS Version 3 – Requisite National Elements
- EMS DataSet The NHTSA / NEMSIS Version 3 National Subset of data elements for the EMS Incident / Patient
Care Report (ePCR/Event or EMS DataSet) submission are listed below. A total of 133 elements
comprise the EMS Incident / Patient Care Report Dataset (EMS DataSet). Three demographic (DEM
DataSet) elements make up the header information specific to the EMS Agency. The actual
ePCR/Event information consists of 130 elements (NEMSIS v3.4.0).
Blue typeface indicates the elements will be removed from public reporting.
NHTSA / NEMSIS
V3 Element Number
NHTSA / NEMSIS
V3 Element Name
Elements Removed
from Public Reporting
HEADER - Demographic EMS Agency Information Group
1 dAgency.01
EMS Agency Unique State ID
2 dAgency.02
3 dAgency.04
EMS Agency Number
EMS Agency State
Removed
Removed
Removed
INCIDENT / PATIENT CARE REPORT (ePCR/Event) Information Group
eRecord Information
1
2
3
4
eRecord.01
eRecord.02
eRecord.03
eRecord.04
Patient Care Report Number
Software Creator
Software Name
Software Version
Removed
Removed
Removed
Removed
eResponse Information
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
eResponse.01
eResponse.03
eResponse.04
eResponse.05
eResponse.07
eResponse.08
eResponse.09
eResponse.10
eResponse.11
eResponse.12
eResponse.13
eResponse.14
eResponse.15
eResponse.23
eResponse.24
EMS Agency Number
Incident Number
EMS Response Number
Type of Service Requested
Primary Role of the Unit
Type of Dispatch Delay
Type of Response Delay
Type of Scene Delay
Type of Transport Delay
Type of Turn-Around Delay
EMS Vehicle (Unit) Number
EMS Unit Call Sign
Level of Care of This Unit
Response Mode to Scene
Additional Response Mode Descriptors
Removed
Removed
Removed
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
Removed
Removed
Public Data
Public Data
Public Data
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NHTSA / NEMSIS
V3 Element Number
NHTSA / NEMSIS
V3 Element Name
Elements Removed
from Public Reporting
eDispatch Information
20 eDispatch.01
21 eDispatch.02
Complaint Reported by Dispatch
EMD Performed
Public Data
Public Data
PSAP Call Date/Time
Unit Notified by Dispatch Date/Time
Unit En Route Date/Time
Unit Arrived on Scene Date/Time
Arrived at Patient Date/Time
Unit Left Scene Date/Time
Patient Arrived at Destination Date/Time
Destination Patient Transfer of Care
Date/Time
Unit Back in Service Date/Time
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
Patient’s Home County
Patient’s Home State
Patient’s Home ZIP Code
Gender
Race
Age
Age Units
Removed
Removed
Removed
Public Data
Public Data
Public Data
Public Data
Primary Method of Payment
CMS Service Level
Public Data
Public Data
First EMS Unit on Scene
Number of Patients at Scene
Mass Casualty Incident
Triage Classification for MCI Patient
Incident Location Type
Incident State
Incident ZIP Code
Incident County
Public Data
Public Data
Public Data
Public Data
Public Data
Removed
Removed
Removed
Date/Time of Symptom Onset
Possible Injury
Chief Complaint Anatomic Location
Public Data
Public Data
Public Data
eTimes Information
22
23
24
25
26
27
28
eTimes.01
eTimes.03
eTimes.05
eTimes.06
eTimes.07
eTimes.09
eTimes.11
29 eTimes.12
30 eTimes.13
Public Data
Public Data
ePatient Information
31
32
33
34
35
36
37
ePatient.07
ePatient.08
ePatient.09
ePatient.13
ePatient.14
ePatient.15
ePatient.16
ePayment Information
38 ePayment.01
39 ePayment.50
eScene Information
40
41
42
43
44
45
46
47
eScene.01
eScene.06
eScene.07
eScene.08
eScene.09
eScene.18
eScene.19
eScene.21
eSituation Information
48 eSituation.01
49 eSituation.02
50 eSituation.07
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51
52
53
54
55
56
NHTSA / NEMSIS
V3 Element Number
NHTSA / NEMSIS
V3 Element Name
eSituation.08
eSituation.09
eSituation.10
eSituation.11
eSituation.12
eSituation.13
Chief Complaint Organ System
Primary Symptom
Other Associated Symptoms
Provider’s Primary Impression
Provider’s Secondary Impressions
Initial Patient Acuity
Elements Removed
from Public Reporting
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
eInjury Information
57 eInjury.01
58 eInjury.03
59 eInjury.04
Cause of Injury
Trauma Center Criteria
Vehicular, Pedestrian, or Other Injury Risk
Factor
Public Data
Public Data
Cardiac Arrest
Cardiac Arrest Etiology
Resuscitation Attempted By EMS
Arrest Witnessed By
CPR Care Provided Prior to EMS Arrival
AED Use Prior to EMS Arrival
Type of CPR Provided
First Monitored Arrest Rhythm of the Patient
Any Return of Spontaneous Circulation
Date/Time of Cardiac Arrest
Reason CPR/Resuscitation Discontinued
Cardiac Rhythm on Arrival at Destination
End of EMS Cardiac Arrest Event
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
Barriers to Patient Care
Alcohol/Drug Use Indicators
Public Data
Public Data
Date/Time Vital Signs Taken
Obtained Prior to this Unit’s EMS Care
Cardiac Rhythm / Electrocardiography (ECG)
ECG Type
Method of ECG Interpretation
SBP (Systolic Blood Pressure)
Method of Blood Pressure Measurement
Heart Rate
Pulse Oximetry
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
eArrest Information
60
61
62
63
64
65
66
67
68
69
70
71
72
eArrest.01
eArrest.02
