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National EMS Database

National EMS Database. Greg Mears, MD FACEP Principal Investigator North Carolina EMS Medical Director University of North Carolina-Chapel Hill. The Project: National EMS Information System. Long Term Goals Electronic EMS Data Standard EMS Dataset Data Systems Local State

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National EMS Database

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  1. National EMS Database Greg Mears, MD FACEP Principal Investigator North Carolina EMS Medical Director University of North Carolina-Chapel Hill

  2. The Project:National EMS Information System Long Term Goals • Electronic EMS Data • Standard EMS Dataset • Data Systems • Local • State • National EMS Database • Data Drives EMS • System • Personnel • Clinical Care

  3. The Team • NASEMSD • Project Management • Regional Meetings • Operational Support • Greg Mears, MD • Principle Investigator • NEDARC • Clay Mann, PhD, Co-Investigator • Mike Dean, MD, Co-Investigator • Technical Assistance • State Data-Managers

  4. The Money • NHTSA • EMS Division (Primary) • HRSA • Trauma and EMS • EMS-C • American Heart Association • Support for EMS Software Development

  5. 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 The Consensus

  6. The National EMS Information System

  7. The Data Sources

  8. Macroscopic Public education and drive policy Identify national trends Drive education Prioritize needs and funding Benchmarking Solidify EMS in the Healthcare family Microscopic Outcomes EMS Research hypothesis Promote research Reality Business structure and management Improve reliability and efficiency Reduce errors Determine effectiveness of systems and patient care The Truth about NEMSIS

  9. The Need • EMS Education • Curriculums • Local Education • EMS Outcomes • Something other than death • System evaluation • EMS Research • Generate hypothesis • Evaluate Cost effectiveness • Identify problems and target issues • EMS Reimbursement • National fee schedule and reimbursement rates

  10. GAOEmergency Medical Services Reported Needs Are Wide-Ranging, With a Growing Focus on Lack of Data

  11. GAO Results….. The extent and impact of the reported needs is difficult to ascertain, however, because there is little standard and quantifiable information that can be used across systems. Most of the available information about the effect of unmet needs is localized and anecdotal.

  12. Local Pulse • Data collection is important • Medical record keeping • Local data analysis • Decision making • Do not detract from patient care • Short time frame of documentation

  13. Local: Where we are • Very little information on local EMS data collection • Most systems are paper based but are discussing or transitioning to electronic • Many systems use paper and scan into databases or do manual entry

  14. Local: Where we are • Few systems are compliant with the NHTSA dataset definitions • Several models for data collection, but no uniformity or consistency across systems • In general, there is an absence of data to drive reimbursement and policy decisions

  15. Electronic data collection Uniform dataset with definitions Patient care Technician System Workflow oriented No dual entry Data comes from the source CAD Medical Devices The health care components are linked Hospital Dispatch Public Health Public Safety Quality Improvement Benchmarking Community based Information is passed to the State office of EMS for finance and policy decisions Local: Where we want to be

  16. Local: How to get there • Technical Assistance • Model administrative and/or statutory language • Standards for data collection and definitions • Attach to EMS Education Agenda and local training programs • National job description for EMS providers • Medical and communication device transmission standards • National Performance Standards

  17. State Pulse • There is no data for: • Resource planning • Budget justification • System-wide evaluation • Injury prevention programs • Target support and assistance

  18. State: Where we want to be • State EMS database on every EMS patient encounter • Electronic data transmission • Privacy and confidentiality protection • System and patient • Statutory authority

  19. State: Where we want to be • System wide Quality Improvement • Benchmarking of compliance and public health indicators • Disaster Management • Bioterrorism Surveillance • Support and Assistance Resources • Annual Report for policy makers • Provide data to the National EMS Database

  20. State: How to get there • Identify resources for a state EMS database • Technical Assistance • Model templates and database schema’s • Model quality improvement reports • Support to the state EMS office • Uniform Dataset and definitions • Peer Review Model Legislation • Promote Research

  21. National Pulse • Asystole

  22. National: Where we are • EMS Agenda for the Future • Monographs, Trade journals • Surveys

  23. National: Where we want to be • National EMS Database • NASEMSD lead the charge • Revision of the NHTSA Dataset • Multidisciplinary approach

  24. Public education and drive policy Identify national trends Benchmarking Reduce errors Business structure and management EMS Research hypothesis Promote research Outcomes Solidify EMS in the Healthcare family Drive education Prioritize needs and funding Determine effectiveness of systems and patient care What will we do with it?

  25. NEMSIS Project • Dataset • XML • Business Model • Pilot Project • Outreach/PR • Software Development

  26. Completed NHTSA Version 2 Dataset EMS Demographic XSD Standard Business Model In Progress Pilot National EMS Database Mississippi North Carolina 4 others Business Logic Record Component Data Element Database Validity EMS Data Collection Software The Progress

  27. Name Definition Variable Definitions Single or Multiple Entry Relationship to other Data Elements Null Values National EMS Database Element Data Element Use Medical Record Quality Management Report Types Possible Collected by Whom Relationship to Other Datasets NHTSA Version 1 NFIRS Utstein Data Dictionary

  28. Data Dictionary: XML • Data Type • Integer, String, Date/Time, Number • Relationship • One to One • Many to One • Required in XML • Minimal Entry Constraint • Maximal Entry Constraint • Formatting

  29. Demonstration National EMS Database States Participating Minnesota Mississippi North Carolina Others as possible Timeline May, 2005 Key Components National Dataset XML Physical Database for Storage Web Based Reporting to the public Pilot Project

  30. The State of the States

  31. 2003 Rural EMS Survey

  32. 2003 Rural EMS Survey

  33. 2003 Rural EMS Survey

  34. 2003 Rural EMS Survey

  35. 2003 Rural EMS Survey

  36. NEMSIS 2005 - 2006 • Limited Implementation of the National EMS Database • Establishment of a NEMSIS Resource and Technical Assistance Center • Documentation • Compliance • Data Validity • Measurement of progress across states • Increased use support and software developer interaction • Software • Database schema • XML test cases • Data entry software • Scripted reports • Other?

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