Transcript Document

Version 3 Update
Purpose of NEMSIS Version 3
• Improve Data Quality
– Business Intelligence, Schematron
• Enhance performance assessment
– Incorporation of performance measures
• Address need for state flexibility (with control)
– Sharepoint, XSD header information
• Prepare for next step (HL7)
– Synchronization of clinical content
– Data Linkage
Development and Maintenance
of NEMSIS V3 XSD
a. Generate V3 Data Dictionary from XSD Tables
i. Software Development tools (i.e. SDK)
ii. Provider data dictionary
b. XSDs Available Through SharePoint
i. NEMSIS will provide complete V3 XSDs.
ii. NEMSIS will provide complete national XSD
(national required elements). In state folders.
iii. NEMSIS will provide information for chosen state
and custom elements along with how state
implement extension and new elements.
Development and Maintenance
of NEMSIS V3 XSD
b. XSDs Available Through SharePoint (cont’d)
iv. States may post XSD for “custom field”
elements, but must demonstrate relationship to
compliant NEMSIS element. In state folders.
v. NEMSIS or states may post “updates” to the
XSDs and interested states/vendors will be
notified of updates through SharePoint.
Development and Maintenance
of NEMSIS V3 XSD
c. Enumerated Tables/Lists Available Through
SharePoint
i. NEMSIS will provide “suggested lists” for
NEMSIS elements with value code sets that are
expansive or periodically updated (e.g., ICD-10
[procedures], RxNorm [medications], state GNIS,
etc).
ii. States may host “suggested lists” associated
with NEMSIS lists requiring tailoring to a state,
but must demonstrate that list fits the “pattern”
for that NEMSIS element.
Development and Maintenance
of NEMSIS V3 XSD
d. Develop Calendar Schedule for Review and
modification of XSD/Data Dictionary
i. Must conform with HL7 Balloting process.
NEMSIS V3
Custom Elements Overview
• Adding a new element outside the NEMSIS V3
Standard
• Extending the values of a NEMSIS V3 Element
– Select a NEMSIS value first, but provides more details
• Adding a value to a NEMSIS V3 Element
– Create a new value for an element
• Limiting the values of a NEMSIS V3 Element
• Do not display an existing value to EMS professional
NEMSIS V3
Custom Elements Overview
• Think of the NEMSIS elements as a puzzle!
NEMSIS Elements
XML Schema
NEMSIS V3
Custom Elements – Adding an Element
• Adding an element outside the NEMSIS
Standard
• e.g., Patient Eye Color
V2.2.1 – Research Element
V3 – Custom Element
NEMSIS
Standard
Additional Elements
NEMSIS V3
Custom Elements – Extending the Values
• Extending the values of a NEMSIS Element
• e.g., moose vs. car crash (Cause of Injury)
– V2.2.1 allowed a “modification” of the Cause of
Injury value list
– Rolling up into existing value, but this didn’t always
happen  result: BAD data nationally & within states
EInjury.01
(v3)
NEMSIS
Standard
NEMSIS V3
Custom Elements – Extending the Values
• Extending the values of a NEMSIS V3 Element
• e.g., car vs. moose crash
– V3 – Custom element
How is it Implemented?
• Dynamically – with Business Intelligence?
• Schematron Rule ?
 Up to the Developer!
End result
is the same
NEMSIS V3
Custom Elements – Adding a Value
• Adding a value to a NEMSIS V3 Element
• Adding “police action” to Scene Delay
– V3 – Custom element
• Utilize Scene Delay eResponse.10
– Choose “police action” among choices
– Activates “Safety” in eResponse.10
NEMSIS
Standard
Additional Elements
NEMSIS V3 Custom Elements –
Adding a Value or Limiting the Values
• Adding a value to a NEMSIS V3 element
that cannot be associated with an
existing value – CAUTION!!
 Breaks the “spirit”
of the standard
• Limiting the values of a NEMSIS V3 Element
– Reason for Choosing Destination eDisposition.20
• Display only: “Closest Facility”, “Protocol”, etc
• Hide values: “Family Choice”, “Patient Choice”, etc
Development and Maintenance
of NEMSIS V3 Business Rules
NEMSIS will develop a core set of business
rules, associated with NEMSIS elements, that
are to be applied at the “field level” to each EMS
record before formal completion and export.
