National EMS Information System, Technical Assistance Center - Salt Lake City, UT
The following timeline illustrates the major accomplishments leading up to the creation of a national EMS database:
(Most of the text for this timeline comes from Mears et al. Future EMS National Database, Prehospital Emergency Care, January/March 2002, Volume 6/Number 1.)
Emergency Medical Services Systems Act
State EMS directors realize that they could not compare data from one state to another in any way or in any standard format or process. The Department of Health, Education and Welfare indentifies 15 essential components of an EMS system. The first legislation to require data or documentation of EMS services.
Utstein Style for Uniform Reporting of Data
First major document is published that specifically addresses EMS systems and their impact on patient outcome.
NHTSA’s Uniform PreHospital EMS Dataset Version 1.0
Realization that different data fields (across all EMS systems) exist for the same issue or event - there is a need for standardization. The National Highway Safety Administration (NHTSA) develops a national consensus document that defines 81 elements important to an EMS information system.
EMS Agenda for the Future
After widespread national input, NHTSA publishes the EMS Agenda for the Future...A Vision for the Nation's EMS System outlining five recommendations for EMS information systems.
Data Elements for Emergency Department Systems
EMS Agenda Implementation Guide
NHTSA produces a follow-up document to EMS Agenda for the Future called EMS Agenda for the Future: Implementation Guide. The document gives suggestions or approaches for the development of 14 components of the EMS Agenda for the future - a comprehensive EMS information system is the backbone for future EMS development.
The National Association of State EMS Directors in conjunction with its federal partners at the National Highway Traffic Safety Administration (NHTSA) and the Trauma/EMS Systems program of the Health Resources and Services Administration's (HRSA) Maternal Child Health Bureau work to develop a national EMS database—known as NEMSIS, the National EMS Information System.
Memorandum of Understanding Signed
EMS Reason for Encounter
A two-year project funded by NHTSA is established to develop a coding system for EMS as well as a uniform description for the reason for an EMS encounter. It is based on EMS curricula and the NHTSA dataset.
After 18 months a 400 page detailed and complex data dictionary is completed. Information about each of the data elements, the variables, and the definitions associated with that data element as well as how to deploy the element in a database are described. See the Data Dictionary's latest release.
Development of Schemas
Physical database schemas or models as well as scripts to automatically create the database are made available in different platforms.
XML Choosen Standard
XML defined as the standard to move EMS data between local and state level or state and national database level. XML's open format provides and easy way to pass data between different software formats.
EMS Uniform PreHospital Dataset Version 2.2
A solid dataset is released and shemas published on the website for integration. The Version 2.2 dataset was created through a national consensus process to update and revise the standard.
Funding for the Technical Assistance Center
NHTSA, HRSA (EMSC), and the CDC see the value from the pilot phase of the project. They provide funding to create the NEMSIS Technical Assistance Center.
The contract is given to the University of Utah School of Medicine (Utah) to operate the NEMSIS Technical Assistance Center. Utah partners with the University of North Carolina to handle all of the customer service needs.