Transcript NEMSIS Form

FireRMS NEMSIS (Part 1)
Presented by Laura Small
FireRMS Quality Assurance
Topics Covered in This Class
Part 1: Overview & Basic Setup:
• NEMSIS Forms and Fields available in FireRMS
• How to enable and setup NEMSIS in FireRMS
• Basic Customization steps – Required Changes
• Translate NEMSIS back to NFIRS – Required Codes
* Part 2 will cover:
• How to Update or Add your own Codes
• Advanced Form and Field Customization
• Creating a default Narrative Template
The NEMSIS Project
The NEMSIS project was developed to help states collect more standardized
data elements and eventually submit the data to a national EMS database.
Systems using NEMSIS collect over 400 data elements based on the NHTSA
EMS Uniform Pre Hospital Dataset Version 2.2.1 dataset standard.
NEMSIS is composed of three separate components: The Demographic
Dataset provides a standardized set of definitions describing an EMS System.
The EMS Dataset provides a standardized set of definitions describing an EMS
event. The third component of the standard is the XML format and definition
created to promote the movement of the data elements between data systems.
NEMSIS provides a national repository to potentially store EMS data from
every state in the nation
NEMSIS in FireRMS

FireRMS is Gold Certified for NEMSIS v2 Reporting - collecting every
required and optional data element from the National Data Sets.

Because not all fields are mandatory for data collection, even at the
National Level, only the most commonly used or mandatory fields are
displayed on the default NEMSIS forms in FireRMS. Additional fields
may be added if desired or required.

FireRMS provides State level support for NEMSIS through Custom
Codes, Rules and Export modules along with the ability to Add and
Remove fields and Customize how data entered in some fields are saved
(codes versus text).
Currently Available Code Sets
As of May, 2012 FireRMS supports local codes, fields and export modules for the
following States and Counties:
Alabama
Arkansas*
California
Colorado*
Florida
Georgia
Idaho*
Kansas*
Maine
Mass.
Michigan
Minnesota*
Missouri*
Nebraska
Nevada*
New
Hampshire*
New
Mexico*
Ohio
Oklahoma*
Oregon*
Utah
Washington* W. Virginia
Wisconsin*
(*) = Supported by the single ‘Image Trend’ system setup.
Don’t see your state? Call Customer Support & we’ll add it!
There is no charge to add your local NEMSIS as an option to FireRMS!
The NEMSIS Dataset
NEMSIS breaks down components of
the PCR report into Distinct Groups of
Data sets.
FireRMS matches this structure in the
forms and fields provided for NEMSIS
reporting.
NEMSIS Controls & Help
FireRMS Provides several ‘control objects’ to help with NEMSIS reporting.
The most commonly used control object is the NEMSIS Null Control
The NEMSIS Null Control displays as the letter ‘N’
next to many text fields, especially if they are
required under certain Rule Sets.
Click the ‘N’ one time to update the value to Not Applicable.
Click the ‘N’ again to change to Not Known.
Click it a third time to change to Not Available
Click the button again and the field will be cleared so you
can enter data after all if desired.
NEMSIS Controls & Help
FIPS is a numerical representation of a City/Town, County, State & Zip Code.
NEMSIS v2 requires that all addresses be provided in FIPS code format.
FireRMS provides a special FIPS control to capture addresses to meet this
requirement.
The State field will default to the State you set for your
Department in FireRMS. You may update the value if
required.
Select or Type in a Zip Code value.
If the Zip Code matches a value available in the FIPS Code
List, the County and City fields will update to display the
correct values, or will present a short list of choices.
If the Zip Code does not match a value available in the FIPS
Code list, you may still select the appropriate values from
the list.
NEMSIS Controls & Help
Because many of the NEMSIS Rules are dynamic, fields may be set to
required based on values you entered in other fields.
To help the user determine why a field is ‘suddenly’ required, special Help
prompts are often displayed next to required fields
Click on the Red Question Mark (?) to see the Help
Prompt.
Special Control Fields
Double clicking on many fields in the intervention
form will pop up special helper controls.
The Date/time control is useful on touch screens.
The Conversion control easily lets you convert
Fahrenheit to Celsius and Pounds to Kilograms.
NEMSIS Forms: Patient
You may add
additional
fields to most
of the
NEMSIS
Forms or
remove fields
you do not
use.
You can move fields from one form to another.
You can hide tabs you do not use.
NEMSIS Forms: Unit
Required
fields are set
based on the
Rules for
your location
Entering
data in one
field may
cause
another field
to become
required.
