1. NEMSIS Version2  NEMSIS Version 3

2. Purpose of NEMSIS Version 3 Improve Data Quality  –Schematron Enhance performance assessment  – Incorporation of performance measures Supports state flexibility  – Sharepoint, XSD header information Prepare for next step (HL7)  – Synchronization of clinical content

3. NEMSIS Version 3 Data Dictionary The NEMSIS Version 3 Data Dictionary is a document describing in detail each of the 578 Version 3 Data Elements. The Data Dictionary is a consolidated source of information for each data elements.

4. Brief History of NEMSIS  1973 – 1997:  The Emergency Medical Services System Act was passed to collect standardized data nationwide  1998 – 2001:  NHTSA produces a document, “EMS Agenda for the Future” and begins to work on a national EMS database  2003 - 2004  Fifty-two states and territories sign a Memorandum of Understanding to collect EMS data and assignment of specific data definitions. A two-year NHSTA is established to develop a coding system for EMS with a detailed National Data Dictionary.

5. Brief History of NEMSIS (Con’t)  2004 – 2005  Database schemas ae developed to create the database and an XML Standard is chosen to move EMS data between local and state level or state and national database level. A uniform EMS Pre-Hospital Dataset data set is developed and a Technical Assistance Center is funded by HRSA (EMSC) and the CDC. The contract is given to the University of Utah School of Medicine (Utah) in partnership with the University of North Carolina.  Present  Movement to NEMSIS version 3 to improve data quality.

6. NEMSIS Standard Version 3 NEMSIS Version 3 is an EMS industry data standard system comprised of a data dictionary with:  574 data elements;  data exchange standard using XML;  business logic validation method using Schematron; and  automated exchange method using web-services EMS Software that has fully implemented the NEMSIS Version 3 Standard may be tested through the NEMSIS Technical Assistance Center for compliance. Details on NEMSIS Version 3 can be found at www.nemsis.org

7. NEMSIS 3: Performance Measurements Version 3 content has focused on objective performance measurement to better describe and evaluate EMS service delivery and patient care. State and National data elements are based on identified performance measures

8. Changes in NEMSIS 3

9. Highlights of NEMSIS 3 Changes  Customized Data Elements have been enhanced  EMS and Response and Transport modes have been enhanced  Hospital Outcome Data have been expanded  EMS Agency Location and GIS information has been enhanced  Compliant, Diagnosis, Injury Cause, and Procedures are now based on ICD-10.  Automated Collision Notification Information has been included

10. Challenges  Data Quality  Goals for NEMSIS  NEMSIS Timeline

11. Some NEMSIS Use Considerations…..  Mandatory Fields  Local Options for Additional Items  Custom Data Elements

12. Null Values Null Value Attributes - Indication that the data element can have null values.  Null Values are used (where permitted) to document that a data element was not or could not be completed. Null Values Accepted - Not all data elements can accept null values. Null values for NEMSIS 3 are noted below  Not Applicable  Not Recorded  Not Reported

13. Negative Values Negative Action Values Negative action values can be associated with a data element, however, not all data elements accept negative action values Use of Null and Negative Values reduces the data quality and should be used accordingly. More information on NEMSIS 3 “NOT” Values can be found: http://nemsis.org/media/nemsis_v3/master/UsageGuides/NEMSIS_v3_NOT_Values_ Use_Guidance.pdf

14. “Not” Values “NOT” Values have been condensed in Version 3 and are summarized below:  Not Applicable: The data element is not applicable or pertinent to the EMS event.  Not Recorded: The data element is considered applicable to the EMS event, but was left blank. The EMS software should auto-populate it with "Not Recorded".  Not Reporting: The data element may not be collected by the EMS agency or state. This NOT value does not apply to National elements where "Usage = Required".

15. Usage Value Descriptions Background The NEMSIS Version 3 standard is comprised of four types of elements identified as Usage Type. Mandatory and required fields collect critical data; null or negative values should be avoided because they diminish the data value and misrepresent actual EMS business operations Usage Value Definition Descriptions There are 4 types of elements in NEMSIS Version 3 that determine the Usage of each element:  Mandatory: These elements are always required and must be filled out in every record and “Not Values” are not allowed.  Required: These elements are always required and they do allow “Not Values” to be used.  Recommended: These elements are optional elements and allow the use of “Not Values”  Optional: These elements are optional and do not allow for “Not Values”

16. Compliance Vs. Compatibility   Ensures Standardization  Increases Data Quality  Not Controlled by State or LEMSAs

19. Seeking Compliance

20. NEMSIS 3: Becoming Compliant Compliance Policy Please contact Jorge Rojas at 801.213.3822 or Jorge.Rojas@hsc.utah.edu or visit: http://nemsis.org/v3/becomingCompliant/compliancePolicy.html

21. NEMSIS 3: Compliance Process NEMSIS version 3 Compliance Process requires that a data system be able to collect, receive, and process data. The documents below are available to assist in your compliance process at the following URL: http://nemsis.org/v3/becomingCompliant/complianceProcess.html Compliance Process & Check List NEMSIS V3 Compliance Application Form Pre-Testing Package v3.4.0 NEMSIS v3 Compliance Document NEMSIS v3.4.0 Pre-Testing Package Pre-Testing Package v3.3.4 NEMSIS v3 Compliance Document (Updated May 5, 2015) NEMSIS v3.3.4 Pre-Testing Package (Updated May 5, 2015)

22. Compliance Testing Schedule There is no official schedule for compliance testing of EMS software products. A software company can submit an application to Jorge Rojas to schedule compliance testing for EMS products. Please reference the NEMSIS V3 Compliance Document on the v3 Compliance Process page for further details regarding the compliance process. Testing Prerequisites All software seeking NEMSIS V3 compliance must first submit a Demographic and EMS dataset to the NEMSIS v3 web service and pass both the XSD and Schematron validation. For NEMSIS Version 3, the NEMSIS Technical Assistance Center (NEMSIS TAC) is offering compliance testing free-of-charge to software developers. Please contact Jorge Rojas at 801.213.3822 or Jorge.Rojas@hsc.utah.edu for a compliance application http://nemsis.org/v3/becomingCompliant/complianceTestingSchedule.html

23. Downloadable Resources (1 of 2) The following tools, XSDs, dataset dictionaries, and other helpful resources to help you when developing NEMSIS compliant software: Dataset Dictionaries http://nemsis.org/v3/downloads/datasetDictionaries.html Demographic (Agency) Dataset Schema http://nemsis.org/v3/downloads/demographicDataset.html EMS (PCR/Event) Dataset Schema http://nemsis.org/v3/downloads/emsDataset.html Medical Device Dataset Schema http://nemsis.org/v3/downloads/medicalDevice.html

24. Downloadable Resources (2 of 2) CAD Dataset Schema http://nemsis.org/v3/downloads/CAD.html Schematron http://nemsis.org/v3/downloads/schematron.html HL7 Products http://nemsis.org/v3/downloads/hl7Products.html Web Services http://nemsis.org/v3/downloads/webServices.html XML File Samples http://nemsis.org/v3/downloads/testCasesXMLSamples.html NEMSIS Archive http://nemsis.org/v3/downloads/v3Archive.html