1. Documenting Transfer of Care from One EMS Agency to Another NEMSIS TAC V3 Implementation Call March 25, 2015 Updated May 2015

2. The Scenario An EMS agency is transferring care to another EMS agency. Common occurrences include: –1 st Responder to Ground BLS or ALS Agency –1 st Responder to Air Agency –Ground BLS to Ground ALS or Air Agency –Ground ALS to Air Agency –Tiered Response: Engine Company to Ambulance Unit (BLS or ALS)

3. Transfer of Care: EMS Agency to EMS Agency eDisposition.12 - Incident/Patient Disposition Document: –Patient Treated, Transferred Care to Another EMS Unit (4212031) eDisposition.21 - Type of Destination Document : –Other EMS Responder (air) (4221015) OR –Other EMS Responder (ground) (4221017)

4. Transfer of Care: EMS Agency to EMS Agency eDisposition.20 - Reason for Choosing Destination Document: –Protocol (4220019) Note: Patients are typically transferred to another EMS Agency based on established protocol.

5. Transfer of Care: EMS Agency to EMS Agency eTimes Elements to document Document: –eTimes.08 - Transfer of EMS Patient Care Date/Time Definition: The date/time the patient was transferred from this EMS agency to another EMS agency for care. –eTimes.13 - Unit Back in Service Date/Time Note: eTimes.12 - Destination Patient Transfer of Care Date/Time is “The date/time that patient care was transferred to the destination healthcare facilities staff”.

6. Transfer of Care: EMS Agency to EMS Agency eDispostion.01 - Destination/Transferred To, Name Definition: The destination the patient was delivered or transferred to. eDispostion.02 - Destination/Transferred To, Code Definition: The code of the destination the patient was delivered or transferred to. NEMSIS TAC: Based on the definition of these elements which includes “transfer of care to”, an EMS agency can use these elements to identify another EMS agency. The elements in dFacility can be used in the creation of a “list” for use within an EMS data collection software system for the destinations and may include EMS agencies. A list for EMS agencies within a state may be provided by the State EMS Office and available in the NEMSIS Version 3 State Data Set XML file. This list includes elements for dAgency.02 - EMS Agency Number and dAgency.03 - EMS Agency Name.

7. Transfer of Care: EMS Agency to EMS Agency dFacility Section Use for creating destination lists including other EMS Agency identifiers. These may include 1.EMS agencies 2.Law enforcement agencies 3.“Generic” codes (e.g., home, private vehicle, private residence, funeral home, etc.)

8. Additional Scenarios An EMS agency assesses the patient but the patient is transported by means other than EMS: –Law Enforcement –Private Vehicle (e.g., family, friend, patient, etc.)

9. Transfer of Care: EMS Agency to Law Enforcement eDisposition.12 - Incident/Patient Disposition Document: –Patient Treated, Transported by Law Enforcement (4212035) eDisposition.20 - Reason for Choosing Destination Document: –Law Enforcement Choice (4220009) eDisposition.21 - Type of Destination Document: –Police/Jail (4221019)

10. Transfer of Care: EMS Agency to Law Enforcement eTimes Elements to document …related to transfer of care Document: –eTimes.08 - Transfer of EMS Patient Care Date/Time Definition: The date/time the patient was transferred from this EMS agency to another EMS agency for care. Note: Law Enforcement is an accountable party. It is important for EMS agencies to document the date and time law enforcement took over responsibility for the patient. –eTimes.13 - Unit Back in Service Date/Time Note: eTimes.12 - Destination Patient Transfer of Care Date/Time is “The date/time that patient care was transferred to the destination healthcare facilities staff” and is not appropriate for this scenario.

11. Private Vehicle Transfer of Care: EMS Agency to Private Vehicle eDisposition.12 - Incident/Patient Disposition Document: –Patient Treated, Transported by Private Vehicle (4212037) eDisposition.21 - Type of Destination Document : –Not Applicable (7701001) Note: The EMS Unit should only document the Type of Destination when the EMS unit and crew transports the patient. In this scenario the patient may be taken to a health care destination by private vehicle. However, this cannot be readily verified by the EMS agency Therefore, “Not Applicable” should be documented..

12. Private Vehicle Transfer of Care: EMS Agency to Private Vehicle eDisposition.20 - Reason for Choosing Destination Document: –Not Applicable (7701001) Note: The EMS Unit should only document the Reason for Choosing Destination when the EMS unit and crew transports the patient. Therefore, “Not Applicable” should be documented. Note: Patients are transported by private vehicle on rare occasions (0.15%) (1). The destination type and reason for choosing the destination should not be documented by the EMS Unit or Crew with a different value unless an EMS crew member was in the private vehicle providing patient care. The reasons are not clearly known, but may include a mass casualty incident when adequate ambulances are not available. (1) NEMSIS Version 2 data from the NEMSIS Cube using all data – April 6 2015.

13. Transfer of Care: EMS Agency to Private Vehicle eTimes Elements to document …related to transfer of care –eTimes.13 - Unit Back in Service Date/Time Note: eTimes.08 - Transfer of EMS Patient Care Date/Time (Definition: The date/time the patient was transferred from this EMS agency to another EMS agency for care) should only be documented if care of the patient is being transferred. If there is no responsible individual taking over patient care this element should not be filled out with a date/time. Note: eTimes.12 - Destination Patient Transfer of Care Date/Time is “The date/time that patient care was transferred to the destination healthcare facilities staff” and is not appropriate for this scenario.

14. Questions?? For any questions please contact the NEMSIS TAC staff from the “Contact Info” page of our website. http://nemsis.org/contactInfo/contactInfo.html