Be sure you understand your rules before removing fields from any form.
NEMSIS Forms: Scene
Never add
or remove
fields from
the Scene
form unless
directed to
do so for
your Local
Reporting
System
NEMSIS Forms: Situation
Providers
Primary
Impression
is required
for NFIRS
reporting
so it will
always be
required
when using
NEMSIS in
FireRMS
NEMSIS Forms: Trauma
Fields on
the Trauma
tab are
enabled or
Disabled
depending
on your
selection in
the field
‘Possible
Injury’
NEMSIS Forms: CPR
Cardiac
Arrest and
Other
Fields on
this tab will
be set to
required if
Provider
Impression
= Cardiac.
NEMSIS Form: History
You may
need to add
codes
manually
before you
may make
selections
from the
history fields
since most
code sets do
not include
these fields
NEMSIS Forms: Narrative
You may
create your
own Auto
Narrative
Template
We’ll show
you how in
the NEMSIS
Part 2 class.
NEMSIS Forms: Injury
Many of the
NEMSIS
tabs may be
hidden if
you do not
need to
collect data
from the
fields on
that form.
NEMSIS Forms: Billing
You must click
Add on the
Insurance
Company
name field to
enable most
of the other
fields on this
form, but you
can leave the
name field
blank or set it
to NEMSIS
Null if it is not
known.
NEMSIS Forms: Intervention
The intervention
form is dynamic:
the view and
displayed fields will
change depending
on which button
you select.
Each intervention
performed will
display in the grid
list box at the
bottom of the form.
Intervention – Physical/Vitals
Physical &
Vitals are two
halves of a
single
Assessment.
After Adding a
New Physical –
click on the
Switch View to
enter Vitals
information for
the same
assessment or
Vice Versa.
NEMSIS Forms: Intervention
Patient
Disposition is
almost
always a
required field.
You may
choose to
move the
field to the
Patient Tab
for faster
report
completion.
NEMSIS Forms: Other
In addition to the Basic NEMSIS Forms, FireRMS Administrators may choose to add
additional forms for Data Collection. Additional forms that may be used with NEMSIS
include:
Disclosures: Available for FireRMS Mobile systems to capture Patient and other
Signatures for Disclosure or other documents.
Life Pak EKG: Available for FireRMS Mobile systems to log EKG Device information
captured on the Physio Control LifePak Defibrillator
ZOLL EKG: Available for core or mobile systems to log EKG Device information
captured on the ZOLL ESeries EKG Device
Attachments: Available for core or mobile systems to add attachments related to the
patient care report. (Note: The attachment tab must be used when logging events
captured by the Zoll ESeries devices.)
Getting Started -- Basic Setup
This section of the Class will provide an overview on how to setup FireRMS version
4.9 and later to use NEMSIS forms for EMS Reporting.
Stop by the Product Showcase Room - or ask for a copy of last year’s NEMSIS Class
- to see how to setup NEMSIS in FireRMS 4.8 or earlier!
For complete information on the setup and creation of NEMSIS reports in FireRMS ,
please refer to the FireRMS NEMSIS Administrator Guide.
Step 1: Select the NEMSIS V2 Option
Click on Tools, Administration, System,
More Settings and select the checkbox
‘NEMSIS V2’.
You’ll be prompted to create a
Demographics Database. Use SQL Utils
to create this database and import
NEMSIS Codes
Step 2: Create the Demographics Database
Use SQL Utils to create a Demographics Database.
In the Other Databases section of the
Create/Update tab in SQL Utils, click on
the Checkbox labeled Demographic
Then, click on the button ‘Create’.
When the create database prompt displays, you can leave the default name
(Demographic) or enter any other name if you desire. Click OK and the
Demographics Database will be created.
Step 3: Import EMS Codes
While you’re in SQL Utils, go ahead & import your NEMSIS Codes.
On the Create/Maintain tab, highlight your FireRMS database name, then go to the
NEMSIS Tab.
1. Click on EMS Codes
2. Select your code set from the displayed list or use the browser to locate
your code file. If you are not sure which code set to use, check the
NEMSIS Admin Guide or Call Technical Support for help.
3. Click ‘Import Codes’ to complete the import.
Step 4: Import FIPS Codes
4. After the code import is complete, click on ‘FIPS5 Codes’
5. Select the file NEMSISFIPS55.txt, then click on Import Codes to complete
the import.
Step 5: Import your Rules
Rules are used to define required fields. Each state typically sets their own rules,
but are also bound by National NEMSIS Rules. Additionally, some fields are
always required for proper NFIRS reporting. Selecting the correct Rules Set helps
ensure your reports will pass validation for your State or Location.
