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What Is This NEMSIS?

What Is This NEMSIS?. An Overview of the National EMS Information System: Where We Are And Where We Are Going Derrick Congdon, MS, NREMT-P Assistant Director, MA EMS Region IV. Snowbird 2007. Where Do We Begin?. The history of EMS data We can date it back to the “modern age of EMS”

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What Is This NEMSIS?

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  1. What Is This NEMSIS? An Overview of the National EMS Information System: Where We Are And Where We Are Going Derrick Congdon, MS, NREMT-P Assistant Director, MA EMS Region IV Snowbird 2007

  2. Where Do We Begin? The history of EMS data We can date it back to the “modern age of EMS” 1966: accidental death and disability • A review of ambulance services in the U. S. showed a scarce amount of patient data. • Also showed a limited system to collect EMS data and to evaluate our systems

  3. More Recent History? 2003:the EMS outcomes evaluation project • No adequate databases • Non-standardized data definitions • Different formats of EMS information • Different criteria for including the information http://www.nhtsa.Dot.Gov/people/injury/ems/emsoutcomes03/

  4. Status of Data in the U.S. Source: NEMSIS TAC Capability Survey, 2006

  5. General Accounting OfficeEmergency Medical Services • Reported Needs Are Wide-Ranging, With a Growing Focus on Lack of Data.

  6. History: Lack Of Data, Now What? Between 1992 and 1993 NHTSA EMS Data Elements Version 1 was Developed • Excellent Effort • Standard was to broad and open • EMS relatively unaware of the potential for computer technology in the field

  7. Forget The Past …On To The Future • Late 90’s, the National Association of State EMS Directors decided there was a NEED for uniform data collection • Development of the NEMSIS Concept and Project

  8. Professional Organizations AAA AAMS ACEP ACS-COT (NTDB) AHA (NRCPR) EMSOP IAFC IAFF NAEMD NAEMSP NASEMSD NENA Federal Partners CDC FEMA HRSA-EMSC HRSA-EMSC/NEDARC HRSA-EMSC/NRC HRSA-ORHP HRSA-Trauma/EMS NHTSA Who’s Involved

  9. Who’s Helping To Fund It? • NHTSA • EMS Division (Primary) • HRSA • Trauma and EMS • EMS-C • American Heart Association • Support for EMS Software Development

  10. EMS Education Curriculums Local Education EMS Outcomes Something other than death System evaluation EMS Research Evaluate Cost effectiveness Identify problems and target issues EMS Reimbursement National fee schedule and reimbursement rates Why Is There a Need For Data?

  11. State & Federal Public education and drive policy Identify national trends Drive education Prioritize needs and funding Benchmarking Solidify EMS in the Healthcare family Local Outcomes EMS Research hypothesis Promote research Everyday Business structure and management Improve reliability and efficiency Reduce errors Determine effectiveness of systems and patient care How Will Data Address The Need?

  12. NEMSIS In The Long-Term • Electronic EMS Data • Standard EMS Dataset • Data Systems • Local • State • National EMS Database • Data Drives EMS • System • Personnel • Clinical Care

  13. Multi-Level System Begins with the local provider Works with the States Feeds the National Database How Will NEMSIS Work?

  14. Where Does The Data Come From

  15. 911 System Where Are We? • Only one piece of the puzzle • Our data helps to improve the overall system

  16. So Where Are We Locally? • Dependent Upon the State you work in. • NH – TEMSIS Program • ME – MEMSRR Program • MA – Statutory language requiring the collection of specific data points • Data collection is important

  17. Locally • Very little information on local EMS data collection • Most systems are paper based but are discussing or transitioning to electronic • Few systems are compliant with the NHTSA dataset definitions • Several models for data collection • No uniformity across systems

  18. Where Do We Want To Be? • Electronic data collection • Uniform dataset with definitions • Data from tools used in patient care • Healthcare components linked • Quality Improvement • Benchmarking • Community based • Information is passed to the State office of EMS for finance and policy decisions

