Transcript Process for Helping States

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
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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
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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
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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
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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
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Call center time
Chute and turn-out time
Dispatch time
Response
Scene
Transport
Total call time
• Delays
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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