1. After the FIPS Code import is complete,
click on the explorer next to the label “Use
rules for” and highlight your local rules set.
2. Then, click the ‘Update NEMSIS
Rules’ button to complete the import.
Step 6: Connect to Demo DB
After the NEMSIS Start Date has been entered
in a FireRMS database, a trigger will cause the
system to create an ODBC connection for the
Demographics database on the next restart of
FireRMS. Two prompts will display: The first
prompt will display the local SQL Server name.
Change the name if necessary.
A new
System DSN
ODBC
The second prompt will display the default
Connection
Demographics Database name. Again,
will be
change the name if necessary (e.g. if you
created to
used an alternate name when creating
store the link
your demographics database.)
between the
Databases.
Step 7: Enable NEMSIS forms
After connecting to the Demographics Database, go back to the
More Settings tab and select NEMSIS V2 for the EMS Module.
The EMS Module forms selection is new in
FireRMS Version 4.9 and allows you to easily
switch between versions of EMS Forms.
Whatever form was used when an incident was
created will be displayed when that incident is
later opened for review.
Step 8: Check permissions
In order to enter your Demographics Codes and statistics and to setup your
personnel for use in the NEMSIS EMS report forms, you must be a member of
a FireRMS Security Group with the following Security Options set to ‘3’ – Full
Access:
Menu, Tools, Administration, Demographic – provides access to the
Demographics Data Entry Forms
Form, Personnel Info, Basic, Demographic – provides access to the
Demographics section of the Personnel Module.
Demographics Setup
Enter Basic Agency Information, then click on the Lookups Tab
NOTE:
Demographics
information is
entered one
time, then
updated
yearly as
necessary.
Levels of Certification
On the Lookups Tab, select the
Levels of Certification first.
These values will be used to
help populate many of the other
fields.
After selecting the Certification
Levels for your agency you must
close the Demographics form to
update the Code Cache Files
Reopen the form and you will be
able to use the Cert Level
Codes to complete setting up
the Rest of the Demographics
Lookups
Update FireRMS with Codes
Depending on how your code set was defined, the following Codes may display in
the NEMSIS Forms in FireRMS only if they have been selected first on the
Demographics Lookup Forms:
Levels of Certification – Used in the FireRMS Personnel Demographics
section.
Procedures, Medications (Given) and Protocols – Used on the Intervention
tab in the NEMSIS EMS Forms.
Zones – Used for the optional Zone field which may be located on the Unit or
Scene tab.
Other Destinations (Description & Code) – Used for the Other Destinations
Code field located on the Disposition tab.
Restart FireRMS or click on Tools, Customize, Update Code Cache Files, after
entering or updating codes in the Demographics forms to ensure they are
properly updated in FireRMS.
Setup Personnel
Update the NEMSIS Section of the Personnel module – Basic Info Tab for each Person that would be involved in an EMS Run or responsible
for EMS Reporting. This information will be automatically copied back to
the Demographics module.
Note: Your Security Group must have Level 3 access enabled for the Security
Object Form, Personnel Info, Basic, Demographic in order to access this section of
the Personnel Basic Info form.
Setup NFIRS Translations
All NFIRS reports that include a Patient Record must include a valid code for
Provider’s Primary Impression. NFIRS also requires additional values for
Cardiac Arrest and Initial Arrest Rhythm if the Primary Impression code is set to
Code 16 – Cardiac.
FireRMS will automatically map all National NEMSIS Codes to the appropriate
NFIRS Codes for the Provider Impression/Assessment and Cardiac fields, but if
your agency uses Non-National codes for these fields, you will need to setup
translation codes to ensure your FireRMS reports sent to NFIRS are
considered valid.
The FireRMS NEMSIS Administrators Guide provides a list of all the available
NFIRS codes to map for any NEMSIS Code and also lists all NEMSIS Codes
that will be automatically mapped.
Setup NFIRS Translations
Click on Tools, Customize, Codes, EMS Codes to display the NEMSIS Code Set.
Open the Provider Impression/Assessment category & add the appropriate
translation codes if necessary..
Repeat the Process for the Cardiac & Initial Arrest Rhythm code sets.
Medications: Codes vs Text
The National NEMSIS Reporting System does not provide any codes for Current
Medications or Medications Given and requires Text values for these fields.
Some State and County NEMSIS systems, however, do provide a list of Codes
for one or both of these fields and require Code values for these fields.