 Ensure proper value for applicable elements
 Ensure proper use of optional elements
 Will allow for errors and warnings
 Only warnings for state and national
submissions
Development and Maintenance
of NEMSIS V3 Business Rules
a. NEMSIS business rules will be technical in
nature
i. No clinical business rules
b. NEMSIS business rules will be expressed as
Schematron script.
c. States/Software may develop additional
business rules for application at the field or
state aggregation level. These will be posted
in state folder.
Development and Maintenance
of NEMSIS V3 Business Rules
d. Application of a Schematron file will be required
for record level validation, but will not be
mandated at levels of case aggregation.
Development and Maintenance
of NEMSIS V3 Web Services
a. The NEMSIS WSDL will be revised
i.
ii.
iii.
iv.
Represent a nominal implementation
Require “file size” feature
Optional “search” feature
NEMSIS will develop the standard WSDL
and post in state folder.
a) States may revise the WSDL
b. NEMSIS will support web services
development based upon SOAP or REST.
NEMSIS Version 3
Software Capabilities, Requirements,
& Compliance
Development and Maintenance
of the NEMSIS V3
Software Compliance Testing Process
a. NEMSIS to host website for
pretesting software
applications against the
national XSD and
Schematron file using sample
test cases
Development and Maintenance
of the NEMSIS V3
Software Compliance Testing Process
b. Software Products Tested by the NEMSIS
Compliance Team
i. “Free standing” software will be requested
and loaded at NEMSIS.
ii. Web (server) based software, NEMSIS will
request an account/admin rights.
iii. If neither is possible, testing will be done via
web conference.
Development and Maintenance
of the NEMSIS V3
Software Compliance Testing Process
c. Attributes to be Tested.
i. Installation/Setup.
1) Require published procedure for
installation/setup (we will utilize).
Development and Maintenance
of the NEMSIS V3
Software Compliance Testing Process
c. Attributes to be Tested (cont’d)
ii.
XSD Structure and Content
a) Validate National NEMSIS XSD
1) 12 to 16 test cases focused on
national/generic state elements
2) Test cases are event-based



Trauma
Cardiac
Stroke
3) Errors included in test cases
Development and Maintenance
of the NEMSIS V3
Software Compliance Testing Process
c. Attributes to be Tested (cont’d)
iii. XSD Structure and Content
a) Application of NEMSIS developed business
rules
b) Generate valid National XML
c) Export via web services
Development and Maintenance
of the NEMSIS V3
Software Compliance Testing Process
d. Ability to Export
i. Demographic (Agency) XML (via test cases)
 All Version 3 elements
 National elements only (subset)
ii. EMS (Event) XML (via test cases)
 All Version 3 elements
 National elements only (subset)
e. Ability to Import
i. CAD XML
ii. Medical device XML
Release of NEMSIS V3 Products
• First Phase of “Implementation Release”
– July 21, 2011
• Data Dictionaries (developer and provider
versions)
• D and E XSDs
• Within One Week:
• “Suggested lists” associated with related elements
– RXNorm medication list, GNIS codes, etc.
• Sample XML file with clinical data
• Documentation regarding header use
• Documentation regarding NOT Values / Pertinent
Negative Values / Nill (blank) use
Release of NEMSIS V3 Products
• Additional Phases of “Implementation Release”
– August 11, 2011 - Second Phase Release
• Web-Services Documentation
• Compliance Testing Process
– August 25, 2011 - Third Phase Release
• Schematron
• Business rules
• Web-Service Portal
• NEMSIS Version 3 “Official Release”
late October 2011
• Compliance testing to begin late October, 2011
NEMSIS Version 3 - Assistance
• All questions related to NEMSIS, Version 3 or
Version 2.2.1 should be directed to the
NEMSIS TAC in Utah
– www.NEMSIS.org
– Clinical / General Information
• [email protected]
• 801-585-1631
– Technical Information
• [email protected]
• 801-213-3822