  19. How Do We Get There? • Technical Assistance • Model administrative and/or statutory language • Standards for data collection and definitions • Attach to local training programs • National job description for EMS providers • National Performance Standards

  20. Where Are We AtThe State Level? • There is no EMS data for: • Resource planning • Budget justification • System-wide evaluation • Injury prevention programs • Target support and assistance

  21. Where Do We Want To Be? • Database tracking every EMS patient encounter • Electronic data transmission between providers and state • Privacy and confidentiality protection • System and patient • Statutory authority

  22. State • System wide Quality Improvement • Benchmarking of compliance • Disaster Management • Bioterrorism Surveillance • Support and Assistance Resources • Annual Report for policy makers • Provide data to the National EMS Database

  23. How Do We Get There? • Identify resources for a state EMS database • Technical Assistance • Utilize model templates and database schemes • Utilize model quality improvement reports • Seek support from NHTSA • Adopt the uniform dataset and definitions • Promote Research

  24. Where Are We At As A Nation? 2005 2007

  25. Nationally • EMS Agenda for the Future • Monographs, Trade journals • Surveys

  26. Where Do We Want To Be AsAn EMS Nation? • National EMS Database • State EMS Directors lead the charge • NHTSA Dataset Standard • Multidisciplinary approach

  27. What Would Be Done With The Data At The National Level? • Public education and drive policy • Identify national trends • Benchmarking • Reduce errors • Promote research • Outcomes • Solidify EMS in the Healthcare family • Drive education • Prioritize needs and funding • Determine effectiveness of systems and patient care

  28. What Ties It All Together And How Does It Work • NHTSA Dataset (Data Dictionary) • Demographic dataset • EMS dataset • Programming for transferring the data

  29. Technical Look At A National System

  30. Standardization Binds The System • What does this mean? • A standardized system makes it easier to report to a national database

  31. Who Is Using The Standard

  32. Who Is Reporting Data

  33. Does The Standard Make It Easy To Submit Data • NEMSIS Pilot Project • Four states with an existing data system were to provide reports • Delaware • Minnesota • Mississippi • North Carolina

  34. Submission • Three out of four states provided data • The data were combined into a common database

  35. Submission • 2006- Five states were going to be submitting data • North Carolina • Minnesota • New Hampshire • Mississippi • Nebraska, North Dakota, or Tennessee

  36. It Was Submitted…Now What? • Design the reporting system to extract data • Capable of analyzing data from a national, state, and local level • 10 report sections for the National EMS Database

  37. Why Is This Important To EMS Providers • We will have more data • We will have consistent data • We will be able to put computers to work • The local efforts will turn into national ones

  38. Most Visible Benefit To The Street Provider .. Treatment Protocols

  39. Snapshot Of New England • New Hampshire • Collects 240 data points • 81.1% of Ambulance Services reporting data • Data being reported at state & national level • 134,326 runs in system • Maine • Collects 185 data points • 12% of ambulance services reporting data • Goal of 80% reporting by 11/2007 • 22,513 runs in system

  40. Snapshot Of New England • Vermont • No statewide run reporting system • Intention to start electronic data collection 2007 • Plan to determine needs and data elements • Goal by end 2007 have on-line • Massachusetts • Early stages of data collection and system development • 139 statutorily required data points • Services have 2 years to be collecting interim data • Full data point implementation date sometime after interim period • Piloting race and ethnicity data collection in the field • Hope to link various databases

  41. Resources • www.nemsis.org • Your own state office of EMS • National Highway Traffic Administration

  42. Where To From Here? The future of EMS is up to you, the provider

  43. Credits • National EMS Database Overview – October 2005 • A Presentation about NEMSIS made to EMS Providers in Massachusetts - April 2006 • New England Council For EMS Fall Conference – November 2006 • MEMSRR website – February 2007 • TEMSIS website – February 2007

  44. Thank You

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