To support both sets of requirements, FireRMS allows the local administrator to
determine whether Codes or Text values should be used for these fields and to
then setup the fields appropriately based on the local requirements.
Medications: Codes vs Text
Breakdown of States/Locations for each type of option:
Code list provided for Medications Given – no additional values allowed, export must include
code: California, Florida, Georgia, Maine, Massachusetts, Nevada
Text value list provided for Medications Given - additional values are allowed, export must
include text value: Colorado, Ohio, Image Trend, Michigan.
No List provided for Medications Given - any values are allowed, export must include Text
Value: All others not listed above.
Code list provided for Current Medications – no additional values allowed, export must include
code: California, Massachusetts, Nebraska and Ohio
No List provided for Current Medications - any values are allowed, export must include Text
Value: All States except California, Massachusetts, Nebraska and Ohio
Changing Medication Fields
Design Mode can be used to update the Current Medications and
Medications Given fields. There are two selections you can make:
1. Allow Add New? -- Setting this value to Y will update the system to
allow the users to type in their own values for Medications.
2. Medication Store Code? – Setting this value to N will update the
system to store and export the Text value for Medications rather than
the Code.
Note: The optional field “Research Survey” may also be setup to use and
save either Text or Code values.
No other fields on the FireRMS NEMSIS Forms should be modified this way.
Changing Medication Fields
To Update the Current Medications Field, enable Design Mode, open a
NEMSIS incident form, then right click in the Green Area around the
Current Medications Field.
Use the same steps to update the Medications Given Field on the
Intervention Form – enable Design Mode, then right click in the Green
space located in the Center of the Interventions Form .
Changing Medication Fields
When you right click on the field, the Design Mode Properties Sheet will
display. Enter the desired choice (Y or N) in the Target Value column, then
press the ‘Save and Close’ button to save your changes.
The setup shown above will update FireRMS to store Medication Text values
(Store Code =‘No’) and allow users to enter their own values for Medications
(Allow Add New = ‘Yes)
Exporting NEMSIS Reports
The NEMSIS Export works just like the NFIRS Export with a few exceptions.
Check with your local Reporting Agency to determine how often NEMSIS
records must be exported and whether or not you must provide a separate
Demographics Export with each posting.
To export your EMS Records to NEMSIS, click on Tools, Export, EMS
Exporting NEMSIS Reports
Select the Date Range,
options and then select
the proper Export Option
for your location.
EMSTARS is the Florida
State Export.
CA-CEMSIS is the
Alameda County, CA
export.
EMS NEMSIS is the
export for all other
locations.
Exporting NEMSIS Reports
NEMSIS Records are exported to
the location you select on the
export screen. The files are date
stamped and will include an update
such as “_01” if multiple exports are
created for a single day.
The file is created in the XML File
format.
Each data element (line) listed
corresponds to a field located on
one of the FireRMS NEMSIS
Forms.
Fields left blank typically export
using the NEMSIS Null Code -20
(Not Recorded)
Exporting NEMSIS Reports
Post the file to your reporting agency depending on your local guidelines.
If you must also provide a Demographics Export (usually required once per year),
click on Tools, Export, Demographic Export and again select the appropriate
export module for your location.
If there are any reported failures in your export, contact Technical Support for
assistance. Sometimes local or State agencies change rules or add or remove
allowed codes and your copy of FireRMS may not include those updates if you
are one or two versions out of date or if the agency failed to notify you or ZOLL
about the changes.
Technical Support can typically provide you with updated codes or rules that you
may import into your current FireRMS product often without the need to upgrade
the FireRMS clients.
Ready To Go…
Once you have completed the setup, you are ready to start using NEMSIS.
All steps shown up to now in this class are required to ensure your system
will be properly setup to capture data and provide reports to both NEMSIS
and NFIRS.
At this point, you know how to:
Import your local Codes and Rules
Define How Medication entries will be saved and exported
Make sure your NFIRS reports will be accurate.
Run the NEMSIS export
You may now open the system up to your users to begin reporting EMS runs
to NEMSIS (and NFIRS).
But Wait -- There’s More!
This section of the NEMSIS Class has shown you everything you need to know to
use NEMSIS in FireRMS.
But…
Data Entry could be easier. Your code lists could be smaller. Fields you don’t use
are still cluttering up the forms. And why doesn’t YOUR Zip Code show up?
Part 2 of this class will go over how to:
•Define and Set Default Values on coded fields
•Create an Auto-Narrative Template
•Customize the EMS and FIPS Code Sets
•Add, move or remove fields
•Hide or show tabs