eArrest.03
eArrest.04
eArrest.05
eArrest.07
eArrest.09
eArrest.11
eArrest.12
eArrest.14
eArrest.16
eArrest.17
eArrest.18
eHistory Information
73 eHistory.01
74 eHistory.17
eVitals Information
75
76
77
78
79
80
81
82
83
eVitals.01
eVitals.02
eVitals.03
eVitals.04
eVitals.05
eVitals.06
eVitals.08
eVitals.10
eVitals.12
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84
85
86
87
88
89
90
91
92
93
94
95
NHTSA / NEMSIS
V3 Element Number
NHTSA / NEMSIS
V3 Element Name
eVitals.14
eVitals.16
eVitals.18
eVitals.19
eVitals.20
eVitals.21
eVitals.22
eVitals.26
eVitals.27
eVitals.29
eVitals.30
eVitals.31
Respiratory Rate
End Tidal Carbon Dioxide (ETCO2)
Blood Glucose Level
Glasgow Coma Score-Eye
Glasgow Coma Score-Verbal
Glasgow Coma Score-Motor
Glasgow Coma Score-Qualifier
Level of Responsiveness (AVPU)
Pain Scale Score
Stroke Scale Score
Stroke Scale Type
Reperfusion Checklist
Elements Removed
from Public Reporting
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
eProtocols Information
96 eProtocols.01
97 eProtocols.02
Protocols Used
Protocol Age Category
Public Data
Public Data
Date/Time Medication Administered
Medication Administered Prior to this Unit’s
EMS Care
Medication Given
Medication Dosage
Medication Dosage Units
Response to Medication
Medication Complication
Role/Type of Person Administering
Medication
Public Data
Date/Time Procedure Performed
Procedure Performed Prior to this Unit’s EMS
Care
Procedure
Number of Procedure Attempts
Procedure Successful
Procedure Complication
Response to Procedure
Role/Type of Person Performing the
Procedure
Public Data
eMedications Information
98 eMedications.01
99
100
101
102
103
104
eMedications.02
eMedications.03
eMedications.05
eMedications.06
eMedications.07
eMedications.08
105 eMedications.10
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
eProcedures Information
106 eProcedures.01
107
108
109
110
111
112
eProcedures.02
eProcedures.03
eProcedures.05
eProcedures.06
eProcedures.07
eProcedures.08
113 eProcedures.10
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
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NHTSA / NEMSIS
V3 Element Number
NHTSA / NEMSIS
V3 Element Name
Elements Removed
from Public Reporting
eDisposition Information
114
115
116
117
118
119
120
121
122
123
124
125
eDisposition.05
eDisposition.06
eDisposition.07
eDisposition.12
eDisposition.16
eDisposition.17
eDisposition.18
eDisposition.19
eDisposition.20
eDisposition.21
eDisposition.22
eDisposition.23
126 eDisposition.24
127 eDisposition.25
Destination State
Destination County
Destination ZIP Code
Incident/Patient Disposition
EMS Transport Method
Transport Mode from Scene
Additional Transport Mode Descriptors
Final Patient Acuity
Reason for Choosing Destination
Type of Destination
Hospital In-Patient Destination
Hospital Capability
Destination Team Pre-Arrival Alert or
Activation
Date/Time of Destination Prearrival Alert or
Activation
Removed
Removed
Removed
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
Public Data
Emergency Department Disposition
Hospital Disposition
Public Data
Public Data
Suspected EMS Work Related Exposure,
Injury, or Death
Public Data
Public Data
Public Data
eOutcome Information
128 eOutcome.01
129 eOutcome.02
eOther Information
130 eOther.05
Note: Element eArrest.10 - Therapeutic Hypothermia Initiated, was retired from the NEMSIS Version 3
Standard in March 2015 with the Version 3.4.0 release. The information can be documented by use
of the procedure “hypothermia induction therapy” in eProcedure.03. The element eArrest.10 was
part of the national requisite elements for previous versions of the NHTSA / NEMSIS 3 standard. If
the Covered Entity is collecting, receiving, and processing data based on the v3.3.4 standard this
element should still be collected and submitted to the NEMSIS Database.
University of Utah (NEMSIS) DUA
Page 15 of 15
Appendix B
Disclosure of Limited Data Set
By Means of the National EMS Database
For the purposes of using the data subset from the Covered Entities (States and Territories), the
following individuals or classes of individuals will have access to different levels of data:
All Data Sent by all Covered Entities (States and Territories) in its Raw Format

University of Utah, Health Sciences Center, National EMS Information System Technical
Assistance Center (NEMSIS TAC)

National Highway Traffic Safety Administration (NHTSA) Office of EMS or the NHTSA
National Center for Statistics and Analysis
Data Sent By the Covered Entity (State or Territory) and Used by the National EMS Database
Reporting Engine.
EXCLUSIONS: None; includes all data submitted by each specific Covered Entity.

The above entities

The Entity (State), Office of Emergency Medical Services
Data Sent By the Covered Entity (State or Territory) and Used by the National EMS Database
Reporting Engine.
EXCLUSIONS: Any elements identifying a patient, zip code elements, EMS provider/agency,
or receiving hospital (listed above in blue typeface and documented as “Removed” in
Appendix A).

The above entities

The public that can access the de-identified National EMS Database Reporting Tools on the
NEMSIS TAC website.