Susan McHenry NEMSIS, Research Agenda National Association of State EMS Officials.
NEMSIS Update
description
Transcript of NEMSIS Update
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
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
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 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
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
Agency C’s Software
911Center
Patient Care
Report
Agency A’s Software
Patient Care
Report
Patient Care
Report
Agency B’s Software
Value of Combined NEMSIS & NTR
NTDBNTDB NEMSISNEMSIS
Translation Table
Outcomes
NTRNTR
“Validator”
“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
EMSSystem
EmergencyDepartment
Hospital
Rehabilitation
Prevention
911System
www.nemsis.org
Available Resources
Michael Ely
(801) 585-9761
Michael Schnyder
(801) 585-1631